Internet-based screening for Chlamydia trachomatis to reach non-clinic populations with mailed self-administered vaginal swabs

Sex Transm Dis. 2006 Jul;33(7):451-7. doi: 10.1097/01.olq.0000200497.14326.fb.


Background: Testing for Chlamydia trachomatis by nucleic acid amplification tests (NAATs) using self-collected vaginal swabs (VS) is acceptable and accurate. The objectives were to implement an educational Internet-based program for women to facilitate home screening, to determine whether women would request and use self-collected VS kits, to determine associated risk factors for infection, and to determine satisfaction with the process.

Methods: The website,, was designed to encourage women > or =14 years to obtain home-sampling kits. Kits could be obtained in the community, requested by Internet/e-mail, or telephone. Users mailed the self-collected VS to the laboratory. Swabs were tested by 3 NAAT assays. Respondents called for results.

Results: Forty-one of 400 (10.3%) women were chlamydia positive; 95.1% were treated. Questionnaires indicated 89.5% preferred self-collection, 93.5% rated collection easy/very easy, and 86.3% would use the Internet program again. Black race and age <25 years were associated independently with being chlamydia positive, while use of birth control and non-consensual sex were protective. Thirty-six of 41 (87.8%) positive samples were positive by all 3 NAATs, 5/41 (12.2%) were positive by only 2 NAATs, and none were positive by only 1 NAAT. The Internet/e-mail request method was better than the community pick-up approach because 97.2% of kit requests were e-mailed and 87.5% of kits returned for testing were e-mail requested.

Conclusions: Women will use the Internet to request and use home-sampling kits for chlamydia. NAAT testing performed well on dry-transported VS. High prevalence was detected and questionnaires indicated high-risk sexual behavior.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Chlamydia Infections / complications
  • Chlamydia Infections / diagnosis*
  • Chlamydia Infections / prevention & control
  • Chlamydia trachomatis / genetics
  • Female
  • Humans
  • Internet*
  • Maryland
  • Mass Screening / methods*
  • Mass Screening / statistics & numerical data*
  • Nucleic Acid Amplification Techniques
  • Patient Compliance
  • Patient Education as Topic
  • Patient Satisfaction
  • Postal Service
  • Reagent Kits, Diagnostic
  • Risk Factors
  • Self Care
  • Surveys and Questionnaires
  • Vaginal Smears / methods


  • Reagent Kits, Diagnostic