Attitudes and Preferences Regarding Non-Clinic-Based Self-Collection for Sexually Transmitted Infection Testing Among Clinic Attendees in British Columbia, Canada

Sex Transm Dis. 2022 Jan 1;49(1):15-21. doi: 10.1097/OLQ.0000000000001513.

Abstract

Background: Sexually transmitted infections (STIs) are a global epidemic; although screening programs reduce transmission, barriers, including access and stigma, hinder success. The World Health Organization highlights the ability to maintain health without the direct support of a health care provider as one form of self-care, which can be applied to STI testing. Self-care through non-clinic-based self-collection for STI testing can address barriers while providing comprehensive care. Before implementation of innovative changes to screening approaches, it is important to understand if communities who rely on in-person care will self-collect outside of the clinic setting. This study investigated willingness to use non-clinic-based self-collection for STI testing among STI clinic attendees in British Columbia, Canada.

Methods: Participants (n = 446) were recruited from STI clinics offering clinic-based self-collection for STI testing and completed a survey assessing self-care attitudes, including willingness to self-collect urine samples, throat swabs, and anogenital swabs outside of the clinic setting. Descriptive statistics, bivariable analyses, and multivariable models were conducted to investigate willingness to use non-clinic-based STI self-collection methods and associated correlates.

Results: This population reported high willingness to use non-clinic-based self-collection methods for STI testing (urine samples, 73%; throat swabs, 67%; anogenital swabs, 65%). Those aged 35 to 54 years compared with 15 to 34 years were more likely to be willing (adjusted odds ratio, 1.87; 95% confidence interval, 1.03-3.50); those identifying as straight/mostly straight compared with gay/lesbian were less likely to be willing (adjusted odds ratio, 0.39; 95% confidence interval, 0.23-0.65).

Conclusions: Non-clinic-based self-collection for STI testing can address barriers to testing while maintaining quality care. Those currently receiving in-person care find these methods highly acceptable. These findings reinforce that self-collection for STI testing used in British Columbia clinics is acceptable to clients and may be extended to collection performed outside of the clinical setting.

MeSH terms

  • Adult
  • Ambulatory Care Facilities
  • British Columbia / epidemiology
  • Female
  • Humans
  • Middle Aged
  • Patient Acceptance of Health Care
  • Sexual and Gender Minorities*
  • Sexually Transmitted Diseases* / epidemiology