Community-based chlamydia and gonorrhea screening through the United States mail, San Francisco

Background: Because gonococcal and chlamydial infections are often asymptomatic, disease control requires population-based screening. This report describes the feasibility of home-based testing for sexually transmitted diseases (STDs) and of specimen transport via the US mail. Goal: This project sought to establish the efficacy and acceptability to the public of screening by means of urine kits made available in public places and mailed in for STD testing. Study Design: Self-selected community participants obtained STD test kits from local businesses, collected urine specimens at home, and mailed kits to the health department for nucleic acid amplification testing. Results: Participants picked up 209 test kits and returned 80 (38%): 3 (3.8%) of 76 were positive for gonorrhea and 1 (1.3%) of 76 was positive for chlamydia. The majority (95%) of participants were white gay men. The cost of specimen collection and transport was similar to that of other population-based screening programs. Conclusion: Using the mail for home-based testing for gonorrhea and chlamydia was feasible and may be a useful addition to STD control efforts.