ADOLESCENT AND YOUNG ADULT PERSPECTIVES ON HOME-BASED TESTING FOR SEXUALLY TRANSMITTED INFECTIONS: A QUALITATIVE STUDY
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Published on: July 27, 2018
Rachael M Johnson1, Allyssa A Abacan2, Meghna Raphael3
1School of Medicine, Baylor College of Medicine, Houston, Texas, United States.
Purpose:
Home-based sexually transmitted infection (STI) testing has emerged as a promising strategy to expand access to sexual and reproductive healthcare (SRH) services. However, perceptions of home-based STI testing among underserved adolescents and young adults (AYA) remain poorly understood. This qualitative study explores AYA attitudes toward home-based STI testing and telehealth, as well as factors influencing acceptability.
Methods:
Semi-structured interviews were conducted with AYA (n=21, 18-24 years old) receiving care at nine urban publicly funded family planning and school-based clinics in Houston, Texas. Interviews explored attitudes, intentions, and perceived barriers and facilitators related to home-based STI testing and telehealth. Deidentified transcripts were qualitatively analyzed using descriptive content analysis. Participants were categorized as expressing acceptance ('Yes'), rejection ('No'), or conditional acceptance ('Maybe') of home-based STI testing.
Results:
Nine participants (42.9%) expressed comfort with home-based STI testing, citing convenience, privacy, and confidence in their ability to self-collect specimens. Many in this group viewed telehealth and in-person care as equally acceptable. Six participants (28.6%) rejected home-based testing, primarily because of low self-efficacy and concerns regarding specimen collection, mailing logistics, and delayed results. This group uniformly preferred clinic-based care. Six participants (28.6%) expressed conditional acceptance, with hesitations centered on logistics and self-efficacy regarding self-collection.
Conclusions:
Most participants demonstrated at least conditional acceptance of home-based STI testing. Successful implementation among underserved AYA may require strategies that enhance self-efficacy, address logistical barriers, and support patient choice through flexible screening pathways. These findings provide actionable guidance for expanding access to STI screening among underserved youth.
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