Alaska Targets Efforts to Expand STD Testing Access
per 100,000 people is Alaska’s chlamydia rate—highest of all 50 states
increase achieved in number of test kits returned, from FY12 to FY14
of 1,671 test kits mailed out over three years were returned for testing
of the samples tested were positive for chlamydia, 0.7% for gonorrhea, and 4.4% for trichomonas
Web-Based Program Lets People Test at Home
Alaska has the highest chlamydia rate of all 50 states—789.4 cases per 100,000 people.1 The state also has the fourth-highest gonorrhea rate—154.2 cases per 100,000 people.2,3 Issues of confidentiality and privacy, geographic isolation, and scarce healthcare resources contribute to disproportionately lower rates of diagnosis and treatment of sexually transmitted diseases (STDs) among Alaska Native people and people living in rural Alaska. The use of traditional clinical methods of STD testing is also limited in rural Alaska. Enabling people to order STD test kits for use at home can improve access to care, reach people who hesitate to seek STD testing in person, and, ultimately, prevent health consequences of untreated STDs, such as pelvic inflammatory disease, ectopic pregnancy, and infertility.4
In 2011, the Alaska Native Tribal Health Consortium (ANTHC) launched an at-home STD testing service called I Want the Kit–Alaska (IWTK–Alaska) in partnership with the IWTK program at Johns Hopkins University. Any Alaskan aged 14 years or older can order a free STD test kit at www.iwantthekit.orgExternal. The kit enables the user to collect genital or rectal samples at home and mail them in to be tested for chlamydia, gonorrhea, and trichomonas. Johns Hopkins maintains the website, distributes kits, and performs all laboratory testing. ANTHC markets the service, provides phone-based risk counseling, notifies participants of their results, reports positive cases to the state, and refers people with positive tests to nearby treatment services.
IWTK–Alaska’s objective is to increase STD testing among high-risk populations: AI/AN women, people aged 15–29 years, and rural Alaskans. To reach these populations, the program advertised extensively through traditional methods (print and TV) and social media (Facebook and Pandora). The social media advertising was made possible by partnering with the Alaska Division of Public Health for a state-funded social marketing campaign called “Wrap It Up Alaska.” Because of this promotion, the number of kits tested through IWTK–Alaska rose from 186 in fiscal year 2012 to 304 in fiscal year 2014—a 63% increase. Preliminary data indicate that IWTK–Alaska use is increasing among high-risk populations.
Between October 1, 2011 and September 30, 2014,
- 1,671 testing kits were ordered by people in 106 communities
- 678 kits were returned for testing, representing 565 people
- 28% were from AI/ANs, 75% of whom were women
- 62% were from people aged 15–29 years
- 45% were from people in rural areas
- 53 chlamydia and 4 gonorrhea cases were identified; one person had both diseases
- 52 of the 53 persons with chlamydia and all 4 persons with gonorrhea were treated
- 25 persons with trichomoniasis were identified, 2 of whom also had chlamydia
- 24 of the 25 persons with trichomoniasis received treatment
The program guides and counsels participants regardless of test results and recommends that they seek further STD and HIV screening. Partners often get tested together, and the program expedites partner therapy for everyone testing positive for chlamydia and gonorrhea.
In implementing IWTK–Alaska, ANTHC learned the following:
- Establishing an at-home STD testing service initially requires significant time and resources to coordinate with all stakeholders and build name recognition, rapport, and program awareness among the target populations. However, as the program grows, maintenance is minimal and costs remain steady. Offering at-home STD testing is a viable solution for overcoming perceived problems of privacy and confidentiality in rural areas, and for people reluctant to seek testing in person at a clinic or doctor’s office.
- Promoting an at-home STD testing service to the target populations requires use of marketing channels that are readily accessible and highly used in rural areas, such as social media. Partnerships with state agencies can support the cost of social marketing campaigns.
- CDC. 2013 Sexually Transmitted Diseases Surveillance. Figure 3. Chlamydia—Rates of Reported Cases by State, United States and Outlying Areas, 2013.
- CDC. 2013 Sexually Transmitted Diseases Surveillance. Figure 14. Gonorrhea—Rates of Reported Cases by State, United States and Outlying Areas, 2013.
- Cecere D, Jones S. Gonococcal infection–Alaska, 2013 Cdc-pdf[PDF – 71KB]External. State of Alaska Epidemiology Bulletin. Department of Health and Social Services, Division of Public Health.
- Cecere D, Jones S. Chlamydial infection–Alaska, 2013 Cdc-pdf[PDF – 88KB]External. State of Alaska Epidemiology Bulletin. Department of Health and Social Services, Division of Public Health.
Publication date: 04/02/2015
For story information, contact
Alaska Native Tribal Health Consortium
Cornelia Jessen, MA; Brenna Simons-Petrusa, PhD; Lisa Rea, BSN; and Jennifer Arnold
I Want the Kit–Alaska Team
The information in Public Health Practice Stories from the Field was provided by organizations external to CDC. Provision of this information by CDC is for informational purposes only and does not constitute an endorsement or recommendation by the US government or CDC.