Researchers at Johns Hopkins have launched the first
government-sponsored study to measure the effectiveness of
a Web- and community-based home test kit for common
sexually transmitted diseases, such as chlamydia and
gonorrhea.
The study will measure how many women make use of the
kit, determine disease prevalence among respondents, record
how effectively test results can be returned to the
participants and assess how well respondents who test
positive follow through with therapy.
The overall aim of the researchers is to replicate the
successful introduction of widely used home pregnancy tests
and lower the rates of sexually transmitted diseases among
young women, who are most at risk of contracting an STD and
least likely to undergo regular check-ups for disease
prevention.
"Many women are left unaware for years that they have
an STD because symptoms do not commonly appear for long
periods after infection," said study lead investigator and
infectious disease specialist Charlotte Gaydos, associate
professor of
medicine at the School of Medicine. "Indeed, chlamydia
is 80 to 90 percent without any symptoms of infection, and
it can take two to three years before infected women
develop signs of pelvic inflammatory disease, a condition
that can leave a woman infertile from resulting scar
tissue."
Funded by the U.S. Centers for Disease Control, the
study test kit will be available only in Maryland, at
participating pharmacies and some recreation centers. The
kit consists of a packaged sterile vaginal swab and
instructions for using it. Also enclosed are sealed
containers for the self-collected swabs and return
envelopes with postage paid for mailing the samples back to
a laboratory at Johns Hopkins, where they will be
tested.
Results will be available within two weeks via a
secured telephone answering service that uses kit numbers
and passwords. For women who test positive for chlamydia or
gonorrhea, a referral is provided to a local community
health clinic for treatment, as part of the confirmation
telephone message.
More than 500 kits are available as part of the
initial pilot program. They are available at locations
listed on the Web site
www.iwantthekit.org.
The kits are contained in plain, brown-paper packaging
meant to resemble a typical prescription. An advertising
campaign in community newspapers, promoting the Web site,
will accompany the study, expected to last six months.
Research shows that self-collected vaginal swabs are
as effective as doctor's cervical exams for diagnosing
STDs. Earlier focus groups suggested that young women
preferred the privacy of home sampling and the convenience
of picking up kits, at no cost, from either within their
home community or through the Internet.
"Our hope is to provide young women with a safe and
effective means for protecting their sexual reproductive
health that is also easy to use," Gaydos said. "If this
home-test kit works, we will have another tool in our
efforts to reduce the spread of STDs through outreach
tactics for disease prevention. We can also use these tests
as an early-warning system to control future outbreaks,
both locally and nationally."
According to the CDC, all people under the age of 25
who are sexually active should be regularly screened for
common STDs, such as chlamydia and gonorrhea.
The pilot study was launched in Baltimore in part
because of the city's high prevalence for STDs. In 2002,
the last year for which statistics are available, Baltimore
had the third highest incidence (new cases per year) for
chlamydia (at 6,267 cases, behind Detroit and Richmond,
Va.) and gonorrhea (at 4,873 cases, behind St. Louis and
Richmond, Va.).