No Clinic, No Problem: Acceptability of STI Self Collection Kits in a National Sample of Adolescents and Young Adults

BACKGROUND: Sexually transmitted infections (STIs) disproportionately affect adolescents and young adults (AYAs), yet testing rates in this group remain low. STI self-collection kits may potentially increase testing uptake. We sought to characterize barriers to using self-collection kits among AYAs. METHODS: This cross-sectional study examined preferences and barriers related to STI self-collection kits among 445 sexually active AYAs aged 15-24 years across high STI incidence counties in the United States (U.S.). Data was collected via social media recruitment and analyzed using descriptive and inferential statistics. RESULTS: The study revealed disparities in comfort levels regarding receiving STI self-collection kits at home and other household members seeing them. Most participants preferred their kit to be delivered to their home, though participants aged 15-19 years and AYAs with lower education preferred to pick it up from school. Discreet delivery was perceived as more feasible by participants aged 20-24 years, those who were employed, and those living in the southern U.S. Individuals with less than a high school education were less likely to feel comfortable self-collecting for STI testing. Participants favored written or video instructions for specimen collection and email or text message for results notification. Participants expressed a high likelihood of referring their sexual partners for testing and treatment. CONCLUSIONS: These findings underscore the importance of tailoring STI self-collection kit design and delivery to AYA subpopulations. Future research and programs should prioritize AYAs' desires for discreet delivery, clear specimen self-collection instructions, and digital communication options to benefit and optimize STI testing for AYAs.