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Self-screening for Neisseria gonorrhoeae and Chlamydia trachomatis in the human immunodeficiency virus clinic--high yields and high acceptability.
Sex Transm Dis. 2011 Dec; 38(12):1107-9.ST

Abstract

BACKGROUND

Despite antiretroviral therapy (ART), incident human immunodeficiency virus (HIV) continues to rise, and sexually transmitted infections (STI) are well known for their part in HIV transmission. National guidelines recommend routine STI screening in HIV-positive individuals, but despite this, reported uptake remains low.

METHODS

We implemented a nurse-led self-screening program for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) in asymptomatic HIV patients. Self-collected samples were tested for CT and GC using the GenProbe Aptima Combo 2 assay. Clinical records were reviewed for ART history, CD4 T-cell count, and plasma viral load. A screening service evaluation questionnaire was handed out.

RESULTS

During an 8-month period, 976 screens were performed. In all, 143 infections were detected which would have been missed without the screening program. Overall prevalence of infection among men who have sex with men was 17.4%: rectal CT and GC, 9.8% (56/571) and 4.2% (24/571), respectively; urethal CT and GC, 2.6% (16/605) and 1.3% (8/605), respectively; and pharyngeal CT and GC, 1.7% (10/589) and 3.9% (23/589), respectively. Among heterosexual men and women, the rates of CT were 2.1% (3/141) and 1.5% (3/201), and there was no GC. Transient viremia was observed at the time of STI diagnosis in 6 patients on ART. All men who have sex with men and most women found self-swabbing acceptable, and most patients indicated that they would like to be offered testing in future.

CONCLUSION

These findings highlight the need for the introduction of similar screening approaches in HIV clinics. Self-collected specimens using sensitive and specific GC and CT nucleic acid amplification tests are a convenient and acceptable way of testing, and it may address some of the barriers to screening in this population.

Authors+Show Affiliations

Department of Genitourinary Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK. suneetasoni@gmail.comNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22082720

Citation

Soni, Suneeta, and John A. White. "Self-screening for Neisseria Gonorrhoeae and Chlamydia Trachomatis in the Human Immunodeficiency Virus Clinic--high Yields and High Acceptability." Sexually Transmitted Diseases, vol. 38, no. 12, 2011, pp. 1107-9.
Soni S, White JA. Self-screening for Neisseria gonorrhoeae and Chlamydia trachomatis in the human immunodeficiency virus clinic--high yields and high acceptability. Sex Transm Dis. 2011;38(12):1107-9.
Soni, S., & White, J. A. (2011). Self-screening for Neisseria gonorrhoeae and Chlamydia trachomatis in the human immunodeficiency virus clinic--high yields and high acceptability. Sexually Transmitted Diseases, 38(12), 1107-9. https://doi.org/10.1097/OLQ.0b013e31822e6136
Soni S, White JA. Self-screening for Neisseria Gonorrhoeae and Chlamydia Trachomatis in the Human Immunodeficiency Virus Clinic--high Yields and High Acceptability. Sex Transm Dis. 2011;38(12):1107-9. PubMed PMID: 22082720.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Self-screening for Neisseria gonorrhoeae and Chlamydia trachomatis in the human immunodeficiency virus clinic--high yields and high acceptability. AU - Soni,Suneeta, AU - White,John A, PY - 2011/11/16/entrez PY - 2011/11/16/pubmed PY - 2012/3/20/medline SP - 1107 EP - 9 JF - Sexually transmitted diseases JO - Sex Transm Dis VL - 38 IS - 12 N2 - BACKGROUND: Despite antiretroviral therapy (ART), incident human immunodeficiency virus (HIV) continues to rise, and sexually transmitted infections (STI) are well known for their part in HIV transmission. National guidelines recommend routine STI screening in HIV-positive individuals, but despite this, reported uptake remains low. METHODS: We implemented a nurse-led self-screening program for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) in asymptomatic HIV patients. Self-collected samples were tested for CT and GC using the GenProbe Aptima Combo 2 assay. Clinical records were reviewed for ART history, CD4 T-cell count, and plasma viral load. A screening service evaluation questionnaire was handed out. RESULTS: During an 8-month period, 976 screens were performed. In all, 143 infections were detected which would have been missed without the screening program. Overall prevalence of infection among men who have sex with men was 17.4%: rectal CT and GC, 9.8% (56/571) and 4.2% (24/571), respectively; urethal CT and GC, 2.6% (16/605) and 1.3% (8/605), respectively; and pharyngeal CT and GC, 1.7% (10/589) and 3.9% (23/589), respectively. Among heterosexual men and women, the rates of CT were 2.1% (3/141) and 1.5% (3/201), and there was no GC. Transient viremia was observed at the time of STI diagnosis in 6 patients on ART. All men who have sex with men and most women found self-swabbing acceptable, and most patients indicated that they would like to be offered testing in future. CONCLUSION: These findings highlight the need for the introduction of similar screening approaches in HIV clinics. Self-collected specimens using sensitive and specific GC and CT nucleic acid amplification tests are a convenient and acceptable way of testing, and it may address some of the barriers to screening in this population. SN - 1537-4521 UR - https://www.unboundmedicine.com/medline/citation/22082720/Self_screening_for_Neisseria_gonorrhoeae_and_Chlamydia_trachomatis_in_the_human_immunodeficiency_virus_clinic__high_yields_and_high_acceptability_ L2 - https://doi.org/10.1097/OLQ.0b013e31822e6136 DB - PRIME DP - Unbound Medicine ER -