Privacy, speed, and convenience—but are they as legit as seeing a doc?

By Sandra Rose Salathe
August 03, 2019
Nurx

STDs remain a socially taboo subject, but getting tested regularly is more important than ever; the STD rates in the U.S. have been rising rapidly, with an estimated 20 million new cases each year, according to the Center for Disease Control and Prevention, and antibiotic-resistant strains of gonorrhea and chlamydia are becoming a real risk.

Despite the increased importance, one in four sexually active adults has never been tested for an STD, according to a survey conducted by the birth control app Nurx. Why?

"I think some patients are scared or in denial, especially in the younger population who've never really been sick before," says Jennifer Butt, M.D., a gynecologist with Upper East Side OB/GYN. "Some patients may decline testing, citing that they're in a monogamous relationship. Or sometimes patients are afraid to ask their new partners [about their STI status]." (Related: How to Have Safe Sex Every Damn Time)

It's true: Fear and anxiety over the results are some of the main reasons people don't get tested more often, and the process itself can leave you feeling embarrassed and just uncomfortable. Not to mention, it can be expensive, especially if you don't have adequate health insurance.

Good news: Getting tested is becoming easier. Thanks to the evolution of telemedicine, direct-to-consumer healthcare companies are now offering convenient and private STD testing kits that you can do right in your own home. After answering a questionnaire online, you can decide on a kit that aligns best with your symptoms and have it delivered directly to your doorstep. The majority take less than 15 minutes to complete, with results ready in two to five business days.

"I think these home kits will provide access to some individuals, who for various reasons, may not be able or comfortable going to a doctor's office or clinic to get tested," says Dr. Butt. (After all, there is a shortage of ob-gyns in the U.S.)

But is home STD testing as reliable as seeing a doc IRL? Plus, with so many new companies to choose from, how do you choose one that you can feel safe with? Here, four solid options, and what you need to know before you try one.

Nurx STI Home Test Kit

Referred to as "the Uber of birth control", Nurx is providing women with accessible medical care once again. This time around, it's in the form of a STI Home Test Kits.

They offer three different options: the Full Control Kit (for male and female) tests for gonorrhea, chlamydia, syphilis, hepatitis C, and HIV, and requires a throat, rectal, and urine sample; the Healthy Women's Kit tests for gonorrhea, chlamydia, trichomoniasis, syphilis, and HIV, and requires a throat and vaginal swab; the Covered with the Basics kit can test for gonorrhea, chlamydia, syphilis, and HIV, and only requires a urine sample.

All three kits are delivered directly to your home and include everything they need in order to collect their samples, including a prepaid envelope to ship them back. After the test is analyzed, a clinical physician from Nurx will reach out to you within seven business days to discuss their results. Whether you pay with or without insurance, you'll also be charged a $12 medical consultation fee, which includes unlimited access to the Nurx medical team. If you test positively, a Nurx medical provider can prescribe you an antibiotic treatment. For STIs that require in-person treatment (such as HIV or hepatitis B and C), Nurx will do a "warm handoff" to make sure they get connected with a nearby clinic.

The quickie facts:

  • Tests available: HIV, chlamydia, gonorrhea, syphilis, hepatitis C, trichomoniasis
  • Cost: $75 with insurance; $150 to 220 without insurance. (Plus a $12 medical consultation fee.)
  • Insurance? Yes
  • Available: Nurx.com

LetsGetChecked

LetsGetChecked doesn't just test for STDs; they also offer hormone tests, HPV tests, diabetes tests, celiac tests, and more. They offer six different kits which test for up to 10 different STDs, including gonorrhea, chlamydia, herpes and syphilis, trichomoniasis, HIV, and both hepatitis B and C. Kits cost between $99 (for just gonorrhea and chlamydia) and $299 (for all 10 STDs), and they don't accept any insurance at this time. (Related: This New At-Home HPV Test Can Help You Learn More About Your Cervical Cancer Risk)

Similar to Nurx, LetsGetChecked provides a prepaid shipping label so that you can mail back their samples within 24 hours. After your sample has been processed, your results will be visible within two to five days. If you test positive for any STDs, a registered nurse will personally call to provide one-on-one support and treatment options. You can also purchase a LetsGetChecked test through CVS Pharmacy, both in-store and online. If you choose the option of ordering from CVS, the process is the same. (Just note: You may need to pay some extra lab fees.) You just order the kit from the CVS website instead of going directly to LetsGetChecked.

The quickie facts:

  • Tests available: HIV, hepatitis C, syphilis, herpes simplex virus type 2, chlamydia, gonorrhea, trichomoniasis, HPV, mycoplasma, ureaplasma
  • Cost: $99 to 299
  • Insurance? No
  • Available: LetsGetChecked.com, CVS, Walmart

Verisana Standard STD Test for Women

Verisana Lab is an online lab that offers diagnostic testing services for things like yeast infections, hormone levels, and common STDs. Their Complete STD Test screens for 10 of the most common viral and bacterial infections, including gonorrhea, chlamydia, syphilis, and herpes. Their prices range from $69 (for a single test) to $299 (for the Complete STD Test), and they currently do not accept any insurance.

Once you order a kit, you collect two samples (both a vaginal swab and blood spot) before sending them back within a prepaid envelope. Unlike Nurx and LetsGetChecked, if you test positive for any STDS, you're expected to speak with your doctor about treatment options. (Verisana does not provide any treatment.)

The quickie facts:

  • Tests available: HIV, hepatitis C, syphilis, herpes simplex virus type 2, chlamydia, gonorrhea, trichomoniasis, HPV, mycoplasma, ureaplasma
  • Cost: $69 per individual test, $89 to 299 for kits
  • Insurance? No
  • Available: Versiana.com

myLAB Box

myLAB Box has been offering at-home STD tests since 2013 (!!). You can choose from their three STD test kit options—the Safe Box (tests for HIV, chlamydia, gonorrhea, and trichomoniasis), the Uber Box (tests for those four, plus hepatitis C, herpes simplex type II, and syphilis) and the Total Box (tests for all the prior listed, plus HPV, Mycoplasma genitalium, and ureaplasma)—or purchase an individual STD test for $79. (Bonus: They even sell tests at Walmart.com.) Each test takes just a few minutes and results are available within a matter of days. If you test positive for any STDs, a trained counselor will provide you with treatment options.

The quickie facts:

  • Tests available: chlamydia (genital, throat, rectal), gonorrhea (genital, throat, rectal), hepatitis C, HIV I & II, herpes simplex 2, syphilis, trichomoniasis, mycoplasma genitalium, HPV
  • Cost: $79 per individual test, $189 to 399 for kits
  • Insurance? No, but FSA and HSA payment cards are accepted
  • Available: myLabBox.com, Walmart

Before You Try an At-Home STD Test

Although these kits act as a promising alternative for straightforward STD testing, evaluating and diagnosing medical concerns isn't always that black and white. That's why some experts don't think these kits should be used as a substitute for getting tested in a doctor's office.

"Nothing should replace an actual doctor's visit," says Dr. Butt. "A thorough health history and physical exam are key elements in the evaluation of a problem. Symptoms that might trigger concerns of an STI could actually be something else that would be otherwise be missed."

And you're not crazy if you think these prices seem a little steep. Getting tested by your doctor and using insurance to pay may cost you significantly less than paying out of pocket for these at-home STD tests. (We're talking as low as $10 to $30.) However, every insurance and doctor is different, and there’s a chance you may also have to pay a co-pay or office visit cost, even for preventative screening. If you get tested often, your insurance may not cover every test.

Then, "without insurance, the cost of an STD test can range from $75 to $380," says Robert Segal, M.D., co-founder of LabFinder.com—yep, about the same price as these at-home STD tests—and you may pay even more for the doctor's visit on top of that. (It's worth noting that, yes, clinics like Planned Parenthood do offer free or low-cost STD testing, but getting to a clinic isn't always an option.) 

The kicker: You should really be getting tested for STDs after every new partner (waiting at least a month afterward for accurate results). Those costs can add up quickly if you're not in a monogamous relationship (or don't trust that your partner is being faithful). You're not alone if you're wondering: If we're encouraging people to get tested often—both for their health and safety as well as their current and future partner's—how can we charge this much for testing?

In the end, hitting "Place Order" on a website can feel less daunting and require less initial effort than going in to see your doctor or visit a clinic—so if that's what it takes to motivate you to get tested, it's certainly better than not getting tested at all.

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