At-home rape kits offer privacy for sexual assault victims, but many public health experts don’t recommend them. Here’s why.

Rape kits have been a divisive topic for years. While they can be used as evidence in court, reports show that testing backlogs are common and that these kits are often placed in evidence storage, where they can languish for years. Even though federal law covers the cost of rape kits, some victims are still charged out-of-pocket costs to have them done. Finding a place to get a rape kit from a specially trained provider can also be challenging. In addition, some survivors feel uncomfortable having a rape kit collected and talking about what they experienced.

So it's not surprising that there is increasing interest in at-home sexual assault test kits. These tools have rape survivors take a test at home and submit it to a lab for testing. A popular option is Leda Health, which says on its website that the company views “sexual health through a survivor-focused lens.” However, Leda Health also says in small print on its website that it “does not claim to be a replacement for professional medical care,” adding, “We encourage survivors to report any assault to law enforcement and to visit their nearest hospitals for medical evaluation.” (A representative for Leda Health did not respond to Yahoo Life's request for comment.)

These at-home sexual assault test kits are controversial — more on that in a moment — but they're gotten plenty of attention lately. Here's what you need to know.

How do at-home rape test kits work?

There have been several home rape test kits that have hit the market, but many, like Preserve, appear to have gone out of business. Leda Health is the main one used by survivors who want to test themselves at home. Leda Health has survivors take swabs of their vagina and mouth to collect DNA samples after sexual assault and submit them to an accredited lab that has a track record of testing sexual assault kits, according to the company website. Test results take about eight weeks.

How soon do you need to use one?

Leda Health doesn't state online how soon after a sexual assault survivors need to use the kit. However, teens and adults can have evidence collected up to 120 hours after an assault for rape tests that are taken in medical centers, Dr. Karen Serrano, medical director of the forensic nursing program at the UNC School of Medicine, tells Yahoo Life.

Is the evidence collected given to police?

It's not clear. However, that doesn't appear to be the case. “Privacy is our top concern, and none of our labs will upload your data or DNA to any DNA database unless you consent or are required by law,” Leda Health says online.

Why are these at-home kits controversial?

Survivor advocates and many public health organizations discourage rape survivors from using home rape test kits. In some states, like Michigan, home rape test kits are banned from being sold, and other states are either considering doing the same or strongly discourage them.

What's the problem? There are a few. “A rape kit from home is not the same thing as a rape kit collected at a hospital,” Stefan Turkheimer, vice president for public policy at the Rape, Abuse & Incest National Network, tells Yahoo Life.

One issue is that survivors who take a home test kit don't get medical care that they may need, Audrey Boyles, SANE (sexual assault nurse examiner) clinical coordinator at UNC Health, tells Yahoo Life. Medical centers often have a SANE nurse who has been specially trained in treating rape survivors.

Many emergency rooms or rape crisis centers can also give victims treatments in advance, such as PrEP to lower the risk of contracting HIV or Plan B to prevent an unwanted pregnancy, Turkheimer says. And hospitals and rape crisis centers can also help support a survivor emotionally, he points out. If a kit is taken at home, that support isn't built in.

There is also the concern of maintaining chain of custody with home rape test kits. Evidence that is collected in a hospital or rape crisis center follows a strict chain of custody that has been established and overseen by law enforcement, according to sexual assault coalition Valor. This is also usually considered a trusted form of evidence that could later be used in court if the survivor wishes. It's unclear if that's the case with at-home sexual assault test kits. “I don't know that it could actually be used in an investigation,” Boyles says. “I don't believe there is infrastructure to maintain the integrity of the evidence collected by victims themselves.”

While private companies say that they have a process to track chain of custody, it's not approved by law enforcement, Valor points out. There have been no public cases of at-home kits being submitted as evidence, and their results are often not admissible in court proceedings, according to Valor.

“These at-home kits may be advertised as ‘evidence kits,’” Turkheimer says. “However, trained medical professionals are essential in collecting samples, examining and treating the victim, and preserving and testing evidence that is obtained during the exam. At-home kits should not be used where the identity of the perpetrator is at issue.” Turkheimer says he “strongly encourages” victims to obtain a medical exam from trained professionals.

“The companies that offer self-collection kits could potentially be doing a disservice to patients and victims, as victims do not receive the extensive training in evidence collection that Sexual Assault Nurse Examiners do,” Boyles says. “Not to mention, they would not be receiving the other aspects of care from a SANE, such as mental health screening, resources, assessment for injury, STI prevention and pregnancy prevention.”

Experts acknowledge that survivors may feel uncomfortable seeking medical care after going through a trauma like rape. However, they stress the importance of seeking care and having a rape test kit done by a trained professional.

“In North Carolina, adult patients have the option of having evidence collected anonymously. This means if the patient does not yet know if they would like to report to law enforcement, they can have evidence collected and preserved within 120 hours of experiencing an assault and make the decision to report or not within one year,” Boyles says. “The evidence will not be sent to the crime lab for processing until the patient reports. There is no consequence for an adult patient choosing to not report an assault that they themselves experienced.” (Every state is different, so it's worth checking your local legislation if you're unsure if you want to report a rape at this time.)

Dr. Creagh Boulger, an emergency medicine physician at The Ohio State University Wexner Medical Center, tells Yahoo Life that medical care providers try to minimize trauma when working with survivors. “The forensic nurses and providers collecting the kits care about the survivors, and we want to do everything we can to support you and avoid any further trauma,” she says.