Could These At-Home STD Tests Replace a Doctor’s Visit?

The past year saw a surge of isolation, death, and NFTs, (don’t leave the chat yet, please), but of all the Big Changes we’ve seen, the increase in popularity of at-home STD tests is one of the most intriguing. “We noticed an explosion of STI at-home collection test kit sales starting in March, [2020]” Christina Song told Quartz, “To be quite candid, we didn’t get why.” Song is a spokesperson for the at-home testing site Everlywell, which is one of many online companies—such as myLab Box, Thryve Inside (albeit, for gut health), Let’s Get Checked, and others—that tests urine and blood samples from customers, who collect and ship it out themselves. Now, we didn’t expect to spend the last year calculating the costs of ordering a wooden cabin from Amazon, or wondering if we could DIY an STD test during lockdown (you can kill oral gonorrhea with Listerine, after all). But here we are, assembling our timber and testing for chlamydia from the comfort of our bathroom. (Quick note for those wondering about the difference between "STIs" and "STDs": “Medically, infections are only called diseases when they cause symptoms,” clarifies Planned Parenthood; “That is why STDs are also called ‘sexually transmitted infections.’ But it’s very common for people to use the terms "sexually transmitted diseases" or ‘STDs,’ even when there are no signs of disease.” ) 

While at-home STD testing kits had been growing in popularity before the pandemic—testing for syphilis, hepatitis C, and common STDs like chlamydia—there’s perhaps something to be said about the correlation between COVID-19 and the most recent uptick in kit orders. In the United States, over 80 percent of STD programs were put on pause in light of COVID, reported Healthline. In New York, for example, “the NYC Department of Health and Mental Hygiene closed seven of eight sexual health clinics, keeping one open for limited and emergency services only.” These days, the CDC has officially recommended self-testing. 

“Getting in to see a healthcare provider can be impossible for many due to an overburdened health care system,” Sherry A. Ross, an OB/GYN, author, and health expert, told VICE. She thinks there has been an increase in test kit sales, “[due to a] a lack of affordable healthcare, or having to miss work to know if something is up down there. The COVID pandemic drove this point home when getting out to see a health care provider was even more challenging, [and] home kits make it possible to know if something is wrong if seeing a healthcare provider is not an option.”

Ross is a practicing OB/GYN, author of She-ology: The Definitive Guide to Women's Intimate Health. Period, sits on the board for Planned Parenthood, Los Angeles, and has been a trusted vocal advocate for women’s health in the United States for over 25 years. So, yeah. She’s seen a lot of innovation—and medical snake oil—in her lifetime. We asked her what’s really up with these tests, to better understand the place they could (or should) have in our lives both during and after the pandemic. 

Ross says that overall, many of the tests are reliable—but make sure to read the box. “There are many home STI kits available,” says Ross, and “If you decide to do home testing for STIs, make sure you have done your research to find high quality kits with 99 percent reliability with the same FDA-approved testing used by doctors and hospitals. It comforts me knowing there is a 99 percent accuracy rate with most of these high-grade and quality home STI tests. There are a number of STI home screening tests that have accurate results for the most common culprits. Many of the high-quality home kits have the same accuracy as you would find in a doctor’s office. As an example, the 8 Panel Home STD Test Pack is a complete and accurate test that can be done at home.” So if your pee burns but you're not quite ready to venture out to a clinic—or just want some privacy for a preliminary screening—these kits can help you figure out what's going on. 

Uber Box 8 Panel At Home STD Test Pack, $269 at myLab Box

The idea is to collect your sample (via swab, finger prick, urine collection) and as Ross says, “mail it to a lab who uses FDA-approved technology. If you get the Uber Box Home STD Test Pack, you are really getting eight of the most common STIs—HIV, hepatitis C, herpes simplex type II, syphilis, chlamydia, gonorrhea, and trichomoniasis—tested which is great! You can even “gift it” to your partner! A couple ‘love box’ gets you both tested for $499.”

Love Box At Home STD Test For Couples, $499 at myLab Box

How cool is it to think that we live in an era where partners could order a couple’s STI testing kit with all the ease of, IDK, a calzone? That being said, a few hundred dollars is a bit more money than pizza change—and forgoing a trip to the doctor’s office is, for so many, a matter of not just emotional, but financial, stress. In that instance, many of the tests at Everlywell run at around $159 (although they test for six, and not eight, STIs):

STD Test (Female), $149 at Everlywell

STD Test (Male), $149 at Everlywell

They also offer tests for hepatitis C, syphilis, and a combined chlamydia and gonorrhea test that all run for $49:

Chlamydia and Gonorrhea Test, $49 at Everlywell 

Where does my health insurance come in, you may be wondering? If your plan includes a health savings account, you can often use it to pay for these tests. “Generally speaking, yes, you can use your HSA/FSA account to pay for an at-home health test,” explains Everlywell. Unfortunately, both Everlywell and myLab Box are not not contracted with any insurance companies at the moment. Still, explains Everlywell, “[our] tests are typically priced lower than out-of-pocket costs associated with such visits.” 

This all begs the question: Could such tests effectively replace a doctor's visit? “My main criticisms with some of the home testing kits,” says Ross, “is [that] from the time you order the tests to the time you get your results can be up to 13 days, which is a long period of time. As a selling point, it reminds you that there are ‘no awkward conversations,’ [but] I would remind young [people] that these awkward conversations are important to have with your doctor! Awkward conversations don’t have to be awkward when you are taking charge of your sexual health. You need to establish a healthy and open relationship with a doctor. Having a conversation with a physician over the phone who will treat your positive results is not my idea of a doctor-patient relationship.”

Another gynecologist, Dr. Shweta Patel, also expressed his concerns to UAB Medicine about whether users are gathering their samples correctly. “Accuracy is essential,” he explains, “The HIV, hepatitis C, or syphilis tests require a blood sample, so a finger prick should provide an adequate sample. However, most tests for chlamydia and gonorrhea require vaginal swabs or urine samples. As a provider, knowing from my practice what is sometimes needed to get an adequate swab sample, I do wonder if people are accomplishing that task at home [although] some people may have limited transportation and can’t get to a clinic easily, so the kits do offer convenience,” he adds, “[and] there is also, unfortunately, still some stigma attached to screening, so the home test offers some level of privacy.”

Dr. Ross agrees. “If you are in a rush or too busy to go to see a doctor it’s better than nothing, but I would definitely make it a point to find a doctor [with which] you can have a healthy and long-term relationship. Taking the best care of our bodies, she explains, means speaking to a medical professional we trust for the most informed and personalized care—which, alas, one cannot get from a cardboard box. “The human contact you have with a doctor is invaluable, she concludes,” and while at-home testing kits offer more accessibility in their privacy, we should think of them not as an end-all—but a stepping stone solution to improving our relationship with our bodies.

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