BACKGROUND: Identification of sexually transmitted infections (STI) is limited by the infrequent assessment of rectal STI. This study assesses usability of self-collected rectal swabs (SRS) in diagnosing rectal Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). METHODS: In 2006 to 2007, clients of the Amsterdam and South Limburg STI outpatient clinics reporting receptive anal intercourse were asked to fill out a questionnaire and provide SRS. A standard provider-collected rectal swab (PRS) was also taken, and both were tested for CT and NG by a nucleic acid amplification tests. SRS performance was compared with PRS as to agreement, sensitivity, and specificity. RESULTS: Prevalence of rectal CT was 11% among the 1458 MSM and 9% among the 936 women. Rectal NG prevalence was 7% and 2%. In 98% of both MSM and women, SRS and PRS yielded concordant CT test results, for NG agreement was 98% for MSM and 99.4% for women. SRS performance for CT and NG diagnosis was good in both groups and was comparable for both study regions. Slightly more (57% of MSM, 62% of women) preferred SRS to PRS or had no preference; 97% would visit the STI clinic again if SRS was standard practice. CONCLUSIONS: Because anal sex is a common practice for MSM and women, and anal STI are frequently present, rectal screening should be an essential part of an STI consultation. SRS is a feasible, valid, and acceptable alternative for MSM and women attending STI clinics, and hence should be considered for other settings as well.
BACKGROUND: Identification of sexually transmitted infections (STI) is limited by the infrequent assessment of rectal STI. This study assesses usability of self-collected rectal swabs (SRS) in diagnosing rectal Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). METHODS: In 2006 to 2007, clients of the Amsterdam and South Limburg STI outpatient clinics reporting receptive anal intercourse were asked to fill out a questionnaire and provide SRS. A standard provider-collected rectal swab (PRS) was also taken, and both were tested for CT and NG by a nucleic acid amplification tests. SRS performance was compared with PRS as to agreement, sensitivity, and specificity. RESULTS: Prevalence of rectal CT was 11% among the 1458 MSM and 9% among the 936 women. Rectal NG prevalence was 7% and 2%. In 98% of both MSM and women, SRS and PRS yielded concordant CT test results, for NG agreement was 98% for MSM and 99.4% for women. SRS performance for CT and NG diagnosis was good in both groups and was comparable for both study regions. Slightly more (57% of MSM, 62% of women) preferred SRS to PRS or had no preference; 97% would visit the STI clinic again if SRS was standard practice. CONCLUSIONS: Because anal sex is a common practice for MSM and women, and anal STI are frequently present, rectal screening should be an essential part of an STI consultation. SRS is a feasible, valid, and acceptable alternative for MSM and women attending STI clinics, and hence should be considered for other settings as well.
Authors: Julia R Raifman; Kelly A Gebo; William Christopher Mathews; Philip Todd Korthuis; Khalil G Ghanem; Judith A Aberg; Richard D Moore; Ank E Nijhawan; Anne K Monroe; Stephen A Berry Journal: J Acquir Immune Defic Syndr Date: 2017-12-01 Impact factor: 3.731
Authors: Julia L Marcus; Jonathan E Volk; Jess Pinder; Albert Y Liu; Oliver Bacon; C Bradley Hare; Stephanie E Cohen Journal: Curr HIV/AIDS Rep Date: 2016-04 Impact factor: 5.071
Authors: Alan G Nyitray; Joseph T Hicks; Lu-Yu Hwang; Sarah Baraniuk; Margaret White; Stefanos Millas; Nkechi Onwuka; Xiaotao Zhang; Eric L Brown; Michael W Ross; Elizabeth Y Chiao Journal: Sex Transm Infect Date: 2017-08-23 Impact factor: 3.519
Authors: Nicholas Yared; Keith Horvath; Oluwaseun Fashanu; Ran Zhao; Jason Baker; Shalini Kulasingam Journal: Sex Transm Dis Date: 2018-05 Impact factor: 2.830
Authors: Joshua D Trebach; C Patrick Chaulk; Kathleen R Page; Susan Tuddenham; Khalil G Ghanem Journal: Sex Transm Dis Date: 2015-05 Impact factor: 2.830