Objectives Despite a high risk of human papillomavirus (HPV) infection among men who have sex with men (MSM), few have ever tested. This study aimed to evaluate the feasibility and accuracy of HPV self-sampling among Chinese MSM, with the purpose of measuring the feasibility of self-sampling as an alternative in HPV testing scenarios.
Methods Eligible participants were those who were assigned male at birth, aged 18 or above, had sex with men in the past year and had never gotten HPV vaccine. Participants followed the instructions to self-sample and were also clinician-sampled from the same anatomical sites (oral fluid, penis and rectum) in both approaches. All specimens were processed using multiplex PCR assay. The reference standard of an individual with a true positive for HPV is determined via PCR test, regardless of sampling methods. Sensitivity and specificity were calculated for each approach independently and kappa test was used to assess the consistency between the two approaches.
Results Overall, 211 MSM were recruited at the local clinic from April to October 2020 in Zhuhai, China. The mean age was 31 years old. Only 3% of the participants sought help from healthcare providers during self-sampling. The prevalence of HPV was 49% (103 of 211). Clinician sampling detected 91 of 103 MSM infected with HPV, with a sensitivity of 88.3% (95% CI 80.2 to 93.6) and a specificity of 100.0% (95% CI 95.7 to 100.0). Self-sampling detected 81 of 103 MSM infected with HPV, with a sensitivity of 78.6% (95% CI 69.2 to 85.9) and a specificity of 100.0% (95% CI 95.7 to 100.0). The level of agreement was moderate between clinician sampling and self-sampling (k=0.67).
Conclusions Self-sampled HPV testing demonstrated comparable accuracy and consistency to clinician sampling among MSM in China. It holds the potential to complement sexual health services especially among key populations.
- Diagnostic Screening Programs
- Homosexuality, Male
- SEXUAL HEALTH
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information.
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Handling editor Federico Garcia
YN and YL contributed equally.
NL and WT contributed equally.
Contributors YN, YiL and SG drafted the manuscript. YN, YiL, XH, YuL, NL and WT contributed to study design. YN, YiL, XH, YuL, YoL, SG, CX, XW, NL and WT contributed to the development and implementation of study procedures. YN, YiL, XH, YoL, JJO, XY, YT and WT participated in the statistical analysis and interpretation of the findings. WT is responsible for the overall content as the guarantor. All authors critically reviewed and edited the manuscript.
Funding This work was supported by the National Key Research and Development Program of China (2017YFE0103800).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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