Comparative effectiveness of two programs for submission of self-collected samples for chlamydia screening on a university campus

Background – Chlamydia (CT) rates and incidence continue to increase, with adolescents/young adults at greatest risk. While university students are known to engage in high risk activities, CT prevalence studies are limited by poor screening rates. Free, self-obtained sample (SoS) kits, used in private student residencies, may reduce screening barriers.

Objective – Determine which SoS kit distribution mechanism was more effective in screening engagement: direct provision of kits to students, or encouraging students to order their kit from a website.

Methods – During 2010-2011, residents of six university dormitories were provided training sessions describing CT, the project, and SoS kit use. Students in three dormitories were provided kits, and the remaining students directed to the website (www.iwantthekit.org).

Results – Of 391 resident students, 163 were provided with kits and 175 were directed to the website. Of provided kits, 12 (8 female) were returned and 2 (16.7%; both female) were positive. All three internet-requested kits were returned (all female) and none were positive. In a post-project survey examining nonparticipation, 26.2% of students were unaware of the project (no difference by dormitory or gender; p>0.05), and 58.5% of females cited prior testing as part of a medical exam.

Conclusions –Direct distribution of kits was more effective in student screening engagement, but would cost more due to non-used kits. While total student engagement was <4%, the positivity rate of 16.7% (2/12) indicates a degree of self selection. The data indicated that SoS kits may effectively complement screening programs in the university setting.