@article {Alexander488, author = {S Alexander and C Ison and J Parry and C Llewellyn and S Wayal and D Richardson and A Phillips and H Smith and M Fisher}, title = {Self-taken pharyngeal and rectal swabs are appropriate for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae in asymptomatic men who have sex with men}, volume = {84}, number = {6}, pages = {488--492}, year = {2008}, doi = {10.1136/sti.2008.031443}, publisher = {The Medical Society for the Study of Venereal Disease}, abstract = {Introduction: Self-taken specimens from men who have sex with men (MSM) could be important in reducing high levels of demand on sexual health services. The performance of self-taken specimens for the detection of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) from both pharyngeal and rectal sites in asymptomatic MSM was assessed.Methods: MSM were examined according to clinic protocol: a rectal and pharyngeal swab for GC culture and a rectal swab for the CT strand displacement assay. An extra set of nurse-taken and self-taken pharyngeal and rectal specimens were also requested and were tested using the Aptima Combo 2 assay and the result compared with the routine clinic result, which was considered the gold standard. Results: A total of 272 MSM was recruited and the sensitivity and specificity of nurse-taken and patient-taken swabs, respectively, was as follows: rectal GC: 94.9\% and 90.1\% (nurse); 92.3\% and 87.9\% (patient); pharyngeal GC: 88.2\% and 91.8\% (nurse); 100\% and 87.8\% (patient); rectal CT: 80.0\% and 99.6\% (nurse); 91.4\% and 98.2\% (patient). No significant difference in sensitivity or specificity was observed between the nurse-taken and the patient-taken rectal swabs for either GC or CT. For the detection of GC from the pharynx, comparable sensitivities were achieved between nurse-taken and patient-taken swabs (pā€Š=ā€Š0.5); however, a significant difference in specificity was observed (pā€Š=ā€Š0.006). This was due to a higher number of false GC-positive self-taken pharyngeal swabs from patients with high rates (90.9\%; 10/11) of confirmed concurrent GC infection in different anatomical sites. Conclusions: MSM are able to collect self-taken rectal and pharyngeal swabs that are comparable to those taken by clinicians.}, issn = {1368-4973}, URL = {https://sti.bmj.com/content/84/6/488}, eprint = {https://sti.bmj.com/content/84/6/488.full.pdf}, journal = {Sexually Transmitted Infections} }