140. Acceptability of Mail-In Self-Collection for Gonorrhea and Chlamydia Screening in Primary Care Clinics

ABSTRACT

Purpose: The United States has seen a rise in sexually transmitted infections (STIs);the need to increase access for screening is essential to reverse this trend, especially for vulnerable populations such as LGBT+ individuals, people of color, or those at a low socioeconomic status. This study's primary objective is to assess preferences for mail-in STI screening among participants assigned female at birth already established with a primary care clinic. The study aims to provide insight into the need for clinicians to adopt mail-in testing for patients to improve screening access. Methods: Participants were recruited for this cross-sectional study from a clinical database of established patients with a focus on USPSTF recommendations for STI screening such as assigned female at birth (AFAB) and aged 18–24 years. Recruitment was done through a mailer from September to October 2021, inviting participants to complete an online survey. Statistical analyses were conducted using SAS software (SAS Institute Inc., Cary NC), version 9.4. Results: Overall, there was as a higher preference for home testing (61/88 = 0.69, 95% CI 0.59-0.79) among respondents. LGBT+ identity, age, recent clinical encounter, relationship status, living situation, or race and/or ethnicity, were not statistically significant associated with preference for home testing. However, there were lower odds for preferring home collection among participants with less education (OR 0.25, 95% CI 0.08-0.77, p<0.05), who lacked insurance (OR 0.19, 95% CI 0.06-0.67, p<0.05), or were unemployed (OR 0.28, 95% CI 0.08-0.95;p<0.05). Conclusions: Results from this survey indicate the desire for home testing among individuals from all demographics, influenced by social determinants of health such as education level and employment and insurance status. with overall acceptability for self-collection STI screening through mail-in methods (61/88=0.69;95% CI 0.59-0.79). The rising rates of STIs among young adults and delays in routine STI services secondary due to the ongoing COVID-19 pandemic and budget cuts emphasize the importance of new approaches to STI screening. Primary care clinics can expand needed screening by integrating such methods into workflows for established patients. These findings indicate a need for innovative outreach efforts to curb rising rates of STIs in the United States with additional consideration for research specific to LGBT+ health care needs, updated USPSTF recommendations for screening, and inclusive public health messaging. Sources of Support Dr. Tana Chongsuwat was supported by the University of Wisconsin Primary Care Research Fellowship, funded by grant T32HP10010 from the Health Resources and Services Administration. The study was funded by a small grant by the University of Wisconsin Department of Pediatrics.