Almost 50,000 home testing kits sought for sexually transmitted infections 

HSE's home STI testing kits. Picture: Eddie O'Hare

A year on from the launch of the HSE’s pilot home testing programme for sexually transmitted infections, almost 50,000 tests have been delivered to service users — 57% of whom had never used any sexual health testing service before.

Under the scheme, users receive a test kit in the post, which they complete and free post back to the lab, and results are usually received by phone or text within 72 hours.

A questionnaire is first completed about who they have sex with, what methods of sex they engage in, and they then receive a tailored set of swabs and supplies for their needs.

One female user said she had never gone to a sexual health clinic before, but ordered an HSE home testing kit in January.

“I had heard really bad things about getting appointments at the clinics, having to get there, and it's like a whole day kind of a thing. But I saw the home testing kits advertised and I said I’d just do it,” she said.

“In my eyes, the home tests are like the rapid antigen tests of STIs. If I had symptoms, I would probably go straight to the clinic. But because I’m just doing it as a check-up, I’m happy enough to do it at home,” she added.

Pandemic

A male user said that before the pandemic he would visit the Gay Men’s Health Clinic in Dublin once every couple of months while sexually active.

“The clinic has been closed throughout the pandemic so until these self-test kits came out, I wasn’t able to access regular free testing anywhere. GP or private tests can cost upwards of €100 and that increases if you want a full range of tests,” he said.

“Whether we like it or not, it’s obvious that people continued having sex or meeting up with people during the pandemic so it seemed so bizarre that accessible sexual health clinics were closed so quickly.” 

He said that he would definitely prefer a mix of in-person and at-home testing in future.

“When in-person sexual health clinics for men who have sex with men are open again, or more accessible, I think I would prefer a mix of in-person and at home. If only for the fact that test centres before the pandemic generally operated Monday to Friday between business hours, which can be really difficult to get to. Testing at home is definitely more flexible if you have work or college,” he said.

“When these kits became available my friend and I got one each, and it’s his very first time getting any sort of test. That’s not a reflection on him, but just shows you have to go out of your way and usually out of pocket to check something that’s pretty important,” he added.

Straightforward

Another female user said she struggled a bit with the blood sample, but overall taking the test was very straightforward. She said a big plus for her was how discreet the home test was.

“I don't want to really show off to someone a package where it says biological samples, but it was the smallest little envelope, and very discreet. They give you the envelope to send it back in, so you don't even need to go into the post office to get a stamp or anything, you just literally put in the box, done, you don't have to interact with anyone,” she said.

Another male user said he was sceptical at first about a self-administered test.

“It was only when I received the packet and they had the various different leaflets there, giving me information, taking me through what each tested and what was required and how to do it, I couldn't believe how straightforward it was. They give you tips to get your blood flowing beforehand and they give you like four or five-finger pricks, but I only needed one.”

The pilot home STI testing service was launched in January 2021, and was available to people living in Cork, Kerry and Dublin — 4,921 test kits were ordered within the first 24 hours.

In May, the pilot programme was extended as public services were significantly curtailed by the pandemic and the HSE cyber attack.

A major indicator of the success of the service in the past year is that 57% of those who requested a home testing kit had never used any STI testing service before.

Contract

In October, the HSE granted the company, SH:24, a fresh contract to provide at-home STI testing, as an emergency response to a national syphilis outbreak. At this time test kits were available in nine counties.

The online STI testing service is now available in 20 counties, and since the pilot service commenced in January, 49,841 test kits have been dispatched.

Professor Fiona Lyons, National Clinical Lead for Sexual Health Services, said: “Some people for reasons of stigma, confidentiality, or embarrassment may wish to have their care done in this way. Also for people who are health literate, have low complexity needs and by and large no symptoms, but recognise that they need to have a check-up, this is a very efficient way to access care without having to go to face to face service,” she said.

“There appears to be a general acceptability around moving to online for everything over the last two years, so I do think it is the way forward, categorically,” she said.

While there is some degree of attrition with home testing, as kits aren’t returned or are not completed properly, Professor Lyons said that even professionally administered testing isn’t perfect.

“For the pilot phase, 67% of the kits that were sent out had been returned by the end of August, and that will continue to rise because someone may have ordered the kit and not used it."

A major indicator of the success of the service in the past year is that 57% of those who requested a home testing kit had never used any STI testing service before — 8% received reactive results requiring further care.

“That suggests that it is reaching people who for whatever reason haven't accessed services before, and the positivity rates are similar to what we would see in people attending in person STI services, which suggests that the right people are being tested,” said Professor Lyons.

The SHCPP have received over €3 million in funding to continue the home testing service, and Professor Lyons said they are currently in the process of awarding a new contract.