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      Direct-to-Consumer Sexually Transmitted Infection Testing Services: A Position Statement from the American Sexually Transmitted Diseases Association

      editorial
      , PhD, MPH , , PhD, MPH, CRNP , , PhD , , MDiv, PhD § , , PhD, MPH, CPH , , PhD, MPH , ∗∗
      Sexually Transmitted Diseases
      Lippincott Williams & Wilkins

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          Abstract

          On behalf of the American Sexually Transmitted Diseases Association, we discuss benefits and challenges of direct-to-consumer test services for sexually transmitted infections and offer recommendations for future directions.

          Abstract

          Direct-to-consumer test services have gained popularity for sexually transmitted infections in recent years, with substantially increased use as a result of the SARS-CoV-2 (CoVID-19) global pandemic. This method of access has been variously known as “self-testing,” “home testing,” and “direct access testing.” Although these online services may be offered through different mechanisms, here we focus on those that are consumer-driven and require self-collected samples, and sample shipment to a centralized laboratory without involvement of health care providers and/or local health departments. We provide the American Sexually Transmitted Diseases Association's position on utilization of these services and recommendations for both consumers and health care providers.

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          Most cited references27

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          Sexually transmitted diseases treatment guidelines, 2015.

          These guidelines for the treatment of persons who have or are at risk for sexually transmitted diseases (STDs) were updated by CDC after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta on April 30-May 2, 2013. The information in this report updates the Sexually Transmitted Diseases Treatment Guidelines, 2010 (MMWR Recomm Rep 2010;59 [No. RR-12]). These updated guidelines discuss 1) alternative treatment regimens for Neisseria gonorrhoeae; 2) the use of nucleic acid amplification tests for the diagnosis of trichomoniasis; 3) alternative treatment options for genital warts; 4) the role of Mycoplasma genitalium in urethritis/cervicitis and treatment-related implications; 5) updated HPV vaccine recommendations and counseling messages; 6) the management of persons who are transgender; 7) annual testing for hepatitis C in persons with HIV infection; 8) updated recommendations for diagnostic evaluation of urethritis; and 9) retesting to detect repeat infection. Physicians and other health-care providers can use these guidelines to assist in the prevention and treatment of STDs.
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            Health Literacy and Use and Trust in Health Information

            There is a need to investigate which health information sources are used and trusted by people with limited health literacy to help identify strategies for addressing knowledge gaps that can contribute to preventable illness. We examined whether health literacy was associated with people's use of and trust in a range of potential health information sources. Six hundred participants from a GfK Internet survey panel completed an online survey. We assessed health literacy using the Newest Vital Sign, the sources participants used to get health information, and the extent to which participants trusted health information from these sources. We performed multivariable regressions, controlling for demographic characteristics. Lower health literacy was associated with lower odds of using medical websites for health information and with higher odds of using television, social media, and blogs or celebrity webpages. People with lower health literacy were less likely to trust health information from specialist doctors and dentists, but more likely to trust television, social media, blogs/celebrity webpages, friends, and pharmaceutical companies. People with limited health literacy had higher rates of using and trusting sources such as social media and blogs, which might contain lower quality health information compared to information from healthcare professionals. Thus, it might be necessary to enhance the public's ability to evaluate the quality of health information sources. The results of this study could be used to improve the reach of high-quality health information among people with limited health literacy and thereby increase the effectiveness of health communication programs and campaigns.
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              Barriers to asymptomatic screening and other STD services for adolescents and young adults: focus group discussions

              Background Sexually transmitted diseases (STDs) are a major public health problem among young people and can lead to the spread of HIV. Previous studies have primarily addressed barriers to STD care for symptomatic patients. The purpose of our study was to identify perceptions about existing barriers to and ideal services for STDs, especially asymptomatic screening, among young people in a southeastern community. Methods Eight focus group discussions including 53 White, African American, and Latino youth (age 14–24) were conducted. Results Perceived barriers to care included lack of knowledge of STDs and available services, cost, shame associated with seeking services, long clinic waiting times, discrimination, and urethral specimen collection methods. Perceived features of ideal STD services included locations close to familiar places, extended hours, and urine-based screening. Television was perceived as the most effective route of disseminating STD information. Conclusions Further research is warranted to evaluate improving convenience, efficiency, and privacy of existing services; adding urine-based screening and new services closer to neighborhoods; and using mass media to disseminate STD information as strategies to increase STD screening.
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                Author and article information

                Contributors
                Journal
                Sex Transm Dis
                Sex Transm Dis
                STD
                Sexually Transmitted Diseases
                Lippincott Williams & Wilkins
                0148-5717
                1537-4521
                November 2021
                21 May 2021
                : 48
                : 11
                : e155-e159
                Affiliations
                From the []The Pennsylvania State University College of Nursing, University Park
                []Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA
                []Association of Public Health Laboratories, Silver Spring, MD
                [§ ]College of Social and Behavioral Sciences, Southwest Institute for Research on Women, University of Arizona, Tucson, AZ
                []School of Public Health, University of North Texas Health Science Center, Fort Worth, TX
                Schools of []Medicine
                [∗∗ ]Public Health, University of Alabama at Birmingham, Birmingham, AL
                Author notes
                [*]Correspondence: Barbara Van Der Pol, PhD, MPH, University of Alabama at Birmingham, 703 19th St S, ZRB 238, Birmingham, AL 35294. E-mail: bvanderp@ 123456uab.edu .
                Article
                STD_210137 00016
                10.1097/OLQ.0000000000001475
                8505153
                34030157
                c4d76317-b766-4782-8a9c-dc4b4259159b
                Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Sexually Transmitted Diseases Association.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

                History
                : 06 May 2021
                : 10 May 2021
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