Perceptions of self-testing for chlamydia: Understanding and predicting self-test use

Abstract: Background: Self-testing technology allows people to test themselves for chlamydia without professional support. This may result in reassurance and wider access to chlamydia testing, but
anxiety could occur on receipt of positive results. This study aimed to identify factors important in
understanding self-testing for chlamydia outside formal screening contexts, to explore the potential
impacts of self-testing on individuals, and to identify theoretical constructs to form a framework for
future research and intervention development. Methods: Eighteen university students participated in
semi-structured interviews; eleven had self-tested for chlamydia. Data were analysed thematically
using a Framework approach. Results: Perceived benefits of self-testing included its being convenient,
anonymous and not requiring physical examination. There was concern about test accuracy and some
participants lacked confidence in using vulvo-vaginal swabs. While some participants expressed
concern about the absence of professional support, all said they would seek help on receiving
a positive result. Factors identified in Protection Motivation Theory and the Theory of Planned
Behaviour, such as response efficacy and self-efficacy, were found to be highly salient to participants
in thinking about self-testing. Conclusions: These exploratory findings suggest that self-testing
independently of formal health care systems may no more negatively impact people than being tested
by health care professionals. Participants’ perceptions about self-testing behaviour were consistent
with psychological theories. Findings suggest that interventions which increase confidence in using
self-tests and that provide reassurance of test accuracy may increase self-test intentions.