Pilot study of the utility and acceptability of tampon sampling for the diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis infections by duplex realtime polymerase chain reaction in United Kingdom sex workers

Abstract

We aimed to evaluate the acceptability of self-collected tampon samples for the screening of female sex workers for sexually transmitted infections. We recruited 65 sex workers, and 63 agreed to provide tampon samples. The tampon samples were processed by realtime polymerase chain reaction (PCR) targeting Neisseria gonorrhoeae and Chlamydia trachomatis. Urethral and endocervical swabs were also obtained from 61 of 63 participants and tested using culture (N. gonorrhoeae) and the BD ProbeTec strand displacement amplification (SDA) (C. trachomatis) assay. Tampon sampling was preferred by 95% of the women and all favoured being tested away from genitourinary medicine clinics; the most common reasons cited were avoidance of embarrassment (40%) and convenience (30%). Besides near-universal acceptability of tampon sampling, the tampon sampling-PCR approach described in this study appeared to have enhanced sensitivity compared with conventional testing, suggesting the possibility of a residual hidden burden of N. gonorrhoeae and/or C. trachomatis genital infections in UK female sex workers.

Obtaining Self-Samples to Diagnose Curable Sexually Transmitted Infections: A Systematic Review of Patients’ Experiences

“…Thirty-six studies recorded participants’ experience of or opinion on self-sampling [ 3 , 5 , 16 , 17 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ] ( S1 Table ). Pooled results from these studies shows that self-sampling is a highly acceptable method with 85% of patients reporting the method to be well-received and acceptable ( Table 2 ).…”

“…Pooled results from these studies shows that self-sampling is a highly acceptable method with 85% of patients reporting the method to be well-received and acceptable ( Table 2 ). Seventeen studies described participants’ desire to self-sample rather than clinician sampling [ 16 , 17 , 24 , 25 , 27 , 29 , 30 , 31 , 32 , 35 , 36 , 38 , 40 , 43 , 45 , 46 , 47 ]. Seven of these compared participants’ preferences for self- versus clinician- administered sampling after undergoing both procedures [ 25 , 29 , 32 , 35 , 36 , 45 , 46 ].…”

“…A strong preference for clinician-sampling was justified by participants’ perception of physicians as experts in sample taking [ 35 ]. An additional ten studies compared participants’ preferences after performing self-sampling against hypothetical physician-sampling and showed a strong preference for the former option [ 16 , 17 , 24 , 27 , 30 , 31 , 38 , 40 , 43 , 47 ]. Some participants with no preferences were in favour for the most accurate test whichever it may be [ 27 ].…”

“…Twenty-eight studies recorded participants’ views on the ease of use of self-sampling methods[ 3 , 5 , 22 , 24 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 38 , 39 , 40 , 41 , 42 , 43 , 46 , 47 , 48 , 50 , 51 , 52 , 53 ] ( S1 Table ). On average, 88% of patients reported that self-sampling was ‘very easy’, ‘easy’ or ‘not difficult’ to perform ( Table 2 ).…”

“…Participants’ opinions on the preferred location for self-sampling was assessed in 11 studies [ 3 , 5 , 32 , 33 , 39 , 40 , 41 , 46 , 48 , 49 , 58 ] ( S1 Table ). Findings from these studies suggest that participants prefer to self-sample at home (65%) than in clinic (44%) ( Table 2 ).…”