Alabama Department of Public Health, United States
Project
The Alabama Department of Health (ADPH) partnered with binx health digital platform to power a population-level program to increase access to sexually transmitted infection (STI) and HIV care through remote self-collection and laboratory-based testing.
Issue
STI rates have continued to increase across the U.S., yet only 11.5% of people aged 15-25 receive routine testing, citing confidentiality, lack of provider engagement, embarrassment, and cost as the main care deterrents. Historically, underserved populations including racial and ethnic minorities and LGBTQ+ communities face even more barriers to preventative care. To help overcome these challenges, ADPH launched a program in partnership with binx health to bring care directly to the patient through the binx everywhere platform and remote logistics solutions. The HIPAA-compliant binx digital platform enabled ordering and delivery of sample self-collection kits. Samples were returned via prepaid envelope and processed at CAP-accredited and CLIA-certified laboratories. Licensed healthcare providers followed up on all positive results and prescribed treatment as appropriate. All results were made available to ADPH with Disease Intervention Specialists (DIS) completing follow-up.
Results
The program was launched in the Spring of 2021 and demonstrated the ability to bridge geographical barriers and reach underserved communities. 4,229 ADPH orders were placed in the first year and reached all counties in the State (Figure 1): 38.6% of participants identified as Black or African American. Approximately 28% of participants had never or were unsure if they had ever tested for HIV before. Privacy preferences (33%) and affordability (24%) were most cited as reasons to participate in the program. 43% of kits were returned to the lab during this period, and positivity rates for anal, oral, and genital chlamydia were 5.0%, 1.4%, and 6.4% respectively, and 2.7%, 4.4%, and 2.7% for anal, oral, and genital gonorrhea, respectively.
Lessons Learned
A well-designed, scalable remote self-collection program in partnership with public health can promote care access and reach communities not previously engaged in routine sexual health testing. Increasing return rates remain a critical key area for improvement and binx health consistently deploys new platform enhancements to promote returns.
