Creating Innovative Sexually Transmitted Infection Testing Options for University Students: The Impact of an STI Self-testing Program.

BACKGROUND: National-level data suggest that sexually transmitted infection (STI) testing rates among young adults are low. The purpose of this study was to evaluate the acceptability of an STI self-testing program at a university health center. Few evaluations on the acceptability of collegiate self-testing programs and their effect on testing uptake have been conducted. METHODS: To assess acceptability and uptake of self-testing (urine and self-collected vaginal swab), we conducted a brief self-administered survey of students accessing a large US-based university health center from January to December 2015. RESULTS: In 2015, University Health Services experienced a 28.5% increase in chlamydia (CT)/gonorrhea (GC) testing for male individuals and 13.7% increase in testing for female students compared to 2013 (baseline). In 2015, 12.4% of male students and 4.8% of female students tested positive for CT/GC via clinician testing, whereas 12.9% of male students and 12.4% of female students tested positive via self-testing. Female students were more likely to test positive for CT/GC when electing to test via self-test versus a clinician test (χ(1, N = 3068) = 36.54, P < 0.01); no significant difference in testing type was observed for male students. Overall, 22.5% of students who opted for the self-test option completed the acceptability survey; 63% reported that their main reason for testing was unprotected sex. In the past year, 42% reported 4 or more partners. The majority were very satisfied and likely to use the service again (82%). CONCLUSIONS: Self-testing may be an efficient and effective way to provide STI testing for students and increase testing uptake. Self-reports of multiple partners, unprotected sex, and detected infections suggest that at-risk students are using the service.

Lessons from managing a campus mumps outbreak using test, trace, and isolate efforts.

In 2017, Penn State University's campus experienced a mumps outbreak that coincided with unrelated restrictions on social gatherings. University Health Services implemented testing, contact tracing, and quarantine and isolation protocols. Approximately half of the supplied contact tracing information was usable, ∼70% of identified contacts were reached, and <50% of those contacted complied with quarantine protocol. Students with confirmed mumps reported ∼7.4 (1-35) contacts on average. Findings from this outbreak can inform future outbreak management on college campuses, including COVID-19, by estimating average contacts per case, planning capacity for testing and quarantine/isolation, and strategically increasing compliance with suggested interventions.