Preparing for the Chlamydia and Gonorrhea Self-Test

Abstract

New technology may soon allow individuals to test themselves for chlamydia and gonorrhea. These new self-tests might help increase screening, but they will also bring new issues for treatment, prevention, and surveillance. Providers will need to decide how to respond to patients who present after a positive screening test and how to approach partner testing and treatment. Research will be needed to identify approaches to increase screening using these tests. Laboratory-based surveillance will not capture infections if testing does not involve a laboratory, so new surveillance techniques will be needed. Self-tests are new tools that will soon be available. We should be prepared to use them.

Giving syphilis and gonorrhea to friends: using in-person friendship networks to find additional cases of gonorrhea and syphilis

“…If a traditional approach to contact tracing is maintained, intervention trials can test whether index cases will be more likely to report both social and sexual contacts if they know that contacts will be offered selfadministered mail-in tests or even self-testing resources for STIs that may be perceived as less intrusive, more accessible in rural areas, and more convenient than referral to clinics [28][29][30][31][32]; internet-accessed STI testing may be particularly effective in reaching young adults who have never been tested for STI [33].…”

Giving syphilis and gonorrhea to friends: Using in-person friendship networks to find additional cases of gonorrhea and syphilis

“…If a traditional approach to contact tracing is maintained, intervention trials can test whether index cases will be more likely to report both social and sexual contacts if they know that contacts will be offered self-administered mail-in tests or even self-testing resources for STIs that may be perceived as less intrusive, more accessible in rural areas, and more convenient than referral to clinics ( 28 -32); internet-accessed STI testing may be particularly effective in reaching young adults who have never been tested for STI (33).…”

Bridging the gap between development of point-of-care nucleic acid testing and patient care for sexually transmitted infections

“…Peterman and colleagues are similarly concerned that selftests for gonorrhea and chlamydia may have potential problems such as poor test accuracy and low predictive value. 332 For this testing format, they note that approaches that use small stand-alone testing units may still be impractical for self-tests; instead, more promising are test cartridges that can be attached to smartphones for both powering the test cartridges and detecting amplified products. Furthermore, a smartphone app might also directly report the positive test to the state or local health department and assist in linking patients to a provider for treatment though such a link might discourage testing among persons who want to remain anonymous.…”

“…Furthermore, a smartphone app might also directly report the positive test to the state or local health department and assist in linking patients to a provider for treatment though such a link might discourage testing among persons who want to remain anonymous. 332 Devices for home-use, sold over the counter, would ideally be non-instrumented (other than smartphone-based detection), and as easy to use as lateral flow strips currently sold in drug stores. In this setting, paper devices with a low-temperature isothermal NAAT method (e.g., RPA) may have an edge.…”