[Question #6923] Accuracy of iCare Instant Chlamydia and Gonorrhea Home Test Kit

11 months ago
Suppose that a person wanted to engage in unprotected activities with a sex worker, but wanted to be cautious about contracting chlamydia and gonorrhea. Suppose also that this person was considering asking the sex worker to use the iCare at-home instant test kits for those diseases, in the person's presence at the beginning of the encounter. It would be great if you could please address the following:

1. How does the accuracy of the iCare tests compare to a test that one might take at a clinic or a lab like Quest?

2. What is the window period for these tests, compared to tests that one might take at a clinic or lab? (In other words, how long would the sex worker need to be infected before the respective tests could accurately detect the infection?)

3. Are there any other instant test brands that one might consider other than iCare?

4. What is the general status of instant, at-home test technology? Is there any exciting technology that might be approved for use in the U.S. soon?

5. Any other concerns that you might have about instant tests, that I may be overlooking?

Thanks!




H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
11 months ago
Welcome back to the forum. Thansk for your continued confidence in our services.

There are no accurate rapid in-home tests for gonorrhea or chlamydia. Having not previously heard of iCare, I did a quick online search. Here's a link to the only study I can find. The results show that the test misses up to 80% of infections, although a positive result is reliable. But it's a worthless test in the setting you describe. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4853942/  It isn't clear to me that the research study used the exact method promoted by iCare. But the professional STI prevention world has been waiting and hoping for an accurate rapid test and the potential use of in-home self testing. A couple of probably accurate home self tests are in development and initial research results are promising, but it's probably at least a year or two before we can expect such a test to be FDA approved and marketed in the United States.

Those comments pretty well cover your specific questions, but to be explicit:

1) This test performs horribly compared with standard testing. As noted above, a positive result is reliable, but a negative result is meaningless. Don't waste your money. Use common sense in partner selection, knowing that some sex workers (especially escorts, i.e. expensive female sex workers by appointment) often are very low risk for STDs. And use condoms.
2) The window period is unknown. For standard tests, it's probably 2-3 days.
3,4) No accurate rapid tests are available but active research is underway and it is possible such a test will be available in the not too distant future. Stay tuned.
5) I have no other concerns, but I think you'll agree these are pretty damning!

I hope these comments are helpful. Let me know if anything isn't cear.

HHH, MD

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