Comparative effectiveness of two self-collected sample kit distribution systems for chlamydia screening on a university campus.

OBJECTIVES: Chlamydia trachomatis (CT) rates and incidence continue to increase, and university students are known to engage in high-risk activities, but studies of CT prevalence in this population are limited by poor screening rates. Utilisation of self-obtained sample (SoS) kits in private student residencies may reduce screening barriers. The authors sought to determine the relative effectiveness, and comparative effectiveness, of two SoS kit distribution mechanisms: one which provided kits directly to students and another encouraging students to order kits from a website.
METHODS: During 2010-2011, residents of six university dormitories were provided training sessions describing CT, the project and SoS kit use. Students in three dormitories were provided kits, and the remaining students directed to the website (http://www.iwantthekit.org).
RESULTS: Of 391 resident students, 163 were provided with kits and 175 were directed to the website. Of provided kits, 12 (8 women) were returned and 2 (16.7%; both women) were positive. Of only three internet-requested kits, all were returned (all women) and none were positive. In a post-project survey examining non-participation, 26.2% of students were unaware of the project (no difference by dormitory or gender) and 58.5% of women cited prior testing as part of a medical exam.
CONCLUSIONS: Though direct kit distribution was more effective in student screening engagement, overall participation was poor despite widespread advertising. The methodology of online testing and SoS kits has been well validated elsewhere, but research is needed to successfully engage university students in screening and refine SoS target populations in light of changing healthcare policies.