Use of a risk quiz to predict infection for sexually transmitted infections: a retrospective analysis of acceptability and positivity

Abstract

Background Individuals who are sexually active may want to make a decision as to whether they are at risk for having a sexually transmitted infection (STI) such as Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis. Our goal was to develop and evaluate a simple self-taken sexual risk quiz for participants, ordering an online STI self-collection test kit to determine whether the score predicted infection status. Methods As part of the IWantTheKit programme for home sample self-collection for STIs, 2010–2013, the programme asked male and female users to voluntarily take a risk quiz. The six-question quiz was about risk behaviour and included an age question. Data analyses were stratified by gender as determined a priori. Scores 0–10 were stratified into risk groups for each gender based on similar risk score-specific STI prevalence. Retrospective analyses were performed to assess whether risk group predicted aggregate STI positivity. Urogenital/rectal mailed samples were tested by nucleic acid amplification tests. Results More females (N=836) than males (N=558) provided voluntary risk scores. The percentage of eligible participants who submitted scores was 43.9% for both females and males. There was a higher STI infection rate in females (14.0%) than in males (7.0%) for having any STI (p<0.001). Multivariate logistic analysis for females, which controlled for age and race, demonstrated that a higher risk score group independently predicted risk for having an STI (OR of 2.2 for risk scores 5–7 and 4.2 OR for scores of 8–10). For males, the multivariate model, which controlled for race, indicated that no risk score group was associated having an STI. Conclusions Results of a participant’s own sexual risk quiz score independently predicted STI positivity for women, but not for men. Further study of this simple risk quiz is required.

Satisfaction and Condomless Anal Sex at Sexual Debut and Sexual Risk Among Young Black Same-Sex Attracted Men

“…Overall sexual risk during recent sex was measured through six questions previously used to assess sexual risk among adolescents via an Internet site (Chai et al, 2010; Gaydos et al, 2015; Gaydos et al, 2009). These questions included items related to number and frequency of sexual partners, history of STI diagnosis, and condom use.…”

“…Participants were classified as having low (score=0–2) or high (score=3–9) risk during recent sex by summing risk scores across the six questions. The majority of participants in this study were classified as high-risk, so to ensure a sufficient number of observations within sexual risk categories, this measure was dichotomized at a cut-off chosen based on prior work (Gaydos et al, 2015; Gaydos et al, 2009). A composite sexual risk score, rather than an examination of specific risky behaviors, was used for this analysis because YBSSAM may be engaging in multiple risky behaviors, and this study sought to explore overall current sexual risk.…”

Protecting our future generation: study protocol for a randomized controlled trial evaluating a sexual health self-care intervention with Native American youth and young adults

“…Innovative, non-clinic based alternatives to traditional sexual health screening and treatment are essential for alleviating these sexual health disparities. Promotion of self-care, or the care taken by individuals towards their own health and well-being may be such a strategy; it is endorsed for improving sexual health outcomes by increasing access to care and individual satisfaction with care through client-driven, confidential options [4, 12–16]. Improving sexual health though the promotion of self-care is increasingly a focus of preventing sexual health disparities due to: 1) increased availability of new technologies, 2) the ease of STI screening using non-invasive samples, and 3) the lack of capacity for routine sexual health care service provision common in many reservation-based and other rural communities [13].…”

Self-testing for Trichomonas vaginalis at home using a point-of-care test by women who request kits via the Internet

“…The participating women were mostly between 18 and 30 years of age (63.7%, 95% CI: 54.4–73.1; Table 1). Results of a risk quiz on the website indicating probability for having an STI 3,4 demonstrated that the majority (71.6%, 95% CI: 62.8–80.3) had a risk score in the intermediate risk category (5–7) and high risk category (8–10), based on a point system of 0–10 (Table 1). …”