P125\u2005Biological Outcome Measurement Through Mail-Based Testing for HIV, STIs, and Substance Use Among Adolescents

Abstract

BackgroundCOVID-19 disrupted in-person clinical research activities. In response, the Adolescent Medicine Trials Network (ATN) CARES study instituted mail-based testing for human immunodeficiency virus (HIV), sexually transmitted infections (STIs), and substance use screening. We assessed the acceptability and feasibility of the ATN CARES mail-based testing program.MethodsFrom September 2020- December 2020, trained study staff sent myLAB Box© mail-based test kits and written instructions to gay, bisexual, and transgender study participants between the ages of 16–26 years. The test kits included a dried blood spot collection card for HIV (4th generation antigen/antibody EIA) and syphilis (TP-EIA) testing, swabs and a urine collection kit for the detection of extragenital and genital Chlamydia trachomatis and Neisseria gonorrhoeae infection, and a urine collection kit for the screening of six substances. Staff tracked shipment status, and when delivery was identified, contacted participants to assist them with self-collection and test kit return.ResultsOf the 65 youth who participated to date, 49.2% (32/65) returned their kit and completed at least one test. Those 32 participants had a median age of 23.5 years (IQR 22–25). The median number of days from test kit ordered to results was 18.5 days (IQR 15–23.5);median number of days from collection to results was 10 days (IQR 8.5–12). MyLAB Box© reported a total of 219 testResults30 HIV, 22 syphilis, 56 chlamydia, 56 gonorrhea, and 55 drug tests processed. Of the 219 tests, 7.3% (16) were rejected due to specimen inadequacy (6 dried blood spot cards, 2 anal swabs, 8 urine specimens).ConclusionsMail-based testing is a promising way to monitor a variety of biological study outcomes among adolescent study participants. Future studies should further investigate how to strengthen utilization and fidelity of mail-based testing.