ORLANDO, Fla. — A recent survey showed that many teenagers would be interested in an over-the-counter, or OTC, test for Chlamydia trachomatis infection. However, only 25% had adequate knowledge of the infection and its complications.
Margaret R. Hammerschlag, MD , professor of pediatrics and medicine and director of the pediatric infectious diseases fellowship program at SUNY Downstate Medical Center, and colleagues said that teenagers, especially females between the ages of 15 and 19 years, have the highest rates of chlamydial infection.
“Chlamydia is a particular problem because the way we deal with it now is that we screen. It is not based on symptoms because they are unreliable,” Hammerschlag told Infectious Disease News. “More than 70% of women are going to be totally asymptomatic. For adolescents, the recommendation is to screen them at least yearly — if not more — if they have a sexual partner. One study that came out of Indiana University found that almost 40% of teenage girls came back within 9 months reinfected. Usually, they are reinfected from an untreated partner.”
Hammerschlag and colleagues noted that point-of-care tests like those used for pregnancy testing are under development for sexually transmitted infections (STIs), including chlamydia. The FDA has considered whether such a test should be available OTC, but a previously FDA-approved OTC HIV test was underused because of cost and accessibility.
To understand if an OTC chlamydia test would be used by teenagers and young adults, Hammerschlag and colleagues conducted an anonymous 12-question survey. The survey collected information on demographics, sexual orientation, knowledge of the infection, whether they had a previous infection and whether they would refer their partner to care. Participants were aged 14 to 21 years.
Most of the 65 teenagers and young adults who provided survey responses had limited or no knowledge about transmission or complications associated with chlamydial infection (75%). Every respondent who had a previous infection received treatment for their infection. However, only 18% informed their sexual partners of their condition.
Slightly less than half of adolescents and young adults (45%) reported that if the OTC chlamydia test was available, they would purchase it. The most accepted price range (70%) would be $30 or less, and most respondents (90%) said they would seek treatment if their test was positive and would inform their sexual partner about their infection.
Hammerschlag and colleagues said that although an OTC chlamydia test would be generally accepted by this age group, concerns about ensuring whether individuals would seek care if their test was positive, linkage to care and ensuring that they would tell their sexual partner still exist. Furthermore, the researchers questioned whether OTC testing would limit the collection of surveillance data.
“Chlamydial infections and other STI rates are going through the roof right now, and there is a lot of ignorance out there,” Hammerschlag said. “Sex education will need to play a key role for this group regarding access to care [and use of the device].” – by Katherine Bortz
Malik R, et al. If we make it, will they take it? Patient attitudes towards acceptability of over the counter testing for Chlamydia trachomatis (CT). Presented at: AAP National Conference & Exhibition; Nov. 2-6, 2018; Orlando, Fla.
Disclosure: Hammerschlag reports no relevant financial disclosures.