Use of a risk quiz to predict infection for sexually transmitted infections: a retrospective analysis of acceptability and positivity.
BACKGROUND
Individuals who are sexually active may want to make a decision as to whether they are at risk for having a sexually transmitted infection (STI) such as Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis. Our goal was to develop and evaluate a simple self-taken sexual risk quiz for participants, ordering an online STI self-collection test kit to determine whether the score predicted infection status.


METHODS
As part of the IWantTheKit programme for home sample self-collection for STIs, 2010-2013, the programme asked male and female users to voluntarily take a risk quiz. The six-question quiz was about risk behaviour and included an age question. Data analyses were stratified by gender as determined a priori. Scores 0-10 were stratified into risk groups for each gender based on similar risk score-specific STI prevalence. Retrospective analyses were performed to assess whether risk group predicted aggregate STI positivity. Urogenital/rectal mailed samples were tested by nucleic acid amplification tests.


RESULTS
More females (N=836) than males (N=558) provided voluntary risk scores. The percentage of eligible participants who submitted scores was 43.9% for both females and males. There was a higher STI infection rate in females (14.0%) than in males (7.0%) for having any STI (p<0.001). Multivariate logistic analysis for females, which controlled for age and race, demonstrated that a higher risk score group independently predicted risk for having an STI (OR of 2.2 for risk scores 5-7 and 4.2 OR for scores of 8-10). For males, the multivariate model, which controlled for race, indicated that no risk score group was associated having an STI.


CONCLUSIONS
Results of a participant's own sexual risk quiz score independently predicted STI positivity for women, but not for men. Further study of this simple risk quiz is required.
Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA Department of Emergency Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Charlotte A
CA
Gaydos
Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Mary
M
Jett-Goheen
Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Mathilda
M
Barnes
Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Laura
L
Dize
Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Perry
P
Barnes
Department of Emergency Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Yu-Hsiang
YH
Hsieh
D000293:Adolescent; D000328:Adult; D017280:Condoms; D059026:Diagnostic Self Evaluation; D005260:Female; D006266:Health Education; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000523:psychology / Q000706:statistics & numerical data*; D021141:Nucleic Acid Amplification Techniques / Q000706:statistics & numerical data*; D015397:Program Evaluation; D012189:Retrospective Studies; D012648:Self Care; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000517:prevention & control / Q000523:psychology / Q000635:transmission*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
CHLAMYDIA INFECTION; CHLAMYDIA TRACHOMATIS; GONORRHOEA; NEISSERIA GONORRHOEA; TRICHOMONAS