Acceptability of rectal self-sampling in non-clinical venues for chlamydia and gonorrhea testing among men who have sex with men: A cross-sectional study in Shenzhen, China

Abstract

BackgroundRectal Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections among men who have sex with men (MSM) have become an increasingly important concern. The study aimed to explore (1) the acceptability of rectal self-sampling for chlamydia and gonorrhea testing among MSM in non-clinical venues in Shenzhen city, China; (2) factors associated with the acceptability of rectal self-sampling; and (3) factors associated with rectal CT and NG infections, respectively.MethodsThis cross-sectional study was conducted in two non-clinical settings in Shenzhen, China, from April 2021 to October 2021. Mixed-effects logistic regression analysis was performed to explore the factors associated with acceptance of rectal self-collection for CT and NG testing.ResultsOf the 306 MSM who were offered to perform rectal self-sampling, 133 (43.46%) accepted, and 96.24% (128/133) of them successfully provided a valid rectal sample. The prevalence of urogenital CT and NG infections among 303 MSM was 4.29 and 0.66%, respectively. The prevalence of rectal CT and NG infections among 128 participants was 31.25 and 9.38%, respectively. Participants having been diagnosed with HIV infection showed a higher acceptance of rectal self-collection for CT and NG testing.ConclusionThis study reported that rectal self-sampling in non-clinical venues for CT and NG testing among MSM was barely acceptable and feasible in China. Most CT and NG infections would have been missed if urethral screening was offered alone, which implies that the CT and NG screening should be scaled up in the above setting. Integrating free CT tests into regular STI interventions for MSM could also be considered.

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

“…Eighty per cent of studies (36 of 45) detected newly diagnosed positive CT/GC infections and 42.2% of studies (19 of 45) measured test accuracy 16 17 20 22–55. Seventeen studies reported 2×2 table values 22 28 30–33 35 36 38–43 51–53.…”

“…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.…”

“…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…”

“…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.…”

“…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 55 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).…”