New Home Tests and Treatments Aim to Reduce STD Rates

The introduction of new at-home testing kits aims to further decrease rates of sexually transmitted diseases (STDs) in the United States. In 2022, the Food and Drug Administration (FDA) approved several innovative testing options, including a test that detects gonorrhea, chlamydia, and trichomoniasis in women, as well as a kit for screening human papillomavirus (HPV), the virus responsible for cervical cancer. This initiative is part of a broader trend that experts hope will help maintain the downward trajectory of STD infections.

The FDA’s actions last year marked a significant step forward in sexual health. The agency not only approved a home test for three prevalent infections but also authorized two new drugs for treating gonorrhea, the first new treatment options in decades. These developments come after a troubling rise in STD cases during the COVID-19 pandemic, which disrupted testing and treatment nationwide.

“Sexual health can be stigmatized and people can be hesitant about testing,” said Dr. Ina Park, a sexual health specialist at the University of California. “Now we have a lot of options for patients who may be wary of going into a provider’s office.”

Convenience and Speed in Testing

Testing company Visby Medical launched its three-in-one test for women after receiving FDA approval in March 2023. The urine-based test includes a vaginal swab and a digital device that processes results and sends them to an online app for review. This test, priced at $150 (approximately €127), also incorporates a telehealth consultation with a medical professional who can discuss the results and provide necessary prescriptions. The entire process can be completed in as little as six hours, a significant improvement over traditional testing methods that typically require days for results.

Dr. Gary Schoolnik, chief medical officer at Visby, highlighted the advantages of this new approach. “Many patients are very hard to track down, and a lot of them, if they have a positive test result, are never treated and are lost to follow-up,” he explained. The FDA granted approval to Visby’s test based on studies demonstrating a detection accuracy rate of around 98 percent, comparable to tests conducted in clinical settings.

Some home-based tests still necessitate lab involvement. In May 2023, the FDA approved Teal Health’s testing kit for HPV. This kit allows women to collect their own vaginal samples, which are then sent to a lab for processing. Notably, updated federal guidelines for HPV screening, announced earlier this month, officially endorse self-collection for the first time.

New Treatment Options Available

The recent approval of two new drugs for treating gonorrhea, Nuzolvenc and Bluejepa, is particularly significant. The bacteria responsible for gonorrhea have developed resistance to many antibiotics, making these new options crucial. Both medications can be taken orally, which presents a major advantage over the traditional injectable treatment using ceftriaxone. Nuzolvenc, developed through a public-private partnership, comes in granules that dissolve in water, while Bluejepa, from GlaxoSmithKline, is a tablet also used to treat urinary tract infections.

The Centers for Disease Control and Prevention (CDC) previously recommended an additional oral antibiotic, azithromycin, but recently removed it from their guidelines due to rising resistance among gonorrhea strains. “We were down to one class of antibiotics recommended to treat gonorrhea and we had no other good options,” Dr. Park stated. “So to have two new options in the same year is very exciting.”

As these new tests and treatments emerge, the CDC’s provisional data for 2024 indicates a third consecutive year of declining gonorrhea cases and decreases in adult chlamydia and syphilis infections. Experts attribute this downward trend to various factors, including reduced sexual activity among young people, increased use of antibiotics as a preventive measure, and the expansion of at-home screening options.

While the new tests are expected to further decrease infection rates, some experts urge caution. Increased home testing could complicate efforts to monitor national STD trends, which have historically relied on data from a limited number of large testing laboratories. Additionally, the higher costs associated with these new tests may restrict access for some individuals. For instance, Visby’s test is not covered by insurance, and recent funding cuts to the CDC and other public health agencies could exacerbate these challenges.

“I’m feeling very optimistic about the fact that people have more testing options and also that we now have access to new drugs,” Dr. Park noted. “What I fear is these cuts to public health are going to decrease access to sexual health care for populations who can least afford to take advantage of these new options.”

As innovative testing and treatment solutions become more widely available, the landscape of sexual health in the United States is poised for significant change, with the potential to further reduce STD rates.