Research Points to Dual STI and HPV Self-Testing as Game-Changer for Preventive Women's Health

The Screening Gap: A Public Health Challenge

Cervical cancer and sexually transmitted infections (STIs) remain major public health concerns, especially among women from low-income and marginalized backgrounds. Access issues, cost, and social barriers mean that many women go without recommended screening—putting them at risk for both cervical cancer and other STIs like chlamydia, gonorrhea, and trichomoniasis. Could at-home self-collection help bridge this gap?

Innovative Approach: Mailed At-Home Testing

A recent secondary analysis of the “My Body, My Test–3” randomized clinical trial evaluated whether mailing self-collection kits for HPV and other STIs could effectively reach low-income, underscreened women across 22 North Carolina counties. The mailed kits allowed women to self-collect cervicovaginal samples, which were tested for HPV and three common STIs using advanced laboratory assays. The approach aimed to streamline preventive care—making it more accessible, convenient, and private.

Revealing Results: Who Benefited and What Was Found

Among 327 women (median age: 42) who returned their kits, 16% tested positive for an STI and 16% for HPV—remarkably, the same rate for each. Nearly 90% of those with an STI tested positive for trichomoniasis. Importantly, most infections would have gone undetected if only HPV had been assessed. Risk factors for testing positive for STIs included being non-Hispanic Black, having multiple sexual partners, being single, and current smoking.

Acceptance and Follow-Up: What Women Thought

Most women (over 80%) had a positive experience with self-collection, citing the convenience and ease of use. Only a small fraction reported concerns, such as uncertainty about performing the test correctly or minor physical discomfort. Nearly all said they would use self-collection again, and a strong majority preferred testing for both HPV and STIs simultaneously in the future. Two-thirds of those with a positive STI result received follow-up care, though this is lower than typical clinic-based follow-up rates.

Implications: Toward Equitable Preventive Care

This study highlights the potential for self-collection kits to address multiple preventive health needs in one simple step, especially for populations facing barriers to clinic-based care. Streamlined screening for HPV and STIs could not only increase early detection but also help reduce health disparities, particularly among women of color and those with limited resources. Future efforts should focus on improving follow-up and expanding access to ensure that more women benefit from these innovations.

Key Takeaways:

At-home self-collection kits detected STIs and HPV in nearly 1 in 6 low-income women.

Streamlined testing found infections that would have been missed by HPV-only screening.

Women reported high satisfaction and willingness to use these kits again.

Follow-up care after positive results occurred in about two-thirds of cases.

Dual self-collection could help close gaps in preventive care for marginalized women.

Citation:

Ganguly AP, Pretsch PK, Brewer NT, et al. Streamlined Self-Collection Screening for Sexually Transmitted Infections and Human Papillomavirus: A Single-Group Secondary Analysis of a Randomized Clinical Trial. JAMA Network Open. 2026;9(1):e2551345. doi:10.1001/jamanetworkopen.2025.51345