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Erschienen in: Infection 2/2024

19.10.2023 | Research

Self-sampled multi-anatomic site testing for uncovering the community burden of undiagnosed Chlamydia trachomatis and Neisseria gonorrhoeae infection in men who have sex with men

verfasst von: Ngai Sze Wong, Denise Pui-Chung Chan, Sze Long Chung, Tsz Ho Kwan, Krystal Chi-Kei Lee, Chi Keung Kwan, Shui Shan Lee

Erschienen in: Infection | Ausgabe 2/2024

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Abstract

Purpose

To detect otherwise undiagnosed asymptomatic sexually transmitted infection (STI), and for estimating prevalence among men who have sex with men (MSM).

Methods

In this community-based study in Hong Kong, adult MSM were recruited. After completion of an online survey, free multi-anatomic sites self-sampling kits (urine specimens, pharyngeal and rectal swabs) for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) tests were delivered to requesting participants. Factors associated with STI positivity were analyzed in logistic regression.

Results

From September 2021 to October 2022, 712 MSM were recruited, with 86% aged 18–39, and 16% reported history of chemsex engagement. A majority (81%) had previously undergone HIV testing, 68% had ever tested for STI, and 35% previously diagnosed with STI. Totally 428 (60%) had requested self-sampling kits, and 276 (39%) returned collected samples. Among participants who returned the samples, about half had never been tested in the past and had no history of STI. Overall 21% tested positive for CT and/or NG (CT/NG)—CT positive 16% and NG positive 7%. By anatomic site, 16% of rectal swabs, 7% of pharyngeal swabs, but just 3% of urine specimens were CT/NG positive. The prevalence of CT/NG was not significantly different by history of STI diagnosis and testing.

Conclusion

Self-sampled STI testing is a potentially useful means for enhancing uptake of screening in MSM in the community, which could uncover otherwise undiagnosed asymptomatic infections. Internet-based self-sampling for STI testing could complement the current clinic-based STI testing for supporting epidemiologic evaluation of STI control in the community.
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Literatur
2.
Zurück zum Zitat Rowley J, Vander Hoorn S, Korenromp E, Low N, Unemo M, Abu-Raddad LJ, et al. Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016. Bull World Health Organ. 2019;97:548-562P.CrossRefPubMedPubMedCentral Rowley J, Vander Hoorn S, Korenromp E, Low N, Unemo M, Abu-Raddad LJ, et al. Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016. Bull World Health Organ. 2019;97:548-562P.CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Dewart CM, Bernstein KT, DeGroote NP, Romaguera R, Turner AN. Prevalence of rectal chlamydial and gonococcal infections: a systematic review. Sex Transm Dis. 2018;45:287–93.CrossRefPubMedPubMedCentral Dewart CM, Bernstein KT, DeGroote NP, Romaguera R, Turner AN. Prevalence of rectal chlamydial and gonococcal infections: a systematic review. Sex Transm Dis. 2018;45:287–93.CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Gray RT, Callander D, Hocking JS, McGregor S, McManus H, Dyda A, et al. Population-level diagnosis and care cascade for chlamydia in Australia. Sex Transm Infect. 2020;96:131–6.CrossRefPubMed Gray RT, Callander D, Hocking JS, McGregor S, McManus H, Dyda A, et al. Population-level diagnosis and care cascade for chlamydia in Australia. Sex Transm Infect. 2020;96:131–6.CrossRefPubMed
6.
Zurück zum Zitat Fistonich GM, Troutman KM, Visconti AJ. A pilot of mail-out HIV and sexually transmitted infection testing in Washington, District of Columbia during the COVID-19 pandemic. Am J Prev Med. 2021;61:S16–25.CrossRefPubMed Fistonich GM, Troutman KM, Visconti AJ. A pilot of mail-out HIV and sexually transmitted infection testing in Washington, District of Columbia during the COVID-19 pandemic. Am J Prev Med. 2021;61:S16–25.CrossRefPubMed
7.
Zurück zum Zitat Melendez JH, Hamill MM, Armington GS, Gaydos CA, Manabe YC. Home-based testing for sexually transmitted infections: leveraging online resources during the COVID-19 pandemic. Sex Transm Dis. 2021;48:e8–10.CrossRefPubMedPubMedCentral Melendez JH, Hamill MM, Armington GS, Gaydos CA, Manabe YC. Home-based testing for sexually transmitted infections: leveraging online resources during the COVID-19 pandemic. Sex Transm Dis. 2021;48:e8–10.CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Wilson E, Free C, Morris TP, Syred J, Ahamed I, Menon-Johansson AS, et al. Internet-accessed sexually transmitted infection (e-STI) testing and results service: a randomised, single-blind, controlled trial. PLoS Med. 2017;14:e1002479.CrossRefPubMedPubMedCentral Wilson E, Free C, Morris TP, Syred J, Ahamed I, Menon-Johansson AS, et al. Internet-accessed sexually transmitted infection (e-STI) testing and results service: a randomised, single-blind, controlled trial. PLoS Med. 2017;14:e1002479.CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Bernstein KT, Chow JM, Pathela P, Gift TL. Bacterial sexually transmitted disease screening outside the clinic–implications for the modern sexually transmitted disease program. Sex Transm Dis. 2016;43:S42-52.CrossRefPubMedPubMedCentral Bernstein KT, Chow JM, Pathela P, Gift TL. Bacterial sexually transmitted disease screening outside the clinic–implications for the modern sexually transmitted disease program. Sex Transm Dis. 2016;43:S42-52.CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Bloomfield PJ, Kent C, Campbell D, Hanbrook L, Klausner JD. Community-based chlamydia and gonorrhea screening through the United States mail San Francisco. Sex Transm Dis. 2002;29:294–7.CrossRefPubMed Bloomfield PJ, Kent C, Campbell D, Hanbrook L, Klausner JD. Community-based chlamydia and gonorrhea screening through the United States mail San Francisco. Sex Transm Dis. 2002;29:294–7.CrossRefPubMed
11.
Zurück zum Zitat Xu F, Stoner BP, Taylor SN, Mena L, Tian LH, Papp J, et al. Use of home-obtained vaginal swabs to facilitate rescreening for Chlamydia trachomatis infections: two randomized controlled trials. Obstet Gynecol. 2011;118:231–9.CrossRefPubMed Xu F, Stoner BP, Taylor SN, Mena L, Tian LH, Papp J, et al. Use of home-obtained vaginal swabs to facilitate rescreening for Chlamydia trachomatis infections: two randomized controlled trials. Obstet Gynecol. 2011;118:231–9.CrossRefPubMed
12.
Zurück zum Zitat Wong NS, Kwan TH, Chan DPC, Lui GCY, Lee SS. Regular testing of HIV and sexually transmitted infections with self-collected samples from multiple anatomic sites to monitor sexual health in men who have sex with men: longitudinal study. JMIR Form Res. 2022;6:e40996.CrossRefPubMedPubMedCentral Wong NS, Kwan TH, Chan DPC, Lui GCY, Lee SS. Regular testing of HIV and sexually transmitted infections with self-collected samples from multiple anatomic sites to monitor sexual health in men who have sex with men: longitudinal study. JMIR Form Res. 2022;6:e40996.CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Weng R, Ning N, Zhang C, Wen L, Ye J, Wang H, et al. 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. Front Public Health. 2022;10:992773.CrossRefPubMedPubMedCentral Weng R, Ning N, Zhang C, Wen L, Ye J, Wang H, et al. 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. Front Public Health. 2022;10:992773.CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Le Roux M, Ngwenya IK, Nemarude AL, De Villiers BE, Mathebula M, Nchabeleng M. Sexually transmitted infections and sexual behaviour among men having sex with men from Tshwane South Africa. Int J STD AIDS. 2023;34:183–90.CrossRefPubMed Le Roux M, Ngwenya IK, Nemarude AL, De Villiers BE, Mathebula M, Nchabeleng M. Sexually transmitted infections and sexual behaviour among men having sex with men from Tshwane South Africa. Int J STD AIDS. 2023;34:183–90.CrossRefPubMed
15.
Zurück zum Zitat Rahman MM, Johnson C, Taylor SN, Peterman TA, Bennett TS, Haydel D, et al. Extragenital sexually transmitted infection testing among Louisiana Parish Health Units, 2016–2019. Sex Transm Dis. 2023;50:274–9.CrossRefPubMedPubMedCentral Rahman MM, Johnson C, Taylor SN, Peterman TA, Bennett TS, Haydel D, et al. Extragenital sexually transmitted infection testing among Louisiana Parish Health Units, 2016–2019. Sex Transm Dis. 2023;50:274–9.CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Wong HT, Wong KH, Lee SS, Leung RW, Lee KC. Community-based surveys for determining the prevalence of HIV, chlamydia, and gonorrhoea in men having sex with men in Hong Kong. J Sex Transm Dis. 2013;2013:958967.PubMedPubMedCentral Wong HT, Wong KH, Lee SS, Leung RW, Lee KC. Community-based surveys for determining the prevalence of HIV, chlamydia, and gonorrhoea in men having sex with men in Hong Kong. J Sex Transm Dis. 2013;2013:958967.PubMedPubMedCentral
17.
Zurück zum Zitat Chan DPC, Ho S, Lam JC, Chan TC. Community-based HIV and STI screening in men who have sex with men in Hong Kong. IJID. 2018;73:336–7. Chan DPC, Ho S, Lam JC, Chan TC. Community-based HIV and STI screening in men who have sex with men in Hong Kong. IJID. 2018;73:336–7.
18.
Zurück zum Zitat Chau CT, Ho KM, Ho CK. Screening of asymptomatic Chlamydia trachomatis and Neisseria gonorrhoeae infections among men who have sex with men in Hong Kong. HK J Dermatol Venereol. 2016;24:113–9. Chau CT, Ho KM, Ho CK. Screening of asymptomatic Chlamydia trachomatis and Neisseria gonorrhoeae infections among men who have sex with men in Hong Kong. HK J Dermatol Venereol. 2016;24:113–9.
20.
Zurück zum Zitat Chan PA, Robinette A, Montgomery M, Almonte A, Cu-Uvin S, Lonks JR, et al. Extragenital Infections Caused by Chlamydia trachomatis and Neisseria gonorrhoeae: a review of the literature. Infect Dis Obstet Gynecol. 2016;2016:5758387.CrossRefPubMedPubMedCentral Chan PA, Robinette A, Montgomery M, Almonte A, Cu-Uvin S, Lonks JR, et al. Extragenital Infections Caused by Chlamydia trachomatis and Neisseria gonorrhoeae: a review of the literature. Infect Dis Obstet Gynecol. 2016;2016:5758387.CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Mustanski B, Feinstein BA, Madkins K, Sullivan P, Swann G. Prevalence and risk factors for rectal and urethral sexually transmitted infections from self-collected samples among young men who have sex with men participating in the Keep It Up! 2.0 randomized controlled trial. Sex Transm Dis. 2017;44:483–8.CrossRefPubMedPubMedCentral Mustanski B, Feinstein BA, Madkins K, Sullivan P, Swann G. Prevalence and risk factors for rectal and urethral sexually transmitted infections from self-collected samples among young men who have sex with men participating in the Keep It Up! 2.0 randomized controlled trial. Sex Transm Dis. 2017;44:483–8.CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Aitlhaj-Mhand R, Bellaji B, Jennane S, Remz C, Charof R, Khoudri I, et al. Assessment of Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis prevalence using a molecular point of care: findings from a respondent driven sampling study among MSM. Infez Med. 2023;31:234–42.PubMedPubMedCentral Aitlhaj-Mhand R, Bellaji B, Jennane S, Remz C, Charof R, Khoudri I, et al. Assessment of Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis prevalence using a molecular point of care: findings from a respondent driven sampling study among MSM. Infez Med. 2023;31:234–42.PubMedPubMedCentral
23.
Zurück zum Zitat Jansen K, Steffen G, Potthoff A, Schuppe AK, Beer D, Jessen H, et al. STI in times of PrEP: high prevalence of chlamydia, gonorrhea, and mycoplasma at different anatomic sites in men who have sex with men in Germany. BMC Infect Dis. 2020;20:110.CrossRefPubMedPubMedCentral Jansen K, Steffen G, Potthoff A, Schuppe AK, Beer D, Jessen H, et al. STI in times of PrEP: high prevalence of chlamydia, gonorrhea, and mycoplasma at different anatomic sites in men who have sex with men in Germany. BMC Infect Dis. 2020;20:110.CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Zhang X, Jia M, Chen M, Luo H, Chen H, Luo W, et al. Prevalence and the associated risk factors of HIV, STIs and HBV among men who have sex with men in Kunming China. Int J STD AIDS. 2017;28:1115–23.CrossRefPubMed Zhang X, Jia M, Chen M, Luo H, Chen H, Luo W, et al. Prevalence and the associated risk factors of HIV, STIs and HBV among men who have sex with men in Kunming China. Int J STD AIDS. 2017;28:1115–23.CrossRefPubMed
25.
Zurück zum Zitat Dudareva-Vizule S, Haar K, Sailer A, Wisplinghoff H, Wisplinghoff F, Marcus U, et al. Prevalence of pharyngeal and rectal Chlamydia trachomatis and Neisseria gonorrhoeae infections among men who have sex with men in Germany. Sex Transm Infect. 2014;90:46–51.CrossRefPubMed Dudareva-Vizule S, Haar K, Sailer A, Wisplinghoff H, Wisplinghoff F, Marcus U, et al. Prevalence of pharyngeal and rectal Chlamydia trachomatis and Neisseria gonorrhoeae infections among men who have sex with men in Germany. Sex Transm Infect. 2014;90:46–51.CrossRefPubMed
26.
Zurück zum Zitat Ivey K, Bernstein KT, Kirkcaldy RD, Kissinger P, Edwards OW, Sanchez T, Abara WE. Chemsex drug use among a national sample of sexually active men who have sex with men,—American men’s internet survey, 2017–2020. Subst Use Misuse. 2023;58:728–34.CrossRefPubMedPubMedCentral Ivey K, Bernstein KT, Kirkcaldy RD, Kissinger P, Edwards OW, Sanchez T, Abara WE. Chemsex drug use among a national sample of sexually active men who have sex with men,—American men’s internet survey, 2017–2020. Subst Use Misuse. 2023;58:728–34.CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Wong NS, Kwan TH, Lee KCK, Lau JYC, Lee SS. Delineation of chemsex patterns of men who have sex with men in association with their sexual networks and linkage to HIV prevention. Int J Drug Policy. 2020;75:102591.CrossRefPubMed Wong NS, Kwan TH, Lee KCK, Lau JYC, Lee SS. Delineation of chemsex patterns of men who have sex with men in association with their sexual networks and linkage to HIV prevention. Int J Drug Policy. 2020;75:102591.CrossRefPubMed
28.
Zurück zum Zitat Kampman CJG, Heijne JCM, Kistemaker-Koedijk PHM, Koedijk FDH, Visser M, Hautvast JLA. Determinants of frequent and infrequent STI testing and STI diagnosis related to test frequency among men who have sex with men in the eastern part of the Netherlands: a 6-year retrospective study. BMJ Open. 2018;8:e020495.CrossRefPubMedPubMedCentral Kampman CJG, Heijne JCM, Kistemaker-Koedijk PHM, Koedijk FDH, Visser M, Hautvast JLA. Determinants of frequent and infrequent STI testing and STI diagnosis related to test frequency among men who have sex with men in the eastern part of the Netherlands: a 6-year retrospective study. BMJ Open. 2018;8:e020495.CrossRefPubMedPubMedCentral
29.
Zurück zum Zitat Crowell TA, Nitayaphan S, Sirisopana N, Wansom T, Kitsiripornchai S, Francisco L, et al. Factors associated with testing for HIV and other sexually transmitted infections in men who have sex with men and transgender women in Bangkok, Thailand. AIDS Res Ther. 2022;19:25.CrossRefPubMedPubMedCentral Crowell TA, Nitayaphan S, Sirisopana N, Wansom T, Kitsiripornchai S, Francisco L, et al. Factors associated with testing for HIV and other sexually transmitted infections in men who have sex with men and transgender women in Bangkok, Thailand. AIDS Res Ther. 2022;19:25.CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat O’Connor L, O’Donnell K, Barrett P, Hickson FCI, McCartney D, Quinlan M, et al. Use of geosocial networking applications is independently associated with diagnosis of STI among men who have sex with men testing for STIs: findings from the cross-sectional MSM Internet Survey Ireland (MISI) 2015. Sex Transm Infect. 2019;95:279–84.CrossRefPubMed O’Connor L, O’Donnell K, Barrett P, Hickson FCI, McCartney D, Quinlan M, et al. Use of geosocial networking applications is independently associated with diagnosis of STI among men who have sex with men testing for STIs: findings from the cross-sectional MSM Internet Survey Ireland (MISI) 2015. Sex Transm Infect. 2019;95:279–84.CrossRefPubMed
31.
Zurück zum Zitat Shrestha R, Lim SH, Altice FL, Copenhaver M, Wickersham JA, Saifi R, et al. Use of smartphone to seek sexual health information online among Malaysian men who have sex with men (MSM): implications for mHealth intervention to increase HIV testing and reduce HIV risks. J Community Health. 2020;45:10–9.CrossRefPubMedPubMedCentral Shrestha R, Lim SH, Altice FL, Copenhaver M, Wickersham JA, Saifi R, et al. Use of smartphone to seek sexual health information online among Malaysian men who have sex with men (MSM): implications for mHealth intervention to increase HIV testing and reduce HIV risks. J Community Health. 2020;45:10–9.CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Grov C, Stief M, Westmoreland DA, MacCrate C, Mirzayi C, Nash D, et al. Maximizing response rates to ads for free at-home HIV testing on a men-for-men geosocial sexual networking app: lessons learned and implications for researchers and providers. Health Educ Behav. 2020;47:5–13.CrossRefPubMedPubMedCentral Grov C, Stief M, Westmoreland DA, MacCrate C, Mirzayi C, Nash D, et al. Maximizing response rates to ads for free at-home HIV testing on a men-for-men geosocial sexual networking app: lessons learned and implications for researchers and providers. Health Educ Behav. 2020;47:5–13.CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat Wilson E, Leyrat C, Baraitser P, Free C. Does internet-accessed STI (e-STI) testing increase testing uptake for chlamydia and other STIs among a young population who have never tested? Secondary analyses of data from a randomised controlled trial. Sex Transm Infect. 2019;95:569–74.CrossRefPubMed Wilson E, Leyrat C, Baraitser P, Free C. Does internet-accessed STI (e-STI) testing increase testing uptake for chlamydia and other STIs among a young population who have never tested? Secondary analyses of data from a randomised controlled trial. Sex Transm Infect. 2019;95:569–74.CrossRefPubMed
34.
Zurück zum Zitat Ogale Y, Yeh PT, Kennedy CE, Toskin I, Narasimhan M. Self-collection of samples as an additional approach to deliver testing services for sexually transmitted infections: a systematic review and meta-analysis. BMJ Glob Health. 2019;4:e001349.CrossRefPubMedPubMedCentral Ogale Y, Yeh PT, Kennedy CE, Toskin I, Narasimhan M. Self-collection of samples as an additional approach to deliver testing services for sexually transmitted infections: a systematic review and meta-analysis. BMJ Glob Health. 2019;4:e001349.CrossRefPubMedPubMedCentral
Metadaten
Titel
Self-sampled multi-anatomic site testing for uncovering the community burden of undiagnosed Chlamydia trachomatis and Neisseria gonorrhoeae infection in men who have sex with men
verfasst von
Ngai Sze Wong
Denise Pui-Chung Chan
Sze Long Chung
Tsz Ho Kwan
Krystal Chi-Kei Lee
Chi Keung Kwan
Shui Shan Lee
Publikationsdatum
19.10.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
Infection / Ausgabe 2/2024
Print ISSN: 0300-8126
Elektronische ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-023-02107-7

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