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Self-sampling for oropharyngeal and rectal specimens to screen for sexually transmitted infections: acceptability among men who have sex with men
  1. S Wayal1,
  2. C Llewellyn1,
  3. H Smith1,
  4. M Hankins1,
  5. A Phillips2,
  6. D Richardson2,
  7. M Fisher
  1. 1
    Division of Primary Care and Public Health, Brighton and Sussex Medical School, Falmer, Brighton, UK
  2. 2
    Department of Genitourinary Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
  1. Ms Sonali Wayal, Room 323, Mayfield House, Division of Primary Care and Public Health, Brighton and Sussex Medical School, Falmer, Brighton BN1 9PH, UK; S.Wayal{at}bsms.ac.uk; sonaliwayal{at}yahoo.com

Abstract

Objectives: To explore the feasibility and acceptability of self-sampling for oropharyngeal and rectal specimens to screen for sexually transmitted infections (STIs) among men who have sex with men (MSM). Participant’s willingness to self-sample at home was also explored.

Methods: Participants of a study to evaluate the sensitivity and specificity of self versus nurse taken oropharyngeal and rectal specimens were surveyed to assess the feasibility and acceptability of self-sampling using specimen collection methods (gargle, OraSure mouth pad to collect oropharyngeal specimens and APTIMA unisex swabs to collect rectal and pharyngeal specimens). Acceptability was measured using a five-point Likert-type response scale (for example, 1 =  strongly disagree; 5 =  strongly agree). Open-ended questions explored participants’ experiences of self-sampling.

Results: Of 334 eligible MSM, 301 (90%) participated in the study. Altogether, 301 participants self-sampled using gargle and rectal and pharyngeal swabs and 288 using mouth pad. Complete questionnaire data from 274 participants showed that feasibility and acceptability of self-sampling using gargle and mouth pad was higher (92%) than pharyngeal swabs (76%). Rectal swabs were acceptable to 82% participants. Despite some discomfort and difficulty in using swabs, 76% were willing to use all four methods for self-sampling in the future. Home sampling was acceptable (84%) as it was perceived to be less intrusive and more convenient than a clinic visit and likely to reduce genitourinary medicine (GUM) waiting time.

Conclusions: Self-sampling for rectal and oropharyngeal specimens is feasible and acceptable to MSM. Self-sampling can be offered as an alternative to clinic-based testing and has the potential to improve choice, access and uptake of screening for STIs.

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Footnotes

  • ▸ An appendix is published online only at http://sti.bmj.com/content/vol85/issue1

  • Funding: This study was supported by Medical Research Council (MRC) Sexual Health and HIV Research Strategy Committee, UK programme grant (G03000706) awarded to Fisher et al. Wayal’s salary was supported through this grant. The design and implementation of the study was independent from the funding body and the views expressed are those of the authors and not necessarily those of the MRC or the Health Departments.

  • Competing interests: APTIMA unisex swabs were provided free of costs by Gen-Probe (San Diego, California, USA). The findings reported in this study do not reflect the opinion of Gen-Probe.

  • Ethics approval: Ethics approval was obtained from the Brighton and Mid Sussex Research Ethics Committee.

  • Contributors: SW: study management, data analysis and interpretation, wrote first and subsequent drafts of the manuscripts and final approval of the published version; CL: study design, study management, critical appraisal and final approval; HS: conception and study design, interpretation of the data and critical appraisal and final approval; MH: conception and study design, interpretation of data and critical appraisal and final approval; AP: data collection and final approval; DR: data collection and final approval; MF: conception and study design, critical appraisal and final approval.

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