Acceptability of self-sampling for etiological diagnosis of mucosal sexually transmitted infections (STIs) among transgender women in a longitudinal cohort study in São Paulo, Brazil

McCartney, Daniel; Pinheiro, Thiago Félix; Gómez, José Luis Valdespino; Carvalho, Paula Galdino Cardin de; Vera, Maria Amélia; Mayaud, Philippe

doi:10.1016/j.bjid.2022.102356

Cited by 13 publications

(13 citation statements)

References 15 publications

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Section: Resultsmentioning

confidence: 99%

“…Acceptability for SS was high (80.0%–100.0%; n=21) 28 30 32–35 41 42 44–46 49–52 55–60. Participants found SS easy (n=14) and comfortable (ie, painless; n=9), and would recommend it to others (n=3) 28 30 33 35 41 44–46 49 51 52 57–60. Only one study in MSM from China reported a lower acceptability for rectal SS (43.6%; 133 of 306) but 100% acceptability for urine SS (306 of 306) 55…”

Section: Resultsmentioning

confidence: 99%

“…Preference for SS over clinician sampling ranged from 23.1% (823 of 3082) to 83.7% (429 of 512) (n=13) 28 30 32 34 42–44 49 51 52 58–60. High trust in accuracy and privacy were cited as reasons for preferring SS (n=3) 44 51 60…”

Section: Resultsmentioning

confidence: 99%

“…Feasibility was evaluated in 10 studies 33–35 42 44 51 52 55 57 60. SS completion rate was high (83.8% (341 of 363)–99.0% (346 of 350); n=5) 35 42 44 55 57.…”

Section: Resultsmentioning

confidence: 99%

“…SS completion rate was high (83.8% (341 of 363)–99.0% (346 of 350); n=5) 35 42 44 55 57. Reasons for refusing or choosing SS were documented in four other studies 51 52 59 60. Participants in a European study were willing to pay between €10 and €20 for at-home SS 33…”

Section: Resultsmentioning

confidence: 99%

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Self-sampling strategies (with/without digital innovations) in populations at risk ofChlamydia trachomatisandNeisseria gonorrhoeae: a systematic review and meta-analyses

et al. 2023

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BackgroundChlamydia trachomatis(CT) andNeisseria gonorrhoeae(GC) resulted in over 200 million new sexually transmitted infections last year. Self-sampling strategies alone or combined with digital innovations (ie, online, mobile or computing technologies supporting self-sampling) could improve screening methods. Evidence on all outcomes has not yet been synthesised, so we conducted a systematic review and meta-analysis to address this limitation.MethodsWe searched three databases (period: 1 January 2000–6 January 2023) for reports on self-sampling for CT/GC testing. Outcomes considered for inclusion were: accuracy, feasibility, patient-centred and impact (ie, changes in linkage to care, first-time testers, uptake, turnaround time or referrals attributable to self-sampling).We used bivariate regression models to meta-analyse accuracy measures from self-sampled CT/GC tests and obtain pooled sensitivity/specificity estimates. We assessed quality with Cochrane Risk of Bias Tool-2, Newcastle–Ottawa Scale and Quality Assessment of Diagnostic Accuracy Studies-2 tool.ResultsWe summarised results from 45 studies reporting self-sampling alone (73.3%; 33 of 45) or combined with digital innovations (26.7%; 12 of 45) conducted in 10 high-income (HICs; n=34) and 8 low/middle-income countries (LMICs; n=11). 95.6% (43 of 45) were observational, while 4.4% (2 of 45) were randomised clinical trials.We noted that pooled sensitivity (n=13) for CT/GC was higher in extragenital self-sampling (>91.6% (86.0%–95.1%)) than in vaginal self-sampling (79.6% (62.1%–90.3%)), while pooled specificity remained high (>99.0% (98.2%–99.5%)).Participants found self-sampling highly acceptable (80.0%–100.0%; n=24), but preference varied (23.1%–83.0%; n=16).Self-sampling reached 51.0%–70.0% (n=3) of first-time testers and resulted in 89.0%–100.0% (n=3) linkages to care. Digital innovations led to 65.0%–92% engagement and 43.8%–57.1% kit return rates (n=3).Quality of studies varied.DiscussionSelf-sampling had mixed sensitivity, reached first-time testers and was accepted with high linkages to care. We recommend self-sampling for CT/GC in HICs but additional evaluations in LMICs. Digital innovations impacted engagement and may reduce disease burden in hard-to-reach populations.PROSPERO registration numberCRD42021262950.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Feasibility was evaluated in 10 studies 33–35 42 44 51 52 55 57 60. SS completion rate was high (83.8% (341 of 363)–99.0% (346 of 350); n=5) 35 42 44 55 57.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Self-sampling strategies (with/without digital innovations) in populations at risk ofChlamydia trachomatisandNeisseria gonorrhoeae: a systematic review and meta-analyses

et al. 2023

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“I felt special!”: a qualitative study of peer‐delivered HIV self‐tests, STI self‐sampling kits and PrEP for transgender women in Uganda

Mujugira,

Karungi,

Mugisha

et al. 2023

J Int AIDS Soc.

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IntroductionPeer delivery is a client‐centred approach that could maximize the coverage and impact of HIV services for transgender women (TGW). We conducted qualitative interviews to examine how peer‐delivered HIV self‐testing (HIVST), sexually transmitted infection self‐sampling (STISS) and oral pre‐exposure prophylaxis (PrEP) influenced prevention choices among TGW and their intimate partners in Uganda.MethodsWithin a cluster randomized trial of peer‐delivered HIVST, STISS and PrEP among HIV‐negative TGW (NCT04328025), we conducted 55 qualitative interviews with 30 TGW, 15 intimate partners and 10 TGW peers (August 2021–February 2022). TGW interviews explored: (1) HIV self‐test and PrEP experiences; (2) HIVST with intimate partners; and (3) descriptions of self‐sampling for STI testing. Partner interviews covered: (1) experiences with HIVST; (2) disclosure of HIV status to intimate partner; and (3) descriptions of sexual behaviours after testing. Peer interview topics included: (1) intervention delivery experiences; and (2) recommendations for peer‐delivered HIV prevention services to TGW, including psychological support and coping strategies. Qualitative data were analysed using an inductive content analytic approach.ResultsPeer‐delivered combination prevention was valued by this group of TGW and their partners. (1) Peer services extended beyond delivering HIV/STI kits and PrEP refills to caring for individual health and wellbeing by providing stigma coping strategies. Peer psychosocial support empowered research participants to become “HIVST ambassadors,” teach non‐study TGW about self‐testing and PrEP, and encourage linkage to care. (2) HIVST with intimate partners and mutual disclosure of HIV status strengthened partnered relationships. PrEP use after both partners tested HIV negative implied infidelity. (3) Self‐sampling enabled TGW to take control of their STI testing and avoid the embarrassment of exposing their bodies. Privacy and confidentiality motivated the uptake of STI testing and treatment.ConclusionsIn this sample of TGW from Uganda, peer delivery of HIVST, STISS and PrEP refills benefitted individual prevention efforts and extended to a new linkage of TGW not engaged in care. Integrating peer services into differentiated PrEP delivery could increase HIV/STI test coverage and PrEP use in this vulnerable population.

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Access Barriers in Testing for Sexually Transmitted Infections across Gender and Sexual Identities

Khan,

Culbreath,

Goldstein

et al. 2024

Clinics in Laboratory Medicine

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Acceptability of self-sampling for etiological diagnosis of mucosal sexually transmitted infections (STIs) among transgender women in a longitudinal cohort study in São Paulo, Brazil

Cited by 13 publications

References 15 publications

Self-sampling strategies (with/without digital innovations) in populations at risk ofChlamydia trachomatisandNeisseria gonorrhoeae: a systematic review and meta-analyses

Self-sampling strategies (with/without digital innovations) in populations at risk ofChlamydia trachomatisandNeisseria gonorrhoeae: a systematic review and meta-analyses

“I felt special!”: a qualitative study of peer‐delivered HIV self‐tests, STI self‐sampling kits and PrEP for transgender women in Uganda

Access Barriers in Testing for Sexually Transmitted Infections across Gender and Sexual Identities

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