Everlywell now has an STI test subscription. Is it worth it?

Everlywell, the HelloFresh of lab tests, debuted an STI subscription service called Current last month.

For $14.99 a month, Everlywell will send you one of five STI tests (usually priced at $49 on their website). The company boasts that you'll get physician-reviewed results within days, a physician from a third-party telehealth network will reach out should you have a positive test, and, on top of that, there's no cancelation fee. But is it something you need?

Current STD testing subscription Credit: everlywell

Current came after sales of Everlywell's STI tests quadrupling during the height of quarantine, which they consider to be March and April of 2020, compared to sales in March and April of 2019.

"When we noticed that people were buying at-home collection STD tests from us in record numbers despite the lockdown, we started thinking about how to deliver testing to these individuals in an accessible, affordable way that wouldn’t put them at further risk of exposure to coronavirus," Dr. Frank Ong, Everlywell's Chief Medical and Scientific Officer, told Mashable.

In an Everlywell study of 500 participants, nearly 25 percent of people reported breaking stay-at-home orders in April in order to pursue sexual activity, Ong cited. "Although their decisions were risky, they still needed testing," he said. "We wanted to provide an affordable option to help people stay up-to-date with their sexual health testing, especially in times like this where many individuals are still taking precautions to avoid hospitals and clinics for non-essential reasons and routine services."

Over a thousand people have signed up for Current so far, according to Everlywell. The subscription sounds enticing in theory, especially in pandemic times: An STI test you don't have to leave your house for, all for 15 bucks a month.

But what do other doctors think?

Dr. Kim Langdon, OBGYN for Medzino, put it bluntly: "The websites that offer these tests claim that they do not claim to diagnose or treat any disease — so what is the point?" While Everlywell does state that their tests are, in fact, diagnostic, their website does say that if you test positive for an STI, you should visit a doctor and establish a treatment plan. The test includes a telehealth visit with a doctor if you get a positive result, during which you can get a prescription if necessary. But, depending on your situation, you may still need to seek in-person medical care.

Furthermore, tests are only one component of a diagnosis, said Michael Tahery MD, an OBGYN in Los Angeles with subspecialty training in urogynecology. He told Mashable that a lot of home testing kits are user-dependent. "How well a person is willing to poke their finger and get enough blood [for] the sample...makes all the difference," said Tahery.

To that, Ong said that this sampling issue is called "Quantity Not Sufficient" or QNS. Everlywell's QNS rate for their sexual health tests ranges between 4 percent to less than 1 percent, said Ong, depending on the test. "It’s slightly higher for specimens using dried blood spot collection (4 percent or less on average) than it is for swab or urine collection (less than 1 percent on average)," he said, "but still quite low across the board."

But even if the patient gathers a perfect sample, there still can be snags. If someone, say, thinks they might have gonorrhea or chlamydia due to discharge and orders that test, the test only tells them whether they have either STI. The test doesn't account for a myriad of other conditions that cause unusual discharge that a doctor can detect during an in-person visit.

"Maybe it's herpes. Maybe it's just a bacterial vaginosis. Maybe it is trichomoniasis," said Tahery. "It could end up not really taking care of the problem they have if [the test] gives them a sense of false reassurance." Indeed, Current's one test a month system won't benefit someone who has a different infection than what they ordered.

On three of their tests — chlamydia/gonorrhea, trichomoniasis, and syphilis — the FAQs say that the test will give you results within greater than 99 percent accuracy. Kecia Gaither, MD, MPH, FACOG, OBGYN and Director of Perinatal Services at NYC Health + Hospitals/Lincoln, said that at-home STI testing has about a 92 percent efficacy as compared to a lab, which has 98 percent efficacy.

"As a physician I think if there is a concern for a sexually transmitted infection, a physicians' visit is recommended," said Gaither. "A history and a physical exam — inclusive of a pelvic will be had — blood, wet prep of vaginal secretions, and cultures will be obtained. Any prescription for antibiotics or anti-viral medications can be prescribed."

Like Tahery, Gaither pointed out that the patient may have an issue going on other than what their Current test detects. She said, "There may be other conditions that are present that may not be appreciated on a home test outside of a physicians' watchful eyes."

Tahery does see some value in these tests. If, for example, someone can't get access to routine medical care, an affordable STI test could help. (They would still have to go to a doctor if the test came out positive, however.) He also gave the example of a young person who doesn’t want their parents to know they’re sexually active but wants to get tested. (The tests are in discreet packages, though for some people that may not be enough to ensure privacy.)

Then there's the case of someone who doesn't want to visit a doctor over COVID concerns — but again, one test doesn't have all the answers. Moreover, Tahery thinks using Current could lead to over-testing. The National Coalition for Sexual Health recommends getting tested at least once every six months if you have multiple partners.

If someone wants an STI test monthly, Tahery wonders if testing is sufficient. "Shouldn't someone talk to this person and discuss safe sex and birth control?" he asked. "There's so many other things that are missing out of the picture than just doing one test and [leaving] it."

Not everyone in the United States has access to medical care; that's an unfortunate fact. For those who do, visiting a doctor will provide more answers than a monthly STI test delivered to you — as well as advice on how to prevent them in the future. For those who don't, Current may provide some peace of mind, as long as the user is aware of the drawbacks.

UPDATE: Oct. 9, 2020, 2:54 p.m. EDT This article has been updated with clarifications from Everlywell.