Evaluation of Self-Collected Versus Health Care Professional (HCP)-Performed Sampling and the Potential Impact on the Diagnostic Results of Asymptomatic Sexually Transmitted Infections (STIs) in High-Risk Individuals
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population and Procedures
2.2. Statistical Analysis
3. Results
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Global Progress Report on HIV, Viral Hepatitis and Sexually Transmitted Infections. 2021. Available online: https://www.who.int/publications/i/item/9789240027077 (accessed on 13 July 2023).
- CDC. STD Diagnoses among Key US Populations, 5-Year Trends. 2018. Available online: https://www.cdc.gov/nchhstp/newsroom/docs/2018/table-data-2018-STD-Prevention-Conference.pdf (accessed on 13 July 2023).
- Preventing HIV and STI among Men Who Have Sex with Men—An ECDC Guidance. 2015. Available online: https://www.ecdc.europa.eu/en/news-events/preventing-hiv-and-sti-among-men-who-have-sex-men-ecdc-guidance (accessed on 13 July 2023).
- Danby, C.S.; Cosentino, L.A.; Rabe, L.K.; Priest, C.L.; Damare, K.C.; Macio, I.S.; Meyn, L.A.; Wiesenfeld, H.C.; Hillier, S.L. Patterns of Extragenital Chlamydia and Gonorrhea in Women and Men Who Have Sex with Men Reporting a History of Receptive Anal Intercourse. Sex. Transm. Dis. 2016, 43, 105–109. [Google Scholar] [CrossRef] [PubMed]
- Dudareva-Vizule, S.; Haar, K.; Sailer, A.; Wisplinghoff, H.; Wisplinghoff, F.; Marcus, U. Prevalence of pharyngeal and rectal Chlamydia trachomatis and Neisseria gonorrhoeae infections among men who have sex with men in Germany. Sex. Transm. Infect. 2014, 90, 46–51. [Google Scholar] [CrossRef] [PubMed]
- Reinton, N.; Moi, H.; Olsen, A.O.; Zarabyan, N.; Bjerner, J.; Tønseth, T.M.; Moghaddam, A. Anatomic distribution of Neisseria gonorrhoeae, Chlamydia trachomatis and Mycoplasma genitalium infections in men who have sex with men. Sex. Health 2013, 10, 199–203. [Google Scholar] [CrossRef]
- Streeck, H.; Jansen, K.; Crowell, T.A.; Esber, A.; Jessen, H.K.; Cordes, C.; Scholten, S.; Schneeweiss, S.; Brockmeyer, N.; Spinner, C.D.; et al. HIV pre-exposure prophylaxis was associated with no impact on sexually transmitted infection prevalence in a high-prevalence population of predominantly men who have sex with men, Germany, 2018 to 2019. Eurosurveillance 2022, 27, 2100591. [Google Scholar] [CrossRef]
- Dewart, C.M.; Bernstein, K.T.; DeGroote, N.P.; Romaguera, R.; Turner, A.N. Prevalence of Rectal Chlamydial and Gonococcal Infections: A Systematic Review. Sex. Transm. Dis. 2018, 45, 287–293. [Google Scholar] [CrossRef] [PubMed]
- Spinner, C.D.; Boesecke, C.; Jordan, C.; Wyen, C.; Kümmerle, T.; Knecht, G.; Scholten, S.; Zink, A.; Krznaric, I.; Noe, S. Prevalence of asymptomatic sexually transmitted infections in HIV-positive men who have sex with men in Germany: Results of a multicentre cross-sectional study. Infection 2018, 46, 341–347. [Google Scholar] [CrossRef] [PubMed]
- Jansen, K.; Steffen, G.; Potthoff, A.; Schuppe, A.K.; Beer, D.; Jessen, H.; Scholten, S.; Spornraft-Ragaller, P.; Bremer, V.; Tiemann, C. STI in times of PrEP: High prevalence of chlamydia, gonorrhea, and mycoplasma at different anatomic sites in men who have sex with men in Germany. BMC Infect. Dis. 2020, 20, 110. [Google Scholar] [CrossRef] [PubMed]
- Harvey-Lavoie, S.; Apelian, H.; Labbé, A.C.; Cox, J.; Messier-Peet, M.; Moodie, E.E.M.; Fourmigue, A.; Moore, D.; Lachowsky, N.J.; Grace, D.; et al. Community-Based Prevalence Estimates of Chlamydia trachomatis and Neisseria gonorrhoeae Infections among Gay, Bisexual, and Other Men Who Have Sex with Men in Montréal, Canada. Sex. Transm. Dis. 2021, 48, 939–944. [Google Scholar] [CrossRef] [PubMed]
- Kularadhan, V.; Gan, J.; Chow, E.P.F.; Fairley, C.K.; Ong, J.J. HIV and STI Testing Preferences for Men Who Have Sex with Men in High-Income Countries: A Scoping Review. Int. J. Environ. Res. Public Health 2022, 19, 3002. [Google Scholar] [CrossRef]
- Ryom, L.; De Miguel, R.; Cotter, A.G.; Podlekareva, D.; Beguelin, C.; Waalewijn, H.; Arribas, J.R.; Mallon, P.W.G.; Marzolini, C.; Kirk, O.; et al. Major revision version 11.0 of the European AIDS Clinical Society Guidelines 2021. HIV Med. 2022, 23, 849–858. [Google Scholar] [CrossRef]
- Spinner, C.D.; Lang, G.F.; Boesecke, C.; Jessen, H.; Schewe, K. Summary of German-Austrian HIV PrEP guideline. HIV Med. 2019, 20, 368–376. [Google Scholar] [CrossRef]
- Vialard, F.; Anand, A.; Leung Soo, C.; de Waal, A.; McGuire, M.; Carmona, S.; Fernández-Suárez, M.; Zwerling, A.A.; Pant Pai, N. Self-sampling strategies (with/without digital innovations) in populations at risk of Chlamydia trachomatis and Neisseria gonorrhoeae: A systematic review and meta-analyses. Sex. Transm. Infect. 2023, 99, 420. [Google Scholar] [CrossRef]
- Wilson, J.D.; Wallace, H.E.; Loftus-Keeling, M.; Ward, H.; Davies, B.; Vargas-Palacios, A.; Hulme, C.; Wilcox, M.H. Swab-yourself Trial With Economic Monitoring and Testing for Infections Collectively (SYSTEMATIC): Part 1. A Diagnostic Accuracy and Cost-effectiveness Study Comparing Clinician-taken vs Self-taken Rectal and Pharyngeal Samples for the Diagnosis of Gonorrhea and Chlamydia. Clin. Infect. Dis. 2021, 73, e3172–e3180. [Google Scholar] [CrossRef]
- McNicol, J.; Debattista, J. Use of the UriSwab collection device for testing of Chlamydia trachomatis and Neisseria gonorrhoeae: Implications for a postal testing service. Int. J. STD AIDS 2013, 24, 477–480. [Google Scholar] [CrossRef]
- Costa, A.G.; Garland, S.M.; Guy, R.; Wand, H.; Tabrizi, S.N. UriSwab: An effective transport medium for nucleic acid detection of Chlamydia trachomatis, Mycoplasma genitalium and Neisseria gonorrhoeae. Sex. Health 2017, 14, 502–506. [Google Scholar] [CrossRef] [PubMed]
- Freeman, A.H.; Bernstein, K.T.; Kohn, R.P.; Philip, S.; Rauch, L.M.; Klausner, J.D. Evaluation of self-collected versus clinician-collected swabs for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae pharyngeal infection among men who have sex with men. Sex. Transm. Dis. 2011, 38, 1036–1039. [Google Scholar] [CrossRef] [PubMed]
Total | Berlin | Cologne | Munich | |
---|---|---|---|---|
Subjects enrolled in the study | 236 | 80 | 79 | 77 |
Age [years] | 37 | 37 | 39 | 36.5 |
(Q1; Q3) | (31; 44.75) | (31; 42) | (31; 47) | (32; 43) |
Missing values, n (%) | 26 (11.0) | |||
Born in Germany, n | 174 | 63 | 60 | 51 |
(%) | (76.0) | (80.8) | (76.9) | (65.4) |
Missing values, n (%) | 7 (3.0) | |||
Living with HIV, n | 44 | 7 | 28 | 9 |
(%) | (18.8) | (8.8) | (35.0) | (11.2) |
Missing values, n (%) | 2 (0.8) | |||
Identifying as MSM, n | 207 | 69 | 72 | 66 |
(%) | (89.6) | (87.3) | (91.1) | (83.5) |
Missing values, n (%) | 5 (2.1) | |||
Having more than 2 sex partners in the last 3 months, n | 181 | 60 | 62 | 59 |
(%) | (76.7) | (75.0) | (77.5) | (73.8) |
Missing values, n (%) | 0 (0.0) |
Reference | Self-Sampling | HCP-Sampling | |||||
---|---|---|---|---|---|---|---|
Positive in Either Sample | n | Sensitivity | Specifity | n | Sensitivity | Specifity | |
C. trachomatis | |||||||
Oropharyngeal swab | 5 | 4 | 0.80 (0.28; 0.99) | 0.97 (0.94; 0.99) | 3 | 0.60 (0.15; 0.95) | 0.99 (0.97; 1.00) |
Rectal swab | 23 | 22 | 0.96 (0.78; 1.00) | 0.86 (0.81; 0.90) | 21 | 0.91 (0.72; 0.99) | 0.90 (0.86; 0.94) |
Urethral swab/urine | 5 | 5 | 1.00 (0.48; 1.00) | 0.96 (0.93; 0.98) | 5 | 1.00 (0.48; 1.00) | 0.96 (0.93; 0.98) |
N. gonorrhoeae | |||||||
Oropharyngeal swab | 13 | 9 | 0.69 (0.39; 0.91) | 0.98 (0.94; 1.00) | 12 | 0.92 (0.64; 1.00) | 0.98 (0.96; 1.00) |
Rectal swab | 13 | 13 | 1.00 (0.75; 1.00) | 0.95 (0.91; 0.98) | 13 | 1.00 (0.75; 1.00) | 1.00 (0.98; 1.00) |
Urethral swab/urine | 2 | 2 | 1.00 (0.16; 1.00) | 0.98 (0.96; 1.00) | 2 | 1.00 (0.16; 1.00) | 0.98 (0.96; 1.00) |
C. trachomatis | ||
Positive in self- and HCP-performed sampling (n) | Only positive in self-sampling (n) | Only positive in HCP-performed-sampling (n) |
30 | 2 | 2 |
1 positive oropharyngeal and anal swab in self-testing, both tests negative when tested by HCPs(HCP-performed sampling first) | 1 positive anal swab in HCP-performed testing and an invalid swab when using self-sampling (HCP-performed sampling first) | |
1 positive oropharyngeal and anal swab in self-testing, invalid anal swab, negative oropharyngeal swab (HCP-performed sampling first) | 1 positive oral swab by the HCP and a negative swab from self-sampling (self-sampling first) | |
N. gonorrhoeae | ||
Positive in self- and HCP performed sampling (n) | Only positive in self-sampling (n) | Only positive in HCP-performed-sampling (n) |
20 | 1 | 2 |
1 positive oropharyngeal swab (HCP-performed sampling first), but CT positive in both sampling methods | 1 positive oropharyngeal swab in HCP-performed sampling, but invalid in self-sampling (self-sampling first) | |
1 positive oropharyngeal swab in HCP-performed sampling, but negative in self-sampling (self-sampling first) |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Weidlich, S.; Schellberg, S.; Scholten, S.; Schneider, J.; Lee, M.; Rothe, K.; Wantia, N.; Spinner, C.D.; Noe, S. Evaluation of Self-Collected Versus Health Care Professional (HCP)-Performed Sampling and the Potential Impact on the Diagnostic Results of Asymptomatic Sexually Transmitted Infections (STIs) in High-Risk Individuals. Infect. Dis. Rep. 2023, 15, 470-477. https://doi.org/10.3390/idr15050047
Weidlich S, Schellberg S, Scholten S, Schneider J, Lee M, Rothe K, Wantia N, Spinner CD, Noe S. Evaluation of Self-Collected Versus Health Care Professional (HCP)-Performed Sampling and the Potential Impact on the Diagnostic Results of Asymptomatic Sexually Transmitted Infections (STIs) in High-Risk Individuals. Infectious Disease Reports. 2023; 15(5):470-477. https://doi.org/10.3390/idr15050047
Chicago/Turabian StyleWeidlich, Simon, Sven Schellberg, Stefan Scholten, Jochen Schneider, Marcel Lee, Kathrin Rothe, Nina Wantia, Christoph D. Spinner, and Sebastian Noe. 2023. "Evaluation of Self-Collected Versus Health Care Professional (HCP)-Performed Sampling and the Potential Impact on the Diagnostic Results of Asymptomatic Sexually Transmitted Infections (STIs) in High-Risk Individuals" Infectious Disease Reports 15, no. 5: 470-477. https://doi.org/10.3390/idr15050047