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Optimizing Screening for Sexually Transmitted Infections in Men Using Self-Collected Swabs: A Systematic Review

Yared, Nicholas, MD*; Horvath, Keith, PhD; Fashanu, Oluwaseun, MBBS; Zhao, Ran, BS; Baker, Jason, MD, MS*‡; Kulasingam, Shalini, PhD

Sexually Transmitted Diseases: May 2018 - Volume 45 - Issue 5 - p 294–300
doi: 10.1097/OLQ.0000000000000739

Background Sexually transmitted infection (STI) rates are increasing in the United States while funding for prevention and treatment programs has declined. Sample self-collection for STI testing in men may provide an acceptable, easy, rapid, and potentially cost-effective method for increasing diagnosis and treatment of STIs.

Methods We conducted a systematic review of articles assessing self-collection of anal, oral, or genital swab samples among adult men for detection of STIs and/or human papillomavirus–related dysplasia. We searched for English-language articles in which men 18 years or older were recruited to participate.

Results Our literature search resulted in 1053 citations, with 20 meeting inclusion criteria. Self-collection methods were highly sensitive and comparable with clinician collection for detection of multiple STI pathogens. However, self-collected samples were less likely to be of adequate quality for anorectal cytology and less sensitive for detection of anal intraepithelial neoplasia than clinician-collected samples. Self-collection was highly acceptable. Overall, studies were small and heterogeneous and used designs providing lower levels of evidence.

Conclusions Self-collection methods are a viable option for collecting samples for STI testing in adult men based on their high feasibility, acceptability, and validity. Implementation of self-collection procedures in STI testing venues should be performed to expand opportunities for STI detection and treatment.

A systematic review evaluating the validity, feasibility, and acceptability of using self-collected swabs for detection of sexually transmitted infections in adult men.

From the *Division of Infectious Diseases and International Medicine, Department of Medicine, and †Division of Epidemiology and Community Health, School of Public Health, University of Minnesota; and ‡Minnesota Medical Research Foundation, Minneapolis, MN

Conflict of Interest and Sources of Funding: Dr Nicholas Yared was funded by a National Institutes of Health Infectious Disease Training in Clinical Investigation Grant (T32 AI055433-11A1). All other authors declare no conflicts of interest.

Correspondence: Yared Nicholas, MD, Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, 420 Delaware St SE, MMC 250, Minneapolis, MN 55455. E-mail:

Received for publication June 8, 2017, and accepted October 3, 2017.

© Copyright 2018 American Sexually Transmitted Diseases Association