2663. Comprehensive at-home Sexually Transmitted and Blood Borne Infection (STBBI) Testing Program: A Pilot Initiative
Bibliographic record
Abstract
Abstract Background Sexually transmitted and blood borne infection (STBBIs) remain a growing concern in North America with rates increasing dramatically since 2000. Although self-testing has been demonstrated to be valid and acceptable, no fully remote STBBI testing programs are available in Canada. To evaluate feasibility and acceptability of at-home STBBI testing, we implemented a fully remote, web-based platform of risk-responsive, non-invasive STBBI diagnostics in a large Canadian health zone. Methods A web-based risk assessment and intake form was developed using RedCap software through a community-facing website (athomestitesting.ca) in partnership with a local sexual health centre. Demographic, sexual practices, and medical history were collected from interested participants through the platform. Diagnostic kits inclusive of testing for gonorrhea/chlamydia (urine and self-swabs of vagina/pharyngeal/rectal) and syphilis/HIV/Hepatitis C (dried blood spot) were mailed to participants based on their survey responses, along with instructions and supplies for collection and return. Outcomes to be assessed include feasibility and acceptability of the web-based platform, testing and positivity rates for STIs, and time to testing and treatment (for positive cases). Results In the first month to date with limited launch, eleven participants completed the intake survey and were mailed testing kits through the platform. Of the completed testing, no new STIs were identified. The median age of the cohort was 38 years old (IQR 32, 41) and six identified as men, four as women and one non-binary. Regarding gender identity, seven identified as gay/queer/bisexual and three as straight/heterosexual. In a follow-up survey, all participants to date stated reported satisfaction or extremely satisfaction with the online testing. Conclusion The platform model demonstrates feasibility in the early pilot phase with acceptability based on participant responses. Next steps include expanded launch of the platform and assessment of testing rates and feasibility of a web-based model for STI diagnostics. Disclosures Caley B. Shukalek, MD, MSc, MPH, Gilead Sciences: Advisor/Consultant|Gilead Sciences: Grant/Research Support|Gilead Sciences: Honoraria|Merck Canada: Grant/Research Support|Merck Canada: Honoraria|PurposeMed Inc: Advisor/Consultant|PurposeMed Inc: Ownership Interest Ranjani Somayaji, M.D., CF Foundation: Grant/Research Support|CIHR: Grant/Research Support|Oncovir: Data and Safety Monitoring Board Fees|Vertex Pharmaceuticals: Advisor/Consultant|Vertex Pharmaceuticals: Grant/Research Support|Vertex Pharmaceuticals: Honoraria
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.004 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.015 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".