Home-Based Self-Sampling and Self-Testing for Sexually Transmitted Infections: Acceptable and Feasible Alternatives to Provider-Based Screening in Low-Income Women in São Paulo, Brazil

In Brief Objective: The objective of this study was to determine whether home-based screening for sexually transmitted infections (STIs) is acceptable, feasible, and increases the proportion of women screened among low-income women in São Paulo, Brazil. Study Design: Eight hundred eighteen women were randomized to receive a clinic appointment or a kit for home-based STI self-collection and testing. All participants collected 2 vaginal swabs, one for polymerase chain reaction detection of chlamydia, gonorrhea, and trichomoniasis and another for a self-conducted rapid test for trichomoniasis. Results: Slightly more women responded to the initiative within 2 weeks in the home group (80%) than in the clinic group (76%) with younger women showing improved response to home-based screening. Ninety-four percent of home group participants successfully completed self-collection and self-testing on their first attempt. Conclusions: Home-based self-collection and self-testing was acceptable, feasible, and resulted in a slightly higher response rate. Home sampling and testing provide promising alternatives to clinic-based STI screening across diverse contexts. A randomized study in Brazil demonstrated that home-based self-sampling and sexually transmitted infection testing is acceptable, feasible, and achieves equivalent if not slightly greater response to screening compared with provider-dependent screening methods.