Assessing association between IWantTheKit risk quiz tool and sexually transmitted infection positivity in male users for sexually transmitted infection screening

Abstract

Our previous pilot study during 2010–2013, based on the IWantTheKit (IWTK) home self-collection program for sexually transmitted infections (STIs), showed that voluntary risk score tool predicted STIs well in female volunteers compared to their male counterparts. Risk score became a required part of the IWTK program in August 2013. We investigated association of IWTK risk score and presence of STI in 592 male participants living in Maryland and Washington DC from August 2013 to April 2015. The risk score quiz includes questions on demographic and sexual risk behavior. Data were analyzed using the Cochran-Armitage test for trend to determine if prevalence of STIs (Chlamydia, gonorrhea, or trichomoniasis) increased with the higher risk score category. Overall, 57% of participants were aged < 30 years (mean: 30.1 ± 9.3 years); 42% white, 42% black, and 16% other races. The majority (67%) of participants had medium risk scores of 3–6, followed by high scores of 7–10 (22%), and 0–2 (11%). The overall prevalence of STIs was 10.5% (62/592). The prevalence of STIs was 3.1% for users with risk scores of 0–2, 10.4% for those with scores 3–6, and 14.3% for those with scores 7–10 (trend test: p = 0.019). Medium and high IWTK risk scores successfully predicted the probability of STIs in male participants after elimination of potential selection biases.

Keywords

Sexually transmitted infection screening men risk score internet-based recruitment Chlamydia gonorrhea trichomoniasis

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References

Falasinnu

Gilbert

Gustafson

et al.

Deriving and validating a risk estimation tool for screening asymptomatic chlamydia and gonorrhea. Sex Transm Dis 2014; 41: 706–712.

Falasinnu

Gustafson

Hottes

et al.

A critical appraisal of risk models for predicting sexually transmitted infections. Sex Transm Dis 2014; 41: 321–330.

Götz

van Bergen

Veldhuijzen

et al.

A prediction rule for selective screening of Chlamydia trachomatis infection. Sex Transm Infect 2005; 81: 24–30.

van den Broek

Brouwers

Götz

et al.

Systematic selection of screening participants by risk score in a Chlamydia screening programme is feasible and effective. Sex Transm Infect 2012; 88: 205–211.

Wand

Guy

Donovan

et al.

Developing and validating a risk scoring tool for chlamydia infection among sexual health clinic attendees in Australia: a simple algorithm to identify those at high risk of chlamydia infection. BMJ Open 2011; 1: e000005–e000005.

Gilbert

Haag

Hottes

et al.

Get checked …where? The development of a comprehensive, integrated internet-based testing program for sexually transmitted and blood-borne infections in British Columbia, Canada. JMIR Res Protoc 2016; 5: e186–e186.

Hottes

Farrell

Bondyra

et al.

Internet-based HIV and sexually transmitted infection testing in British Columbia, Canada: opinions and expectations of prospective clients. J Med Internet Res 2012; 14: e41–e41.

Gaydos

Barnes

Aumakhan

et al.

Can e-technology through the Internet be used as a new tool to address the Chlamydia trachomatis epidemic by home sampling and vaginal swabs?

Sex Transm Dis 2009; 36: 577–580.

Gaydos

Dwyer

Barnes

et al.

Internet-based screening for Chlamydia trachomatis to reach non-clinic populations with mailed self-administered vaginal swabs. Sex Transm Dis 2006; 33: 451–457.

10.

Chai

Aumakhan

Barnes

et al.

Internet-based screening for sexually transmitted infections to reach nonclinic populations in the community: risk factors for infection in men. Sex Transm Dis 2010; 37: 756–763.

11.

Gaydos

Barnes

Quinn

et al.

Trichomonas vaginalis infection in men who submit self-collected penile swabs after internet recruitment. Sex Transm Infect 2013; 89: 504–508.

12.

Gaydos

Hsieh

Y-H

Barnes

et al.

Trichomonas vaginalis infection in women who submit self-obtained vaginal samples after internet recruitment. Sex Transm Dis 2011; 38: 828–832.

13.

Gaydos

Jett-Goheen

Barnes

et al.

Use of a risk quiz to predict infection for sexually transmitted infections: a retrospective analysis of acceptability and positivity. Sex Transm Infect 2016; 92: 44–48.

14.

Novak

Karlsson

. Simplifying chlamydia testing: an innovative Chlamydia trachomatis testing approach using the internet and a home sampling strategy: population based study. Sex Transm Infect 2006; 82: 142–147.

15.

Novak

. Risk factors for Chlamydia trachomatis infection among users of an internet-based testing service in Sweden. Sex Reprod Healthc 2013; 4: 23–27.

16.

van Bergen

Fennema

van den Broek

et al.

Rationale, design, and results of the first screening round of a comprehensive, register-based, Chlamydia screening implementation programme in the Netherlands. BMC Infect Dis 2010; 10: 293–293.

17.

Maryland – 2015 State Health Profile. Centers for Disease Control and Prevention, https://www.cdc.gov/nchhstp/stateprofiles/pdf/maryland_profile.pdf (2015, accessed 11 January 2017).

18.

Chlamydia, https://www.cdc.gov/std/stats15/chlamydia.htm (2016, accessed 1 May 2017).

19.

Patton

Kidd

Llata

et al.

Extragenital gonorrhea and chlamydia testing and infection among men who have sex with men – STD Surveillance Network, United States, 2010–2012. Clin Infect Dis 2014; 58: 1564–1570.

20.

Annan

Sullivan

Nori

et al.

Rectal chlamydia – a reservoir of undiagnosed infection in men who have sex with men. Sex Transm Infect 2009; 85: 176–179.

21.

Barbee

Dombrowski

Kerani

et al.

Effect of nucleic acid amplification testing on detection of extragenital gonorrhea and chlamydial infections in men who have sex with men sexually transmitted disease clinic patients. Sex Transm Dis 2014; 41: 168–172.