Public Health Institute at Denver Health, Denver, Colorado, USA.
Preventive Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
Clin Infect Dis. 2023 Jun 16;76(12):2148-2153. doi: 10.1093/cid/ciad071.
Innovative approaches such as online, at-home programs may address important barriers to sexually transmitted infection (STI) and human immunodeficiency virus (HIV) screening in the United States. This study evaluated the first year of an online, at-home program offering HIV and triple-site (urogenital, rectal, and pharyngeal) gonorrhea (GC) and chlamydia (CT) testing in Colorado.
Test Yourself Colorado (TYC) is an online, at-home program that provides free mailed HIV tests and/or GC/CT tests to Colorado adults. Program use and outcomes between 1 June 2021 and 31 May 2022 were analyzed.
A total of 1790 unique clients utilized TYC. Of 1709 clients who ordered HIV tests, 508 (29.7%) were men who have sex with men (MSM), and 41.3% (210/508) of these clients reported having never been tested for HIV before or were not tested in the prior year. Hispanic clients had lower STI test return rates (37.1%; 134/361) compared with non-Hispanic clients (45.9%; 518/1128) (P = .003). Positive STI tests were identified in 9.6% (68/708) of clients. Positive STI tests were more common in MSM clients (15.7%; 34/216) compared with all other sexual orientations (6.9%; 34/492) (P < .001). STI treatment was confirmed in 80.9% (55/68) of clients.
The TYC online, home testing portal is a scalable tool that reaches clients at risk of STIs and HIV and navigates those with positive STI tests to treatment. HIV/STI home testing programs need to further assess and address utilization and outcomes for disparities by race and ethnicity to assure programs equitably benefit all at-risk communities.
在美国，创新方法，如在线、家庭式项目，可能会解决性传播感染（STI）和人类免疫缺陷病毒（HIV）筛查的重要障碍。本研究评估了科罗拉多州一个在线、家庭式项目的第一年，该项目提供 HIV 和三联部位（泌尿生殖道、直肠和咽）淋病（GC）和衣原体（CT）检测。
“自我检测科罗拉多州”（Test Yourself Colorado，TYC）是一个在线、家庭式项目，为科罗拉多州的成年人提供免费邮寄的 HIV 检测和/或 GC/CT 检测。分析了 2021 年 6 月 1 日至 2022 年 5 月 31 日期间的项目使用情况和结果。
共有 1790 名独特的客户使用了 TYC。在 1709 名订购 HIV 检测的客户中，508 名（29.7%）是男男性接触者（MSM），其中 41.3%（210/508）的客户表示之前从未接受过 HIV 检测，或在过去一年中未接受过检测。西班牙裔客户的性传播感染检测返回率较低（37.1%；134/361），而非西班牙裔客户的返回率为 45.9%（518/1128）（P=0.003）。在 68/708 名客户中发现了阳性 STI 检测结果。在 MSM 客户（15.7%；34/216）中，阳性 STI 检测结果比其他性取向（6.9%；34/492）更为常见（P<0.001）。在 80.9%（55/68）的客户中确认了 STI 治疗。
TYC 在线、家庭检测门户是一种可扩展的工具，可以接触到有 STI 和 HIV 风险的客户，并引导那些 STI 检测呈阳性的客户进行治疗。HIV/STI 家庭检测计划需要进一步评估和解决种族和民族方面的利用和结果差距，以确保计划公平地惠及所有高危社区。
