Background:
In August of 2000, the San Francisco STD Program successfully piloted self-collection for gonorrhea/chlamydia screening in gay/bisexual men through a pharmacy test kit pick-up system. Because women under 20 years are at greatest risk for chlamydia and less than half are screened through routine health care, we piloted a pharmacy test kit pick-up system in this high-risk population.

Objective:
To assess the feasibility of distributing self-collected vaginal swab tests to young women through pharmacies.

Method:
The self-collected vaginal swab test kit project was conducted in collaboration with two pharmacies in a predominately Latino neighborhood, with high STD morbidity rates. Materials were developed in English and Spanish, targeting young women ages 14 –20 years. Test kits included visual and written instructions on specimen collection that would take place in the home. Promotional materials were distributed to local youth service agencies and businesses, via street outreach. Bilingual test kit request cards were developed for young women to present to pharmacists, so they could avoid making a verbal request. Pharmacists called project staff for specimen pick up. Vaginal swab specimens were tested using a previously validated assay (Genprobe APTIMA) by the public health laboratory. 250 hours of outreach were spent promoting the project.

Result:
50 kits were picked up from the pharmacies. 7(14%) were returned with no chlamydial infection detected. For each kit picked up, we performed 5 hours of outreach.

Conclusion:
The pilot demonstrated that pharmacies were willing to participate in methods to increase chlamydia screening coverage in young women. However, few kits were picked up by the Latina women target population and even fewer returned.

Implications:
Further research is needed to understand why acceptance by Latina women was low and what alternative strategies might be more successful. Successful prevention strategies in one population might not always be successful in another target population.