title: Acceptability of self-testing for trichomoniasis increases with experience.
abstract: OBJECTIVE
  Self-testing and point-of-care (POC) tests could improve the detection of sexually transmitted infections (STIs) in adolescents. This study aimed to (1) validate a scale measuring acceptability of self-testing for trichomoniasis, (2) compare acceptability of self versus clinician testing using a POC test for trichomoniasis, (3) examine changes in acceptability after experience and review of results, and (4) examine predictors of acceptability.
  
  
  METHODS
  Women (14-22 years old) performed the POC test and completed surveys assessing acceptability of self and clinician testing at baseline, after testing, and after discussion of results. Factor analysis examined scale structure; changes in mean scale scores were assessed with mixed models. Generalised linear models examined predictors of acceptability.
  
  
  RESULTS
  Of 247 participants, 54 (22%) had a positive POC test for trichomoniasis. Factor analysis confirmed four acceptability subscales: trust of results, confidence, comfort, and effects of testing. At baseline, trust and confidence were higher, and comfort was lower, for clinician versus self testing. For self-testing, all subscale scores increased from baseline to after testing, and trust increased from after testing to after discussion. Trust of self and clinician results was not significantly different after discussion. A positive attitude towards home testing predicted higher self-test acceptability on all subscales. Tampon use was associated with increased self-test comfort at baseline. Concordance between self and clinician results predicted increased trust of self testing after discussion.
  
  
  CONCLUSIONS
  Many young women lack confidence in their ability to self-test for trichomoniasis. Allowing women to try a POC test and review the results with a clinician increases acceptability of self-testing.
authors.affiliation: Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA. jill.huppert@cchmc.org
authors.forename: Jill S
authors.initials: JS
authors.lastname: Huppert
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Hesse
authors.forename: Molly A
authors.initials: MA
authors.lastname: Bernard
authors.forename: Yang
authors.initials: Y
authors.lastname: Xiao
authors.forename: Bin
authors.initials: B
authors.lastname: Huang
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Gaydos
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Kahn
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D010342:Patient Acceptance of Health Care; D057240:Patient Preference; D019095:Point-of-Care Systems; D012648:Self Care / Q000592:standards*; D020377:Self Efficacy; D013048:Specimen Handling; D014245:Trichomonas Infections / Q000175:diagnosis*; D055815:Young Adult