At-Home STI Tests Are Everywhere Right Now. How Well Do They Work?

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In the past few years, we’ve gotten very familiar with at-home rapid testing for COVID-19. In the midst of the pandemic, the need for another kind of health screening skyrocketed: Rates of STIs rose starkly between 2020 and 2021. Syphilis cases jumped up by 32%, and chlamydia and gonorrhea cases also increased. The rates of those three STIs had been steadily ticking up before the pandemic, but, as people had less access to in-person health care, it created a recipe for infections to run amok unchecked.

Since then, there’s been a surge in the availability of at-home STI testing, meaning you can now do some panels without leaving your house. This concept isn’t totally brand-new—home HIV testing collection kits increased access to detection and care in the mid-1990s. But for a long time, these HIV test kits were the only STI screenings that were FDA-approved for safe, effective use at home.

The FDA started approving STI self-tests other than HIV tests in late 2023, the first being the not-inexpensive Let’sGetChecked Simple 2 test ($99, letsgetchecked.com) for chlamydia and gonorrhea, which works by way of a vaginal swab or penile urine sample. That opened the door for even more tests to be cleared by the agency (though not all on the market are). The Know test ($99.95, testwithknow.com) is the first approved kit that screens for four STIs: chlamydia, gonorrhea, trichomoniasis, and mycoplasma genitalium. It also detects yeast and bacterial vaginosis (BV) infections. It claims to provide accurate results from a urine sample in 15 minutes and offers follow-up telehealth support, including options for treatment, should you have a positive test result.

But…with health clinics back open, is it ever worth spending your money to do an often pricier STI screening at home? We asked ob-gyns what’s actually up with do-it-yourself sexual health tests.

What are the potential benefits of at-home STI tests?

They’re discreet.

You can place an order online and have a test kit from your cart to your front door in about two days. The procedure might involve a finger prick, urine test, or vaginal swab, all of which are pretty fast to complete. They’re also convenient in that some can test for several strains concurrently and offer you the additional discretion of testing out of the comfort of your own home, Kecia Gaither, MD, MPH, FACOG, the director of perinatal services/maternal fetal medicine at NYC Health + Hospitals, tells SELF.

The exact type of test depends on the potential infection: For most viral infections, including HIV, a blood test is necessary, but for most bacterial infections or viral infections that can cause lesions—for instance, herpes—either a urine test or a swab of the affected area can be used. In-person testing usually yields results within a few days (blood tests for viruses can be quicker to process than bacterial swab or urine testing).

You’re not saving a ton of time by testing at home if you go with a mail-in option, which could take longer to provide results than a doctor’s office or clinic, Dr. Gaither points out. (For instance, LetsGetChecked’s test takes at least two to five days to provide results—and you’re at the mercy of the USPS when it comes to how long it takes your sample to reach the lab.) Still, the privacy factor might outweigh that for some people.

They offer an alternative if you can’t get to a clinic (or don’t want to go to one).

STIs have social stigma attached to them, and this can be even more pronounced for people who need STI testing but have anxiety or trauma about seeking care due to having experienced dismissal or discrimination in connection to their health. Women, LGBTQ people, and people of color are more likely to have had negative experiences affecting their care. Due in part to historical medical racism, in particular, it’s common for marginalized groups to have mistrust in medical systems and therefore avoid clinical settings.

A 2019 study found that Black people were 73% more likely to report mistrust in medical systems than white people were, and Latinx people were 49% more likely. This ends up having an effect on STI testing: According to the CDC, higher rates of STIs in communities of color are due to health inequity. Because of many providers acting on bias related to those statistics, marginalized people might not want to go to in-person clinics for STI testing if they can avoid additional encounters with medical racism.

For people with disabilities or mobility limitations, at-home kits might be a useful tool. The at-home STI kits might also be useful for people in health care deserts, which are (mostly rural) areas of the US where there’s insufficient access to basic primary care services like STI testing, Dr. Gaither adds. Sadly, since the overturn of Roe v. Wade in 2022, at least 26 sexual and reproductive health clinics have closed nationally. Now, in many areas, there’s only one reproductive health center per 5,000 people. (According to Power to Decide, a nonprofit tracking reproductive health care access in the US, regions in which a single clinic serves 1,000 people are typically known as contraceptive deserts, where people can’t get the full range of birth control methods. These can also be sexual health care deserts, since people often go to the same clinics for a range of those services too.)

All of this comes with the massive caveat that most tests, like Know and the Let’sGetChecked kits, come with significant price tags. Since disabled people, people in health care deserts, and people of color are often also facing financial instability, it’s unlikely that these are a magic solution to increased STI testing access for people who might especially need it.

The potential downsides to STI self-testing panels

At-home tests are sometimes less accurate.

Though they might test for the same amount of strains of STIs as a health care provider’s office, at-home kits might not be as accurate as those conducted by a health care provider, Dr. Gaither says. A finger-prick test should usually be accurate enough to get proper STI results, but getting “enough” to test from a vaginal swab or urine test can be trickier if you’re doing it yourself.

You’ll pay more than you would in many clinics.

According to Planned Parenthood, clinical STI testing is often available for free or at a reduced cost with health insurance or with Medicaid; some states, like Indiana and parts of Oregon and California, offer free take-home options too. On the flip side, it’s difficult to find a self-testing STI kit that screens for more infections than only chlamydia and gonorrhea for less than $100; often, the cost increases along with the amount of tests on a panel. If you have health insurance, it likely won’t cover the cost of at-home testing. At-home tests might be eligible for reimbursement if you have a health savings account, but you’ll end up paying out of pocket and then filling out paperwork to make that happen.

If you decide to take an STI test at home, it’s important to get care afterward.

If you do receive a positive STI result, you’ll need treatment, Dr. Gaither says. And some of the tests, like those from Know and Let’sGetChecked, only test for a few different infections, not including HPV, HIV, or herpes. Regardless of what a given test checks for: “These results are difficult to interpret and need to be within the clinical context,” Andrew Rubenstein, MD, director of the generalist division of obstetrics and gynecology at NYU Langone Health, tells SELF. In the case of a positive result, you can follow up via a telehealth appointment, if the testing service offers that, or head to a sexual health clinic for additional care and treatment, Dr. Rubenstein says.

All told, if you can afford at-home tests and prefer the convenience and discretion of them, there isn’t anything wrong with testing via (ideally FDA-approved) home kits. But for the best handle on your diagnosis and care plan, whether you receive a positive result or need additional testing for persistent symptoms after a negative one: Follow up with a provider who can help you figure out what’s next.

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Originally Appeared on SELF