UW STD Prevention Training Center · Health education
By tailoring visual aids to diverse populations and integrating them into community health programs, we helped ensure that self-testing reaches the most vulnerable.
The challenge
The CDC estimates that over 26 million new cases of sexually transmitted diseases occur each year.1 Infections can persist for an extended period, and most people are unaware they are infected until advanced symptoms appear.2
Screening is critical to stemming person-to-person spread, and it is the first step toward successful treatment.3 Bacterial STIs disproportionately affect HIV-infected men who have sex with men compared with HIV-uninfected MSM — while screening for gonorrhea and chlamydia at extragenital sites, the pharynx and the rectum, remains low.4
UW PTC recognized that this gap was driving underdiagnosis and continued transmission, particularly in high-risk groups.5 They partnered with us to transform STI testing through a creative, accessible and scalable solution.
The build
We developed a series of self-test visual guides that standardize and simplify self-collection for pharyngeal, rectal and vaginal samples — empowering individuals to take control of their sexual health, improve testing rates, and reduce the burden of STIs nationally and internationally.
The approach
The guides leverage visual communication's power to overcome the real barriers to testing: lack of awareness, inconsistent practices and patient discomfort. The first iteration, in 2014, focused on pharyngeal and rectal self-testing, when screening at those sites hovered around 2.3–8.5%.4
Over the next eight years the project expanded to vaginal self-testing, acknowledging the importance of comprehensive screening for women. It then added a Spanish series and illustrations sensitive to diverse ethnic backgrounds, and moved to a universal design approach — in line with the National Network of STD Clinical Prevention Training Centers' call for welcoming, holistic clinical environments for vulnerable populations.8
In 2022 the UW team returned to make the series more inclusive — adjusting skin tones and adding 20 further language translations. We generated several palette options; in the end our teams settled on blue, green and purple, one for each testing type.
pharyngeal testing after implementation
rectal testing after implementation
languages the guides are available in
Findings presented by UW's Dr. Lindley Barbee at the 2014 CDC STD Prevention Conference: “Effectiveness and Patient Acceptability of a Self-Testing Intervention for STI in an HIV Primary Care Setting.” An STI self-testing program at a large HIV clinic led to significant increases in screening coverage.7
The craft
The process began with photo references shot against real sample swabs and test tubes provided by UW, moved to high-fidelity pencil sketches, then hand-drawn colour drafts, and finally to vector illustration.
Impact
found the Patient Assessment Form extremely helpful
found the throat poster extremely helpful
found the rectal poster extremely helpful
What makes this work unique is the fusion of evidence-based research with creative design. The project directly addresses the need to enhance the capacity and quality of STI services8 — as the NNPTC notes, providers must extend that capacity to extragenital chlamydia and gonorrhea testing to meet rising rates.8
The client was most pleased with the guides' ability to reach diverse audiences, and with the tangible impact they have had on increasing testing rates and improving patient experiences. The project models how visual communication can address a critical public health challenge and promote a more equitable approach to care.
In use by
“We have greatly increased our outreach from what was previously possible. Now that people can download our guides at will, and in 22 languages, we have been able to serve populations previously not reached.”
Jess Johnson
Continuing Education Coordinator, UW PTC
