Last week I got a STI screening for chlamydia, gonorrhoea, syphilis, and HIV - the full shebang.
Something that should be easy to do ended up with me taking an hour off work to go to my doctor and paying $60 for a standard appointment (I timed it so I had other things checked up on too) only to then be referred to Labtests for a swab and blood tests.
I then spent another hour on a Saturday morning waiting in a crowded Labtests clinic.
As I waited all I could think was it’s no wonder some people can’t be arsed getting tested. Surely it shouldn’t be this annoying.
The push to make STI checks more accessible
Getting an STI check through a standard GP appointment (if you aren’t already planning to go for something else) can be one of the more expensive ways to do it.
Thankfully in New Zealand, some STI checks can be free or subsidised.
If you are a New Zealand resident under 22 you can get free STI checks from Family Planning. Or if you have a community card you can access STI checks at Family Planning for $5.
Otherwise, a ‘quick STI check’ at Family Planning where you can rock up and test yourself for chlamydia and gonorrhoea - the most common STIs - with a swab or urine sample without needing to speak to a clinician costs $25.
Youth One Stop Shops and sexual health clinics around the country can also offer free STI checks.
Even though these options are available, trying to work out the most affordable place to get an STI check feels like a confusing quest you have to figure out on your own.
For example, at 24 I only just learnt I can call the nurse at my GP and request a referral to Labtests for an STI check and it will be free.
I’ve been getting STI checks since I was 18, why wasn’t I told about this then?
The barriers to young people getting STI checks
Family Planning’s national nurse advisor Rose Stewart says since they started offering STI checks where people can swab themselves without needing to see a clinician, they have seen a huge uptake in people getting tested.
“It is a really un-embarrassing way to test. You don't have to explain yourself to anyone or undergo any questions which can scare people off. It also saves you having to book an appointment too.”
She says the move to make STI checks more autonomous is the only way testing will increase.
In the United Kingdom, at-home STI checks where you can test yourself for chlamydia, gonorrhoea, and even HIV and syphilis through a finger prick blood sample are becoming more common.
A UK study in 2021 found at-home tests for chlamydia and gonorrhoea were increasing testing rates and diagnoses while freeing up clinicians' time.
At-home STI checks are already a success in New Zealand
Five years ago the Burnett Foundation started offering at-home checks for HIV.
Instead of the tedious process of going to a lab to get a blood test, you could swab your gums, wait 20 minutes and the test would tell if you were positive or negative - similar to a Covid-19 RAT test.
Burnett Foundation chief executive Joe Rich says they saw an overall increase of 50% in their testing numbers once they offered at-home testing.
“We also saw a significant increase in the number of Māori accessing services and half of our home-test kits going to people who live outside of the main cities.”
When the Burnett Foundation surveyed people about why they preferred the at-home tests, the top reasons were privacy and discretion as well as convenience.
“Free sexual health clinics are also mainly in Auckland, Christchurch, and Wellington so if you are in smaller cities and towns in New Zealand you have a lot less options.”
Rich says the at-home tests cost them $65 but they use their government funding and donations to subsidise the tests to $20.
Because the Burnett Foundation is funded to provide accessible STI checks to men who have sex with men, this scheme specifically targets this group.
“It's been one of the most successful testing interventions we've provided as an organisation,” Rich says.
“We’ve sung it from the rooftops hoping the health system will pick this up for the rest of the population.”
At-home tests across the country
There are a growing number of independent organisations that provide at-home STI checks.
For example, Sexual Health 101 is an online STI testing service where you can order STI checks and lab forms to your door.
You can do the chlamydia and gonorrhoea swab at home and send this to a lab or drop them off at a collection point. However, you still need to visit the lab to get a blood test for HIV and syphilis.
The downside is, once you order a swab for chlamydia and gonorrhoea and a lab form for HIV and syphilis you are charged $56 (which includes a $6 delivery fee).
The price is steep because lab tests are only covered by the healthcare system if they are ordered by a clinician. And these organisations don’t receive the same funding and donations as the Burnett Foundation or Family Planning do to subsidise fees.
Rich says they’ve previously tried to work with district health boards (DHBs) to roll out at-home tests across the country but it “isn’t easy” because each DHB has a different contract with different labs.
“Everything got complicated because DHBs are set up so differently. But with this plan to have a centralised health system, it would be a no-brainer to roll it out, or at least fund more organisations to provide these services to more people.”
A Ministry of Health spokesperson says the ministry aims to publish a Sexually Transmitted and Blood Borne Infection Strategy and an HIV Action Plan by the end of 2022.
“This includes actions to reduce barriers to testing and exploring innovative testing and outreach models, such as self-testing.”
The spokesperson says timely and equitable access to testing will be a key part of the strategy and the ministry welcomes research on how the existing barriers to STI checks in New Zealander can be overcome.
Until then, the Burnett Foundation, Family Planning and dedicated sexual health clinics - you can search for here - offer free or the most affordable STI testing.
And it's also worth trying out whether you can call the nurse at your GP for a free referral to a lab for your tests - this is the ultimate life hack that would save you from having to pay for a standard appointment.
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