Sexually Transmitted Diseases

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Sexually Transmitted Diseases:
doi: 10.1097/OLQ.0b013e3181a44b8c

High Performance and Acceptability of Self-Collected Rectal Swabs for Diagnosis of Chlamydia trachomatis and Neisseria gonorrhoeae in Men Who Have Sex With Men and Women

van der Helm, Jannie J. MSC*; Hoebe, Christian J. P. A. MD, PHD†‡; van Rooijen, Martijn S. MSC*; Brouwers, Elfi E. H. G. MSC†‡; Fennema, Han S. A. MD, PHD§; Thiesbrummel, Harold F. J. MD*; Dukers-Muijrers, Nicole H. T. M. PHD*†‡

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Background: Identification of sexually transmitted infections (STI) is limited by the infrequent assessment of rectal STI. This study assesses usability of self-collected rectal swabs (SRS) in diagnosing rectal Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG).

Methods: In 2006 to 2007, clients of the Amsterdam and South Limburg STI outpatient clinics reporting receptive anal intercourse were asked to fill out a questionnaire and provide SRS. A standard provider-collected rectal swab (PRS) was also taken, and both were tested for CT and NG by a nucleic acid amplification tests. SRS performance was compared with PRS as to agreement, sensitivity, and specificity.

Results: Prevalence of rectal CT was 11% among the 1458 MSM and 9% among the 936 women. Rectal NG prevalence was 7% and 2%. In 98% of both MSM and women, SRS and PRS yielded concordant CT test results, for NG agreement was 98% for MSM and 99.4% for women. SRS performance for CT and NG diagnosis was good in both groups and was comparable for both study regions. Slightly more (57% of MSM, 62% of women) preferred SRS to PRS or had no preference; 97% would visit the STI clinic again if SRS was standard practice.

Conclusions: Because anal sex is a common practice for MSM and women, and anal STI are frequently present, rectal screening should be an essential part of an STI consultation. SRS is a feasible, valid, and acceptable alternative for MSM and women attending STI clinics, and hence should be considered for other settings as well.

© Copyright 2009 American Sexually Transmitted Diseases Association


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