Public Health in the Rockies 2026

Background: Syphilis remains a public health priority nationally and in Colorado. Test Yourself Colorado (TYC) is an online, at-home STI testing program administered by the Denver Sexual Health Clinic that provides free mailed HIV tests and/or gonorrhea (GC) and chlamydia (CT) testing statewide. In 2026, TYC launched a pilot at-home syphilis self-testing program as an additional service for clients reporting never having syphilis.

Methods: The TYC at-home syphilis pilot utilizes the First to Know® Syphilis Test, the first FDA authorized over-the-counter self-administered test. The test utilizes fingerstick blood and results in 15 minutes. Clients are provided with resources for seeking further clinical evaluation in the event of reactive results. Syphilis test kits were offered as part of TYC first from 2/15/2026 -2/28/26 and then again starting 4/10/2026. We report initial programmatic results from the syphilis at-home testing pilot program as of 5/8/2026. Future evaluations will assess client satisfaction and barriers to use.

Results: During the pilot, 417 total orders were placed with TYC. Of these, 154 (37%) included a syphilis test. Of syphilis orders, 45 (29%) were among cis-men; 106 (69%) were among cis-women; 2 (1%) were among trans clients. Eighty-seven (56%) syphilis orders were among White, Non-Hispanic individuals; 7 (5%) were among Black non-Hispanic clients; and 31 (20%) were among Hispanic clients. The remaining orders (29; 19%) were among individuals who preferred not to answer the race/ethnicity question or who identified as a different race/ethnicity. Fifteen (10%) syphilis orders were among men who have sex with men.

Implications: Initial utilization of TYC’s at-home syphilis testing service indicated modest interest in the syphilis test. Ongoing efforts to promote the program in addition to the importance of syphilis screening among priority populations are merited. As efforts continue to address the syphilis epidemic, at-home testing services should be considered.