title: Accuracy and trust of self-testing for bacterial vaginosis.
abstract: OBJECTIVE
  Two point-of-care tests are available to detect bacterial vaginosis (BV), a common vaginal condition. This study aimed to (1) compare the accuracy of two self-performed BV tests with clinician-performed BV tests and with clinical diagnosis of BV; and (2) compare trust of results for self-performed BV testing with clinician-performed BV testing.
  
  
  METHODS
  Participants (14-22 years old) in a study assessing self-testing for Trichomonas vaginalis were also asked to perform a self-test for BV (using a pH or sialidase test). Results were compared with clinician-performed tests and with clinical diagnosis of BV (defined by modified Amsel criteria). A two-item subscale from a larger acceptability scale was used to assess trust at baseline, after testing, and after discussion of results.
  
  
  RESULTS
  All 131 women performed self-BV testing correctly. Agreement between self- and clinician-performed tests was good (κ: .5-.7) Compared with clinical diagnosis of BV, self-pH was 73% sensitive and 67% specific, and self-sialidase was 40% sensitive and 90% specific. Trust in self-performed BV testing was lower than trust in clinician-performed BV testing at baseline, but increased after testing and discussion of results.
  
  
  CONCLUSIONS
  Young women can perform self-tests for BV with reasonable accuracy, which could increase testing when pelvic examinations are not feasible. Trust in self-testing increased after experience and after discussion of test results. Although the pH test is available over the counter, young women may continue to rely on clinicians for testing.
authors.affiliation: Division of Pediatric and Adolescent Gynecology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 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: Marianne Claire
authors.initials: MC
authors.lastname: Bernard
authors.forename: Justin R
authors.initials: JR
authors.lastname: Bates
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Gaydos
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Kahn
mesh_terms: D000293:Adolescent; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D012648:Self Care / Q000592:standards*; D012680:Sensitivity and Specificity; D014246:Trichomonas vaginalis / Q000302:isolation & purification*; D035502:Trust; D016585:Vaginosis, Bacterial / Q000175:diagnosis*; D055815:Young Adult