Scaling Up CareKit: Lessons Learned from Expansion of a Centralized Home HIV and Sexually Transmitted Infection Testing Program

TitleScaling Up CareKit: Lessons Learned from Expansion of a Centralized Home HIV and Sexually Transmitted Infection Testing Program
Publication TypePublication
Year of Publication2021
AuthorsNorelli J, Zlotorzynska M, Sanchez T, Sullivan PS
JournalSex Transm Dis
Volume48
Issue8S
PaginationS66-S70
Date Published2021 08 01
ISSN1537-4521
KeywordsChlamydia Infections, COVID-19, Gonorrhea, HIV Infections, Homosexuality, Male, Humans, Male, Pandemics, SARS-CoV-2, Sexual and Gender Minorities, Sexually Transmitted Diseases, Syphilis, United States
Abstract

<p><b>BACKGROUND: </b>Despite advances in implementing human immunodeficiency virus (HIV)/sexually transmitted infection (STI) services for men who have sex with men (MSM), many remain underserved because of barriers like stigma, low facility coverage, and provider competency. This article describes the implementation of centralized nationwide mailed HIV/STI home testing (CareKit).</p><p><b>METHODS: </b>The Emory Center for AIDS Research developed CareKit for research study participants to request HIV self-test kits, STI specimen collection kits, and condom/lubricant packs to be shipped to any mailing address in the United States. Sexually transmitted infection kits were customized according to study needs and could include materials to collect whole blood, dried blood spots, urine sample, and rectal and pharyngeal swab samples for syphilis, gonorrhea, and chlamydia testing. Specimens were mailed back to a central Clinical Laboratory Improvement Amendments-approved laboratory for testing, and results were returned to participants.</p><p><b>RESULTS: </b>CareKit was used by 12 MSM studies and mailed 1132 STI kits to 775 participants between January 2018 and March 2020. Participants returned 507 (45%) STI kits, which included 1594 individual specimens. Eighty-one kits (16%) had at least one positive STI test result: pharyngeal chlamydia (n = 7), pharyngeal gonorrhea (n = 11), rectal chlamydia (n = 15), rectal gonorrhea (n = 12), genital chlamydia (n = 6), genital gonorrhea (n = 1), and syphilis (n = 54). In this same 2-year period, 741 HIV self-test kits were mailed to 643 MSM.</p><p><b>CONCLUSIONS: </b>CareKit successfully met studies' needs for home HIV/STI testing and diagnosed many STIs. These processes continue to be adapted for research and programs. The ability to mail home test kits has become increasingly important to reach those who may have limited access to health care services, particularly during the COVID-19 pandemic.</p>

DOI10.1097/OLQ.0000000000001473
Alternate JournalSex Transm Dis
PubMed ID34030160
PubMed Central IDPMC8284343
Grant ListU01PS005181 / ACL / ACL HHS / United States
1U19 HD089881 / NH / NIH HHS / United States
U01PS004977 / ACL / ACL HHS / United States
R01 MH110358 / MH / NIMH NIH HHS / United States
5R01 DA045612 / NH / NIH HHS / United States
R01 MH114692 / MH / NIMH NIH HHS / United States
P30 AI050409 / AI / NIAID NIH HHS / United States
1U01 PS005181 / NH / NIH HHS / United States
U19 HD089881 / HD / NICHD NIH HHS / United States
R21 AI136657 / AI / NIAID NIH HHS / United States
1R01 MH114692-01 / NH / NIH HHS / United States
1U01 PS004977 / NH / NIH HHS / United States
R01 DA045612 / DA / NIDA NIH HHS / United States