Apparently pubs in the Bath area are going to be trialling a new form of STI test in pubs, which builds on the fantastic work done by the Chlamydia Screening Programme and the Ealing project. This goes a step beyond the leaving pink and blue boxes of chlamydia tests in pharmacies for young people to pick up and send off, but will give you a result just by going to the loo in the pub! Apparently it was developed alongside this using this technology but only now is the smallscale trial being conducted.
The idea is that the toilet bowl will be laced with the test reagent which will cause a colour change in your urine according whether you are infected with any of the following three STI’s- Chlamydia, Trichomoniasis and Gonorrhoea, and notices on the loo’s will advise you what to do next.
While I welcome anything that makes access to testing much easier and more commonplace- I have issues with this initiative for several reasons.
1) Firstly- what if you are infected with a different STI to the three listed above? (what about HIV, Syphillis, HPV, Herpes, pubic lice etc) Will a negative result not leave people feeling confident they are in the clear when they may not be? Where is the onus on getting tested for all the other STI’s too?
2) If you are in the “clear” (even though you may not be- its just you haven’t had a FULL screen)- will that impact on your sexual behaviour? Make you take more risks?- I have visions of groups of people under the influence on a friday night competing to be in the clear and then have a “worry free” sexual conquest as a result?
3) If you do test positive- what procedures are there in place for followup and getting treatment? It seems the onus is on the urinator to seek help once they have their result- but will this really happen?
4) How is the testing going to be administered? All loos? Surely that brings up consent issues? One specific “sex test” loo? Doesn’t that then mean people will avoid it? or use it for dares? What about privacy issues- in cubicles is fine but what if urinals are used- can the “results” be flushed away quickly?
5) Reading between the lines of the clinical trials- it seems initially there were some issues with testing for women being more accurate than for men. It is unclear whether this has been solved- this then creates issues of gender biases in results and possible imapcts on sexual behaviour?
6) Where is the role of support and education? Previously youth workers have been employed with great success to administer chlamydia testing at festivals etc. Will this still be employed to support people who test positive or is this as I suspect some kind of cost-cutting exercise by the council to put the onus on individuals and remove specialist support? Also if there isn’t a trained person in the loos supporting the testing process then how the instructions going to be displayed? How are they going to find the balance between sufficient information about how to do the test interpreting and dealing with the results and making it easy for everyone to understand including those with learning difficulties?
7) There is already widespread misconceptions that public toilet seats can transmit STI’s. I wonder whether this project will harm that further.
Anyhow I think it will be interesting times for this innovative but unusual project but I fear it needs a lot more careful consideration before anyone even dreams of rolling it out nationwide.
Watch this space….