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Poster Presentations
PS02 – POSTER VIEWING SESSION – TUESDAY
Tuesday, July 16, 2019 5:45 PM – 7:00 PM
P628 The impact of including throat and rectal swabs for chlamydia and gonorrhea testing online in british columbia, canada
Free
  1. Aidan Ablona1,
  2. Troy Grennan1,
  3. Trevor Hart2,
  4. Jean Shoveller3,
  5. Joseph Cox4,
  6. Gina Ogilvie5,
  7. Mel Krajden6,
  8. Christopher Fairley7,
  9. Devon Haag1,
  10. Mark Gilbert1
  1. 1BC Centre for Disease Control, Clinical Prevention Services, Vancouver, Canada
  2. 2Ryerson University, Psychology, Toronto, Canada
  3. 3University of British Columbia, School of Population and Public Health, Vancouver, Canada
  4. 4McGill University, Epidemiology, Biostatistics and Occupational Health, Montreal, Canada
  5. 5BC Women’s Hospital, Women’s Health Research Institute, Vancouver, Canada
  6. 6BC Centre for Disease Control, Public Health Laboratory, Vancouver, Canada
  7. 7Monash University, Central Clinical School, Carlton, Australia

Abstract

Background GetCheckedOnline (GCO) is a comprehensive, online sexually-transmitted infection (STI) testing service in British Columbia, Canada, which includes urine nucleic acid amplification testing (NAAT) for chlamydia (CT) and gonorrhea (GC). In 2016, responding to mounting evidence of missed infections with urine-only screening, self-collected throat and rectal swabs were added. We aimed to describe missed infections with urine-only screening.

Methods We retrospectively analyzed all CT/GC-related testing episodes conducted through GCO in 2016–2018. Urine testing is recommended for all GCO clients. Rectal swabs are recommended to clients reporting receptive anal sex in the past 3 months; throat swabs are recommended to men who have sex with men (MSM) who indicate giving oral sex in the past 3 months. We described prevalence by site and quantified the proportion of CT/GC infections missed with urine-only screening.

Results Of 10,724 CT/GC urine test episodes, 2746 (25.6%) and 2288 (21.3%) included throat and rectal swabs, respectively. 95.0% and 86.0% of clients recommended for throat and rectal swab testing submitted samples, respectively. Among women, 3760 CT/GC urine test episodes were conducted, with 560 (14.9%) including rectal swabs. Percent positivity by infection-site was 3.6% CT-urine, 3.0% CT-rectal, 0.1% GC-urine, and 0.2% GC-rectal. Urine testing alone detected 95.3% of CT/GC infections. Among MSM, 3088 CT/GC urine test episodes were conducted, with 2587 (83.8%) including throat swabs and 1635 (52.9%) including rectal swabs. Percent positivity by infection-site was 1.5% CT-urine, 0.7% CT-throat, 5.1% CT-rectal, 0.5% GC-urine, 2.4% GC-throat, and 2.8% GC-rectal. Urine testing alone detected only 25.4% of all CT/GC infections.

Conclusion The majority of GCO clients recommended for self-collected throat and rectal swabs submitted samples. Approximately three-quarters of CT/GC infections among MSM would have been missed if swabs had not been offered. Online STI testing services should provide comprehensive biospecimen collection when indicated to facilitate CT/GC detection and treatment.

Disclosure No significant relationships.

  • Neisseria gonorrhoeae

https://doi.org/10.1136/sextrans-2019-sti.696

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