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Background: Previous research indicates that emergency contraception (EC) users are less likely to have visited a gynecologist in the past year, and more likely to report ever having an STI compared to non-users. In studies outside the U.S., Chlamydia (CT) prevalence has been as high as 9% for EC users accepting screening in the pharmacy setting.
Objectives: This ongoing study explores whether EC purchasers represent a missed opportunity for STI screening, and assesses the feasibility and acceptability of pharmacy screening.
Methods: Customers purchasing EC (~$50) from nine pharmacies in Manhattan receive vouchers for free urine-based CT and gonorrhea (GC) testing at onsite medical clinics. Participants completing testing and a brief self-administered survey receive a $20 incentive, and their lab results within 3-4 days. Analysis includes clients enrolled between February and September 2011.
Results: Only 32 participants have enrolled: 88% female, 28% 17-24, 44% 25-29 years old, 50% White Non-Hispanic, 25% Hispanic; and 69% college graduates. Overall, 74% purchased EC before, 56% purchased EC because they did not use birth control at their last encounter, 71% were not STI-tested in the past year, and 68% reported a new partner in the past 3 months. None tested positive for CT/GC. All participants agreed pharmacies should offer STI testing and most reported that they would be willing to purchase an STI take-home kit at the pharmacy or online. Challenges included: recruitment, pharmacy staff compliance, location, and advertising with discretion.
Conclusions: This study found low screening uptake among EC users; however, providing STI testing in the pharmacy setting is feasible. Collaborating with and training pharmacy and medical staff are key elements of service provision.
Implications for Programs, Policy, and Research: Our research is an example of health reform-relevant partnering for STI prevention. Future research should explore how different permutations of expanding screening in non-traditional settings improve uptake and detect additional cases.