Article Text
Abstract
Introduction Self-taken vulvovaginal swabs analysed by nucleic acid amplification tests (NAATs) for chlamydia and gonorrhoea are standard practice worldwide. Extra-genital sampling (rectum and pharynx) is becoming increasingly important in women, with evidence that urogenital sampling alone may miss infections. Yet, little is known about women’s views of extra-genital sampling. We explored the acceptability of self-taken extra-genital samples for women as part of a clinician versus self-taken extra-genital sampling study.
Methods Women attending a sexual health clinic were invited to participate in a ‘swab yourself’ trial. After randomisation, both clinician and self-taken samples for chlamydia and gonorrhoea NAATs from vulvovaginal, pharyngeal and rectal sites were taken. Participants were then invited to complete a questionnaire about the extra-genital sampling.
Results 400 surveys were returned from 402 women recruited (response rate >99%), age range 17–57 (mean 25.2) years.
75% disagreed/strongly disagreed with the statement ‘taking my own samples was difficult’. 72% agreed/strongly agreed that they felt confident taking their own swabs but 30.5% agreed/strongly agreed they felt uncomfortable taking their own swabs; of these 53 (43%) stated they had never had anal sex. 42% agreed/strongly agreed that they would prefer to take their own samples compared to 34% who agreed/strongly agreed they would prefer clinician-taken swabs. 66% agreed/strongly agreed they would be happy to take the samples themselves in a non-clinic setting.
Free comments covered themes of ‘more confidence if had clinician samples taken before’, ‘concerns if self-swabbing would give correct results’. Nine commented specifically on discomfort, but none disagreed with the statement ‘I would be happy to take my own swabs in a non-clinic environment’.
Conclusion Extra-genital sampling was highly acceptable to the majority of women, with high levels of confidence and low reports of discomfort. This has positive implications for the future of extra-genital testing in women, especially in non-clinic settings.
Disclosure of interest statement Dr Janet Wilson has received honoraria and travel and accommodation expenses from BD Diagnostics, and research grants in the form of diagnostic kits from Hologic/Gen-Probe.