Testing for STIs at home? It's possible, and an increasingly popular option
The rise of home testing for STIs/HIV started long before the pandemic (the FDA approved its first HIV home test collection kit way back in 1996), but COVID-19 seems to have accelerated the popularity of getting tested from the comfort of our homes. It makes sense; during lockdown home tests were the only option in many places and some health departments began offering “drive thru” testing where you could pick up a test kit from a staff member in the clinic parking lot, go home and collect samples, and then drop it back off to be sent to a lab.
Moreover, the invention of home antigen tests for COVID-19 itself helped us all get more comfortable with the idea of being our own lab tech. For many of us, swabbing our noses, twirling it in a plastic test tube, and putting drops of the collection fluid on a test strip has become second nature.
At-home STI testing is different, because while you collect the samples yourself, for the most part, you don’t get the results right away. Instead, you send the samples to a lab which conducts the test and provides results within a few days.
Still, public health experts believe that at-home STI testing can help ensure that more and more people get tested by removing the barriers involved with having to see a healthcare provider—whether that’s finding a clinic, scheduling an appointment that doesn’t interfere with work, securing transportation, or overcoming the feelings of embarrassment that can happen when talking to a doctor in person.
It’s vitally important that we get past these barriers and others because testing is the first step to all STI treatment (you can’t get treated for symptoms or cured until you know what infection you have) and prevention (you can still pass an infection to others until it is treated or cured).
This article answers some of the most frequently asked questions about STI testing at home.
The answer to this question is different for everyone because it can depend on factors like your age and your behavior. For example, younger people, especially women, are biologically more susceptible to STIs. Additionally, certain groups (like men who have sex men) may have higher STI rates in their communities. If a person has multiple sexual partners, they may also need to test more often.
In general, everyone should be tested for HIV at least once in their lives and anyone who is sexually active should be tested for most STIs about once a year. Some people may want to be tested more frequently if they have multiple partners and some people may need fewer tests because they have only one partner and are sure their partner doesn’t have any other partners. Check for an explanation of CDC’s specific recommendation for each STI.
Home testing is best used as a method for regular screenings. If you have symptoms such as genital itching, burning, or unusual discharge it can be better to see a healthcare provider because a physical exam can help you get a quick and accurate diagnosis and start treatment right away.
You can test for most STIs at home including HIV, chlamydia, gonorrhea, trichomoniasis, and hepatitis C. You can also test for syphilis, but these tests are considered less accurate because they may pick up an old infection that isn’t active anymore (meaning it doesn’t need treatment and won’t be spread to a partner). Herpes tests may be available as well, but blood tests for HSV are considered less accurate and are known to return a significant number of false positive results.
There are many ways to get an STI test that you can do at home. You can get them over the counter in some pharmacies, like CVS. Or you can go online where a slew of companies such as Nurx, TBD Health, Lemonaid, Let’s Get Checked, and myLAB box sell home test kits. Many of these companies will mail out a test kit for you to use at home and mail back. Others connect you to an online provider, either through telehealth or an online survey, who will write an order for you to go to a local lab where you will provide samples (not quite at home but still avoids the need for an in-person doctor’s appointment).
Some health departments are also offering at-home test kits that you can pick up or have mailed to you.
While health departments often offer their test kits for free, other providers have a wide range of pricing. The CVS test kit sells for $99. Most of the online companies seem price their test kits at about $99 as well but they also offer more comprehensive kits (that test for additional STIs) that are more expensive. Some can be over $200. Some companies offer a membership program so that people who want to be tested frequently can receive a discount.
While there may be exceptions for tests ordered by a telehealth provider and done at a local lab, for the most part home STI tests are not covered by insurance. For a test purchased at a pharmacy, like CVS, it may be possible to use funds from an HSA plan, if you have one.
Each test kit will be a little different, but most will ask you to either prick your finger and put a drop of blood on a test card or provide a urine sample (or both). The dried blood test is used for HIV, Hepatitis-C, and syphilis. The urine sample is used to test for gonorrhea, chlamydia, and trichomoniasis. Depending on what you are testing for, some kits may also ask for a vaginal swab, an anal swab, and/or a throat swab.
There is also a rapid HIV test that uses a sample of saliva collected by swabbing your gums.
For most STIs, home tests should be as accurate as the tests done in a doctor’s office because they are being conducted in a laboratory. That said, the only tests that have been approved for home use by the FDA are those that test for HIV. The lab tests for other STIs were approved by the FDA using samples collected by health professionals and the agency is still questioning whether the tests remain as effective when the samples are collected at home.
Experts seem to agree that home tests for chlamydia, gonorrhea, trichomoniasis, and hepatitis-C are reliable. When it comes to syphilis and herpes, however, there are fears that the tests will pick up old infections or return too many false positives. Even so, these tests can be valuable by providing reliable negative results. Anyone who gets a positive result on one of these tests will likely be advised to seek additional testing to confirm.
FREE At-Home Testing (in Select Areas)
While there are many commercial options for at-home testing, as mentioned above, there are also free options in some areas of the country, typically offered in coordination with health departments.
Free HIV Self Tests
- Together TakeMeHome
Together TakeMeHome is a collaboration between Emory University, Building Healthy Online Communities, the U.S. Centers for Disease Control and Prevention, NASTAD, OraSure, and Signal. This service offers free HIV self-tests—any person living in the U.S. (including Puerto Rico), is 17 years of age or older, and has not ordered from TakeMeHome in the past 90 days, is eligible to request one or two HIV self-tests.
- State and Local Resources for Free HIV Self Tests
This resource lists from We>AIDS includes resources across the country.
HIV and STI Home Test Kits
- I Want The Kit (IWTK)
IWTK stated as a project at Johns Hopkins University School of Medicine, offering STI testing kits in Maryland. The service now offers free and confidential in-home specimen collection and lab-based testing for two common STIs, chlamydia and gonorrhea in 8 states—Maryland, Alaska, Oklahoma, Kansas, New Mexico, Utah, Nevada and Arizona. IWTK also offers trichomonas testing for women and in-home HIV test kits for residents of Baltimore City.
TakeMeHome is a partnership between Building Healthy Online Communities (based at Springboard HealthLab), NASTAD, and Emory University. This service enables state and local health departments to offer free in-home sexual health tests to eligible community members. It is currently available in parts of Indiana, California, and the entire state of Oregon.
- Free STI Home Testing Kits for Alabama Residents
STD/HIV home specimen collection and laboratory testing kits are available by mail for all Alabama residents, and to selected individuals who are on PrEP therapy. Persons may request one test every three months. Test kits include chlamydia, gonorrhea, syphilis, and HIV.
GetCheckedDC is a free program that provides DC residents with confidential, convenient testing for HIV, chlamydia, and gonorrhea.
- TalkTestTreat Central Florida
This initiative from the Florida Department of Health provides free HIV/STI self-collection test kits by mail to Florida residents.
This program offers free home test kits for chlamydia and gonorrhea to young women, girls, transmen, and any person with a vagina age 12 to 24 in select counties in California.