Raise your hand if you agree that down-there doctor appointments are the worst. Extended waiting room sojourns, rushed consultations, urine samples, vaginal swabs, cold stirrups, needles, and a see you in a year wave on the way out.
While I get tested every six months, or between partners, it's one of my least favorite extracurriculars. It's cold, it's wet, it's bloody, it hurts a little, and well, it gives me a decent bit of nerves.
But here's the thing: All the data we can find says that we should be a little nervy, because STIs are on the rise. A recent report by the Centers for Disease Controls and Prevention (CDC) estimates that up to 20 million new STI infections occur each year in the U.S., and that 59 million women in the U.S. currently have at least one STI.
So when I found out that my bathroom could be transformed into a STI-testing medical lab, thanks to SmartJane, uBiome's new at-home STI test, I was way interested.
SmartJane is the world's first sequencing-based clinical microbiome screening test for STIs, and vaginal flora and HPV, explains Jessica Richman Ph.D., co-founder and CEO of uBiome. Basically, what that means is that in addition to testing for four common STIs gonorrhea, syphilis, chlamydia, mycoplasma genitalium SmartJane also tests for 19 different types of HPV and the balance of 23 types of vaginal flora (a.k.a. the bacteria in your vagina that help keep it healthy and at the right pH).
Find out how often you should get tested for STIs:
It Was As Easy As Putting In A Tampon
A single Q-tip-shaped swab and three minutes is all it takes. Seriously. While a traditional gynecology appointment typically takes about an hour, this at-home STI test took me less than six minutes (including going to my mailroom to pick up the package). I went downstairs, opened the package, registered my kit online, then followed the simple instructions in the box to set up my at-home lab.
Then, when I was ready, I squatted down and stuck the six-inch Q-tip up and inside me about five inches (as deep as a tampon usually goes) for a little swirl action. After a minute of that, I swished the Q-tips around in one of the mini vials for another minute, then closed the lid on the vial and shook it up. After double-checking that it was closed tight, I put it in the returnable envelope and walked it down to my mailbox.
Taking the test was pretty anticlimactic. At worst, it felt like the vagina-equivalent of cleaning my ear.
Are The Results In Yet?
Waiting for the results was the hardest part. While typical STI tests take only about three days to get results, at-home STI tests takes closer to three weeks. That's a long time to wait... not to mention enough time to pass an infection or virus onto a partner if I wasn't safe.
But when the time came, I got my tests results from SmartJane the same way I got them from my gynecologist: An email led me to a patient portal where I filled out a username and password before viewing a chart with the verdict. The biggest difference: Had the results been positive, my gynecologist would have called me to talk about a course of action.
However, the SmartJane chart was astonishingly more user-friendly than the report from my doc. It was color-coded, detailed, and explained everything in very simple terms. The 10-page chart not only let me know if I was "negative" or "positive" for STIs, it also explained what the balance of my vaginal flora was, and which health conditions I might be more prone to because of that balance (based on published research).
I was so impressed by the design of the result chart that I sent a screenshot of it to my wellness-inclined friend exclaiming, "Dude, this is the future of our health!"
Should You Try At-Home STI Testing?
While STI tests represent another step forward into a future of convenience and ease, they aren't foolproof. For one, not all at-home kits test for the same things in-person gynecologists tend to test for, says Denise Howard M.D., senior attending physician and assistant professor of clinical obstetrics and gynecology at Weill Cornell Medicine-Qatar, and author of The Essence of You: Your Guide to Gynecologic Health.
For example, when I was last tested at the doctor's office, in addition to chlamydia, gonorrhea, syphilis, mycoplasma genitalium, and HPV, which SmartJane tests for, I was also tested for herpes, HIV, hep B, hep C, and trichomoniasis (as well as for a yeast infection and bacterial vaginosis). Not to mention that a test collection done by a healthcare provider involves an actual examination, says Howard. For example, even if you can't see any genital warts in your vaginal canal during an at-home test, your gyno can easily spot them during a down-there visit.
STI tests done without any professional supervision are also prone to more errors in collecting, handling, and storing of the sample, says Howard, so follow the instructions exactly. That makes sense: My bathroom certainly is not as well-equipped or clean as a medical lab or office, and I'm certainly no doctor.
But, in general, the effectiveness of at-home tests is comparable to those collected in the office. The key is to know where the company sends its specimens for testing. It should be a reputable laboratory with the appropriate accreditations to ensure quality processing, she says. It's also worth making sure the test you're taking is FDA approved because many are not, says Sarp Aksel, M.D., resident physician at Montefiore Health System.
The upsides of an at-home STI test include convenience, privacy, ease of use, cost effectiveness, and accessibility, Howard says. While tests collected by the doctor are ideal, they're simply not feasible for many, which means that at-home STI tests could mean that more people are getting tested, she says.
However, if a test is positive, it puts a lot of onus on the patient to seek treatment, says Aksel. At-home tests won't get you the treatment you need. They're simply the first step in figuring out what's going on down there. You really need to discuss the results with a doctor and figure out what the best course of action is, he says. SmartJane doesn't prescribe a treatment or medicine, but we have an online chat with doctors that's always available, and a phone line where you can ask for a gynecological referral in your area so that you can get the treatment you need, Richman explains.
If a test is negative, however, and you have symptoms, you still need to go into your doctor, says Aksel.
The bottom line: If I was really in a bind and not able to see my favorite gyno for some reason, I'd probably use an at-home test again. But considering that if any of the tests read positive or I had symptoms, I'd need to head to the doctor anyway, I think I'd prefer to go there to start.