Repeat chlamydia screening by mail, San Francisco.
OBJECTIVE
To assess the feasibility and acceptability of home screening for repeat chlamydial infection using urine test kits sent through the mail.


METHODS
A letter offering home rescreening was mailed to 399 adults who previously tested positive for chlamydia. Kits were then mailed to anyone who did not actively decline. The home testing kits contained instructions on how to collect a urine specimen and return the specimen by mail. Specimens were tested with strand displacement amplification. A short survey asked individuals their level of concern about confidentiality, safety, and privacy of mail screening.


RESULTS
Among the 313 potential test kit recipients, 22.4% responded. Response rates were highest among homosexual and bisexual men (38.6%), people 35 years or older (34.3%), and white people (34.6%). The overall positivity rate was 3.2% (2/63). In women 18-25 years old, the positivity was 13.3% (2/15).


CONCLUSIONS
Home testing with mailed urine collection kits is feasible and an acceptable method to screen for recurrent chlamydial infection. Young women would probably benefit most because of their higher rates of reinfection and risk for sequelae.
Bloomfield
P J
PJ
Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Steiner
K C
KC
Kent
C K
CK
Klausner
J D
JD
D000293:Adolescent; D000328:Adult; D001727:Bisexuality; D002690:Chlamydia Infections / Q000175:diagnosis*; D005240:Feasibility Studies; D005260:Female; D006699:Home Care Services / Q000458:organization & administration*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000458:organization & administration*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011177:Postal Service; D011933:Reagent Kits, Diagnostic; D012008:Recurrence; D012495:San Francisco
D011933:Reagent Kits, Diagnostic