Why California is making home STI testing easier
This month, California became the first state to require insurance plans to cover home testing for sexually transmitted infections.
Officials hope the move will make STI testing more affordable and accessible. Sexually transmitted infections such as syphilis, gonorrhea, and chlamydia have been on the rise for years in the United States, and the pandemic has only made matters worse.
“We hope these home test kits will help [those] people who just don’t feel comfortable going to a clinic,” Fresno County Public Health Department health educator Leticia Berber told ABC30 (KFSN-TV).
Last spring, the Centers for Disease Control and Prevention announced that annual reported cases of STIs in the United States hit an all-time high for the sixth consecutive year in 2019. The agency cited a number of reasons for this. trend, in particular the difficulty of access. Prevention and care of STIs, decreased condom use among vulnerable groups, including youth and gay and bisexual men, and cuts to STI programs at national and local levels.
[Related: America’s sexually transmitted disease rates are out of control]
The fact that these infections may be asymptomatic may also play a role, says Sarah Horvath, OB-GYN at Penn State Health Obstetrics and Gynecology. “Many patients may not know they have chlamydia, gonorrhea or syphilis; all three can be quiet,” she says. “So they can’t ask for care.” An additional factor may be that people who have already been treated may also be reinfected by their partners, she says.
The arrival of COVID-19 has compounded this problem. “I’m very, very concerned that we’re going to see even bigger increases for 2020 and 2021,” Horvath says. Since the start of the pandemic, people have become more hesitant to get tested or undergo routine examinations. Some spend more time with abusive partners who can limit their access to health care, says Horvath. On top of this, health systems in many areas have been overwhelmed, limiting their ability to easily treat and diagnose STIs.
“In some places, even if a patient really wanted to come in, they see longer wait times,” says Horvath. “Especially if it is a new patient, whether they live in a rural area or are part of an already somewhat marginalized group within the health system, it is even more difficult to access to care.”
Requiring insurance companies to cover home testing for HIV, chlamydia and other infections is one of several measures included in the new California law to combat rising STI rates. “This is the first law of its kind, and I would say it’s state-of-the-art,” said Stephanie Arnold Pang, senior director of policy and government relations for the National Coalition of STD Directors, to Kaiser Health News (KHN). “We want to remove all the barriers that prevent someone from getting tested for STIs, and the out-of-pocket cost is a huge factor.”
The rule went into effect Jan. 1 for people with state-regulated private insurance plans, though how much they pay will depend on their plan, provider and whether they qualify for free testing. Meanwhile, the state’s Medicaid program is still updating its billing codes to pay for the tests. Another potential complication is that some labs may be reluctant to test the samples people send in because the tests haven’t been approved by the U.S. Food and Drug Administration for home use, KHN noted, which means they have not yet been thoroughly tested by the federal government. agents, such as home COVID-19 testing.
“I think anything that improves a patient’s ability to access that care is fantastic,” says Horvath. “The question is whether or not they will be able to access the treatment they need if they test positive.”
Still, she says, home testing has a number of advantages. “It has a level of privacy that some patients may find very appealing,” says Horvath. “It’s a very good alternative for patients who can access this care without having to go to the clinic.”
In the future, she hopes to see similar bills passed in other states that cover home testing for people with state-sponsored insurance, as well as those with private insurance or no insurance. A top priority, says Horvath, is to “ensure everyone has access to testing and to ensure there is a mechanism to get patients and their partners to prompt treatment if and when a test is positive. “.
Equally vital to slowing the spread of STIs, Horvath adds, is making sure people have access to resources about these infections and how to protect themselves.