Issue: February 2016
January 29, 2016
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Quiz predicts STI risk in young women

Issue: February 2016
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A quiz assessing age and sexual history predicted the risk for sexually transmitted infections in young women, according to recent data.

The quiz was developed by STI experts in adolescent sexual health care as a supplement for an Internet educational outreach program and STI testing kit campaign, IWantTheKit (IWTK).

On the IWTK website, users aged 14 years and older from Maryland and Washington D.C., are able to request a free testing kit and voluntarily respond online or in a paper-based assessment to a six-question survey that estimates the risk of having an STI based on a participant’s age, number of sexual partners, condom use and past infection status. With the testing kit, participants can self-collect penile, vaginal and rectal swabs and send them to a laboratory for complimentary chlamydia, gonorrhea and trichomoniasis testing. Instructions and a pre-addressed postage-paid return mailer are included in the kit.

More than 6,500 women and 3,500 men have utilized the program since it was launched in 2004, Charlotte A. Gaydos, DrPH, MPH, professor of medicine in the division of infectious diseases at Johns Hopkins School of Medicine, said in a press release.

“We test a lot of people who are not infected, and although a tool like this might not predict every single case, we think it can be helpful in rapidly predicting the likelihood of an STI for physicians and patients,” Gaydos said.

During a recent investigation, Gaydos and colleagues examined data on 836 women and 558 men aged 20 to 24 years who completed the home sampling and risk quiz from November 2010 to August 2013.

The scoring system varied between women and men since STI prevalence and high-risk behavior differ between genders, the researchers wrote. Women were categorized as high risk if they scored eight to 10 points, medium risk if they scored five to seven points, and low risk if they scored zero to four points. Men were categorized as high risk if they scored seven to 10 points, medium risk if they scored three to six points, and low risk if they scored zero to two points.

According to the data, women were more likely than men to test positive for an STI (14% vs. 7%; P < .001). Chlamydia was the most common infection in both genders (5.4%).

A multivariate logistic analysis adjusted for age and race showed the quiz predicted that women with medium- and high-risk scores were two and four times more likely to have an STI vs. women with lower scores (OR = 2.23; 95% CI, 1.41-3.52; OR = 4.22; 95% CI, 2.08-8.58). In men, however, there was no association between risk scores and STI prevalence.

“We are not quite sure why this is, but untruthfulness or the fact that men tend to have lower rates of STIs are possibilities,” Gaydos said in the release.

Follow-up research is planned to increase the accuracy of the quiz, she added.

The IWTK website began offering a home-performed HIV test in January, Gaydos said in the release. If future research confirms the accuracy of the quiz, a properly funded national campaign could provide information and testing to thousands of people.

“The risk assessment tool could be used in family planning clinics or primary care clinics where STI prevalence would be expected to be low, but where it might motivate an astute clinician to order a screening test based on a personalized risk score,” Gaydos and colleagues wrote. – by Stephanie Viguers

Reference: IWantTheKit.org

Disclosure: The researchers report no relevant financial disclosures.