The check is in the mail: piloting a novel approach to Chlamydia trachomatis testing using self-collected, mailed specimen

Abstract

Objectives: To develop, implement and evaluate the processes of a novel approach to chlamydia testing that is accessible, confidential, free of charge, easy to use, and allows for self-collection of specimens, their transportation by regular mail and the central management of results. Methods: A ‘self-collection kit’ was developed including all items and instructions necessary to obtain a sample. A network of distribution sites at locations frequented by the target population has been established. The ‘kits’ can be requested via an advertised website and by phone. Specimens are returned via reply paid mail. A centralised system for the management of results and follow up has been established. Test results are conveyed by the participant’s method of choice. Treatment is organised via a network of health care providers. Results: Of the first 100 returned kits 99% were safely packed and 86% were sent back with a completely filled out pathology request form. Ninety-two participants provided contact details; 70.7% indicated mobile phone or SMS as the preferred methods to receive results. Seven positive cases were identified and treatment was confirmed for all within 6 days. Discussion: These findings provide evidence that the presented approach to chlamydia testing is easy to implement, achieves excellent follow-up and treatment rates, and therefore opens important new channels to otherwise difficult to access high-risk populations, such as young people and geographically and socially isolated populations.