Three-site screening for STIs in men who have sex with men using online self-testing in an English sexual health service
Three-site screening for STIs in men who have sex with men using online self-testing in an English sexual health service
Objectives: Among men who have sex with men (MSM) in the UK,Chlamydia trachomatis (CT) and Neisseria gonorrhoea (NG) infections commonly occur asymptomatically at extragenital sites. Therefore, MSM seeking sexual health services are offered three-site (oropharyngeal, rectal and urogenital) STI screening. To increase access to screening, some UK sexual health services enable asymptomatic service users to order free STI screening kits online for self-sampling at home. We sought to assess prevalence of overall and extragenital CT/NG infection among asymptomatic MSM who used online self-testing in Hampshire, UK. Methods: We assessed prevalence of CT/NG infections from non-pooled samples among asymptomatic cisgender MSM using an administrative database with results from 5601 STI screening kits returned between 20 December 2016 and 31 January 2020. We compared number of diagnoses of extragenital infection with urogenital results of the same individuals to determine prevalence of infection that would have been missed with urine testing alone. Results: Among 5051 valid CT and 5040 valid NG asymptomatic test results, overall prevalence was 5.9% (298/5051) and 4.5% (228/5040), respectively. Among MSM with asymptomatic CT, 71.8% (214/298) had extragenital infection only, χ2 (1, n=298)=56.71, p<0.001. Among those with asymptomatic NG, 89.9% (205/228) had extragenital infection only, χ2 (1, n=228)=145.281, p<0.001. Conclusions: Overall, most CT/NG infections among asymptomatic MSM who used online self-testing were extragenital. Given this and the likelihood of onward transmission from asymptomatic infection, it is recommended that three-site testing remain standard for MSM and free screening services be expanded in easily accessible ways.
Gonorrhoea, Online; MSM; Extragenital; Asymptomatic; Gay and Bisexual Men, STI, Screening, Online, MSM, Extragenital, Asymptomatic, Gay and bisexual men
Charin, Gideon
825eebb8-ed0d-46b1-a62a-6118da7b85d7
Symonds, Ynez
57a07944-cf5f-439a-9d60-ac6c80356378
Scholfield, Clare
be4d126a-3da1-444d-b562-c1fe05b6fdfd
Graham, Cynthia
ac400331-f231-4449-a69b-ec9a477224c8
Armstrong, Heather
3dc9c223-1a61-47ad-ab0b-50d06cddf4f2
2 June 2022
Charin, Gideon
825eebb8-ed0d-46b1-a62a-6118da7b85d7
Symonds, Ynez
57a07944-cf5f-439a-9d60-ac6c80356378
Scholfield, Clare
be4d126a-3da1-444d-b562-c1fe05b6fdfd
Graham, Cynthia
ac400331-f231-4449-a69b-ec9a477224c8
Armstrong, Heather
3dc9c223-1a61-47ad-ab0b-50d06cddf4f2
Charin, Gideon, Symonds, Ynez, Scholfield, Clare, Graham, Cynthia and Armstrong, Heather
(2022)
Three-site screening for STIs in men who have sex with men using online self-testing in an English sexual health service.
Sexually Transmitted Infections, [sextrans-2021-055243].
(doi:10.1136/sextrans-2021-055243).
Abstract
Objectives: Among men who have sex with men (MSM) in the UK,Chlamydia trachomatis (CT) and Neisseria gonorrhoea (NG) infections commonly occur asymptomatically at extragenital sites. Therefore, MSM seeking sexual health services are offered three-site (oropharyngeal, rectal and urogenital) STI screening. To increase access to screening, some UK sexual health services enable asymptomatic service users to order free STI screening kits online for self-sampling at home. We sought to assess prevalence of overall and extragenital CT/NG infection among asymptomatic MSM who used online self-testing in Hampshire, UK. Methods: We assessed prevalence of CT/NG infections from non-pooled samples among asymptomatic cisgender MSM using an administrative database with results from 5601 STI screening kits returned between 20 December 2016 and 31 January 2020. We compared number of diagnoses of extragenital infection with urogenital results of the same individuals to determine prevalence of infection that would have been missed with urine testing alone. Results: Among 5051 valid CT and 5040 valid NG asymptomatic test results, overall prevalence was 5.9% (298/5051) and 4.5% (228/5040), respectively. Among MSM with asymptomatic CT, 71.8% (214/298) had extragenital infection only, χ2 (1, n=298)=56.71, p<0.001. Among those with asymptomatic NG, 89.9% (205/228) had extragenital infection only, χ2 (1, n=228)=145.281, p<0.001. Conclusions: Overall, most CT/NG infections among asymptomatic MSM who used online self-testing were extragenital. Given this and the likelihood of onward transmission from asymptomatic infection, it is recommended that three-site testing remain standard for MSM and free screening services be expanded in easily accessible ways.
Text
MSM three site screening manuscript (Mar 22, 2022) Accepted version
- Accepted Manuscript
More information
Accepted/In Press date: 14 May 2022
e-pub ahead of print date: 2 June 2022
Published date: 2 June 2022
Additional Information:
Publisher Copyright:
© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.
Keywords:
Gonorrhoea, Online; MSM; Extragenital; Asymptomatic; Gay and Bisexual Men, STI, Screening, Online, MSM, Extragenital, Asymptomatic, Gay and bisexual men
Identifiers
Local EPrints ID: 457469
URI: http://eprints.soton.ac.uk/id/eprint/457469
ISSN: 1368-4973
PURE UUID: d19522b7-3c87-42cc-944c-84136b3fc28c
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Date deposited: 09 Jun 2022 16:51
Last modified: 17 Mar 2024 07:19
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Author:
Gideon Charin
Author:
Ynez Symonds
Author:
Clare Scholfield
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