Many young adults favor at-home STI testing for convenience and privacy

Stigma, privacy and inconvenience are among the many barriers that may prevent some adolescents and young adults from addressing sexual health with a traditional health provider.

But many young people prefer testing for sexually transmitted infections (STIs) in the comfort of their own home, a new study suggests.

Ninety one percent of survey participants ages 14-24 indicated that they’d use free STI self-collection kits, according to recent Michigan Medicine-led findings in the Journal of Adolescent Health.

“There is an urgent need to prioritize and increase the accessibility of sexually transmitted infection testing among youth,” said senior author Okeoma Mmeje M.D., M.P.H., associate professor of obstetrics and gynecology at the University of Michigan Medical School and an OBGYN at U-M Health Von Voigtlander Women’s Hospital.

“STI self-collection is an effective alternative that addresses barriers that often deter this population from seeking traditional reproductive health care services. The autonomy and confidentiality offered through this option may empower young people to take charge of their sexual health without fear of judgment or social stigma.”

The Centers for Disease Control and Prevention reported over 2.4 million cases of syphilis, gonorrhea, and chlamydia in the U.S. in 2023. These conditions disproportionately affected adolescents and young adults aged 15-24 who comprised nearly half of all STI cases in the country.

STIs account for nearly a third of infertility in women and may also increase the risk of ectopic pregnancy, preterm labor and birth, pregnancy loss, neonatal complications and endometriosis.

“While most sexually transmitted infections are asymptomatic and treatable, we will continue to see STI-related complications unless we improve access to testing and treatment services,” said lead author Jayelin Parker, M.S.W., M.P.H., researcher in the U-M Medical School, Department of Obstetrics and Gynecology.

“STI screening should be available and accessible to young people in various forms. User-friendly STI self-collection kits encourage more frequent testing, early detection, and treatment of STIs.”  

She notes that STI self-collection kits offer the ease and comfort of collecting a urine sample or vaginal swab at home, which may reduce the potential discomfort and anxiety associated with testing.

Additionally, researchers point out, historically marginalized groups in the U.S., including youth from sexual and gender minority populations, are disproportionately affected by STIs because of sexual stigma, medical mistrust, discrimination, and lack of health-care access.

Researchers utilized MyVoice, a nationwide text message survey of adolescents and young adults, collecting responses from 763 participants in 2022. Convenience, privacy, and comfort were cited as reasons for preferring STI self-collection kits

The 6% of young people who said they would not use this at-home testing option cited concerns about test result accuracy and discomfort with specimen collection.

“It’s a public health priority to address the social and political determinants of health that impact the ability of youth to access reproductive healthcare services,” Mmeje said.

“Our findings offer insight into the unique sexual health care needs and preferences of adolescents and young adults. Highlighting these attitudes and experiences provides policymakers with data to shape inclusive and effective sexual health policies that meet the diverse needs of this population.”

Paper cited: Self-Collected Testing for Sexually Transmitted Infections: A National Text Message Survey of Adolescents and Young Adults