Accurate self-testing helps remove stigma of checking for Sexually transmitted diseases
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Accurate self-testing helps remove stigma of checking for Sexually transmitted diseases
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Accurate self-testing helps remove stigma of checking for Sexually transmitted diseases.
If there’s one lesson the COVID-19 pandemic has taught us, it’s the value of being tested for infection at home without having to travel to a healthcare facility.
Now, a series of studies have found that testing for sexually transmitted infections (STIs) in one’s own home can remove the stigma associated with maintaining sexual health and improve treatment outcomes.
Another thing that has happened in the years following the COVID pandemic has been an increase in sexually transmitted infections. According to the Centers for Disease Control and Prevention, between 2020 and 2021, reported cases of chlamydia and gonorrhea in the United States increased by 4%, and syphilis increased by 32%, so testing and treatment for these curable diseases become a priority.
Self-testing for HIV and hepatitis C viruses is already available, prompting Monash University-led researchers to conduct the world’s first systematic review of syphilis self-testing (SST) research to assess its value.
Jason Ong, corresponding author of the study, said: “The COVID-19 pandemic has shown us the value of self-testing. Self-testing for syphilis is a key that opens the door to widespread testing and treatment, just as self-testing for HIV, Hepatitis C Hepatitis plays the same role as COVID-19.”
Spread by oral, vaginal, anal, pregnancy, and blood transfusions, syphilis is a preventable, curable bacterial sexually transmitted disease that can lead to serious health problems if left untreated.
The researchers looked at 11 publications from seven studies between 2000 and 2022 that included data on any syphilis rapid test or HIV-syphilis dual test. An SST is defined as any test performed by a person who collects the specimen, performs the test, and interprets the test results themselves.
When analyzing the data, the researchers considered testing accuracy, availability, proportion of participants who were tested (acceptance rate), number of participants who tested positive for syphilis, links to sexual health services or confirmatory testing after a positive test, Costs and any harm following the test, such as self-harm, pressure to test or disclose the results.
They found that SST had relatively high uptake and acceptability and a low per capita cost compared with facility-based testing. Participants indicated that reasons for using SST included convenience, privacy, rapid results, autonomy, empowerment, reduced contact with institutions, and saving money or time. However, the researchers also noted some important challenges, including a lack of understanding of SST and STIs, and privacy concerns when reporting results using apps or social media.
Overall, though, the researchers found compelling evidence that SST is safe, acceptable, effectively administered, and cost-effective, especially in populations that are not typically covered by existing medical services. They concluded that the potential benefits of SST outweighed any potential risks.
“If we can increase the availability of syphilis self-testing, we can also have a significant impact on the current syphilis epidemic in Australia and beyond,” said Ong. “This has global implications for countries licensing and allowing syphilis self-testing kits. impact, so that people who are unlikely to go to a medical facility for testing can self-test privately, accurately, and conveniently.”
Meanwhile, two studies presented at the 2023 Annual Science Meeting & Clinical Lab Expo in Anaheim evaluated the effectiveness of self-tests for detecting common sexually transmitted infections, human papillomavirus (HPV), chlamydia, and gonorrhea. reliability. The expo is sponsored by the Association for Diagnostic and Laboratory Medicine (formerly the American Association for Clinical Chemistry (AACC)).
Human papillomavirus, the main cause of cervical cancer, is a common virus that is transmitted sexually from person to person. Currently, HPV is detected by taking a cervical swab in a clinical setting.
In one study, researchers from LetsGetChecked Laboratories and Permanente Medical Group compared the HPV test results of 144 pairs of self-collected cervical swabs with those collected at a healthcare facility. Some of these self-collected samples were exposed to temperatures that simulated extreme weather fluctuations. They found that most self-collected samples had the same results as those collected by providers. The difference was due to the low amount of detectable virus in the samples, which was caused by exposure to extreme temperatures. After showing the instructional video to the participants, sample effectiveness increased by 8.5%.
In another study, researchers from the Los Angeles County Department of Public Health and LetsGetChecked Laboratories compared provider-collected and self-collected test results for C. trachomatis and N. gonorrhoeae, which are The causative bacteria of chlamydia and gonorrhea.
Chlamydia is a very common sexually transmitted infection that, if left untreated, can cause pelvic inflammatory disease in women, leading to chronic pain and infertility. In men, chlamydia can cause pain and swelling in the testicles if left untreated. Gonorrhea can cause infections of the genitals, rectum, and throat. If left untreated, it can also lead to infertility in women. These two STIs usually have no symptoms.
The researchers compared the results of 164 pairs of provider-collected and home-collected rectal swabs and 159 pairs of throat swabs. They also evaluated urine and vaginal swabs for the effects of temperature fluctuations, hand contamination, and under- or over-filling of self-collected urine samples.
Compared with samples taken by healthcare providers, self-collected rectal swabs were 95.5 percent concordant in detecting chlamydia bacteria and 100 percent concordant in detecting gonorrhea bacteria. Self-collected throat swabs were nearly 100% concordant with those collected by healthcare workers for the detection of both infections. Interestingly, some self-collected throat swabs could detect both bacteria, while provider-taken throat swabs could not. Hand contamination had little effect on test results, as did temperature changes and improper filling of urine samples, the study found.
Brendan Hockman, one of the authors of the study, said: “Self-collected rectal and throat swabs were more sensitive than swabs taken by doctors for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae , without compromising the analytical performance of the test. Therefore, collection of STI specimens at home provides a viable option for increasing access to STI screening and may provide a non-stigmatizing approach to sexual health. method.”
Each of the above studies demonstrates that self-testing for STIs is not only accurate and cost-effective, but can also reduce the global impact of these diseases in an intimate and destigmatizing manner.
The Monash University study was published in The Lancet Public Health.
Accurate self-testing helps remove stigma of checking for Sexually transmitted diseases.
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