Background: Self-collected sexually transmitted infection (STI) specimens are an effective strategy to increase screening uptake and useful for research studies. Self-directed collection, in which the individual collects the specimen and mails it to the laboratory for testing, does not involve contact with clinic/research staff, and may be valuable post-Covid as telemedicine and online research gain popularity. People who use illicit opioids (PWUIO) have elevated STI risk and unmet healthcare needs, and self-collection may be valuable, yet little research has assessed self-collection in this population. Methods: Within a cohort study among PWUIO in New York City, we conducted a substudy from November 2021-August 2022 assessing sexual health with a one-time online survey; participants could opt-in to receive a self-collection kit (n=120). If elected, participants were mailed a kit containing the collection method (males: urine, females: vaginal swab), pre-paid return label, self-collection and shipping instructions, and educational information on STIs. Specimens were sent to HIV/STD Core lab of the Center for AIDS research at University of North Carolina at Chapel Hill and tested for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) using nucleic acid amplification tests (Aptima Combo 2, Hologic, Inc). We measured the number of kits requested, delivered, mailed by participants to the lab, and CT/GC positive. We assessed sociodemographic and STI risk factors correlated with requesting a kit. Results: Of 120 participants, 118 had valid study identification numbers. Sixty-three kits were requested (Figure), with 41 delivered; the remaining were not delivered due to no address provided, invalid addresses, and duplicate requests. Of the 41 kits delivered, 3 were sent to the lab for testing, of which one had a positive result for CT and GC; the positive result was reported to the participant and health department. Younger participants, those with past-year sex trade and casual partnerships, and those who experienced relationship violence were more likely to request a kit. Conclusion: While STI self-collection may be desirable for some PWUIO, particularly those at high STI risk, there may be barriers in obtaining and/or returning specimens. Research is needed to understand feasibility and acceptability of self-directed methods for STI screening among PWUIO.
