QUEBEC CITY – Women with a history of chlamydia were significantly more likely to get retested if they could collect samples at home rather than having to visit a clinic, based on data from 404 women.
Women with recurrent chlamydia infections can be at increased risk for long-term complications, but few women comply with the Centers for Disease Control and Prevention recommendation for chlamydia rescreening 3 months after an initial treatment, Dr. Fujie Xu of the CDC said during a presentation of the findings at a congress of the International Society for Sexually Transmitted Diseases Research.
"The need for a clinic visit and a vaginal speculum examination likely contribute to poor compliance with the rescreening recommendation," she said.
Dr. Xu and her colleagues surmised that offering women at-home testing instead of a clinic visit might increase rescreening rates.
They were right. The study’s primary end point was the rescreening rate during a 7-week window from 1 week before to 6 weeks after a date of 3 months past the patient’s initial treatment. A total of 80 of 196 women (41%) randomized to perform a home test were rescreened, compared with 43 of 208 women (21%) randomized to a follow-up clinic visit. The difference was statistically significant.
Women in the take-home group also were significantly more likely to be rescreened at any point during the study, compared with the clinic group (49% vs. 28%).
The women were recruited from Jackson, Miss., New Orleans, and St. Louis. The average age of the women was 21 years; 85% of the home test group and 88% of the clinic test group were black. The education levels were similar between the two groups. All study participants had previously tested positive for chlamydia.
When the researchers analyzed the findings by demographic factors, women in the at-home test group who had a high school eduction or less were significantly more likely to be rescreened than were similarly educated women in the clinic group. For women who had some college education, there was no significant difference in screening rates between the at-home test and clinic test groups.
At the rescreening visits, 93 specimens from home test patients and 55 from clinic test patients were tested. The percentage of positive tests upon rescreening was similar between the groups: 13% in the home group and 15% in the clinic group.
Overall, rescreening rates were almost twice as high in the at-home test group as in the clinic group, Dr. Xu said. In several study subgroups, rescreening rates were consistently higher among women who used home tests, compared with clinic tests, she added.
Home testing for chlamydia represents a new tool, "but not the magic bullet," Dr. Xu said. More research is needed to identify better ways to remind patients to get rescreened for chlamydia, and more support is needed for FDA-approved tests for home specimen collection, she said.
Additional data from this study were published online in the August issue of Obstetrics & Gynecology (2011 August;118:231-239 [doi: 10.1097/AOG.0b013e3182246a83]).
Dr. Xu said that she had no financial conflicts to disclose.