Evaluation of Self-Collected Versus Health Care Professional (HCP)-Performed Sampling and the Potential Impact on the Diagnostic Results of Asymptomatic Sexually Transmitted Infections (STIs) in High-Risk Individuals

Simon Weidlich; Sven Schellberg; Stefan Scholten; Jochen Schneider; Marcel Lee; Kathrin Rothe; Nina Wantia; Christoph D Spinner; Sebastian Noe

doi:10.3390/idr15050047

Evaluation of Self-Collected Versus Health Care Professional (HCP)-Performed Sampling and the Potential Impact on the Diagnostic Results of Asymptomatic Sexually Transmitted Infections (STIs) in High-Risk Individuals

Infect Dis Rep. 2023 Aug 25;15(5):470-477. doi: 10.3390/idr15050047.

Authors

Simon Weidlich¹, Sven Schellberg², Stefan Scholten³, Jochen Schneider¹, Marcel Lee¹, Kathrin Rothe⁴, Nina Wantia⁴, Christoph D Spinner^{1

5}, Sebastian Noe^{1

6}

Affiliations

¹ Department of Internal Medicine II, School of Medicine, University Hospital Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany.
² Novopraxis Berlin, Mohrenstr 6, 10117 Berlin, Germany.
³ Praxis Hohenstaufenring Köln, Richard-Wagner-Str 9-11, 50674 Cologne, Germany.
⁴ Institute for Microbiology, Immunology and Hygiene, School of Medicine, Technical University of Munich, Trogerstr. 30, 81675 Munich, Germany.
⁵ German Center for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany.
⁶ MVZ München am Goetheplatz, Waltherstr. 32, 80807 Munich, Germany.

Abstract

Sexually transmitted infections (STIs) are increasing among men who have sex with men (MSM). Screening can improve the detection and outcome of asymptomatic STIs in high-risk populations. Self-sampling may be a resource-optimized strategy; however, its diagnostic reliability compared to testing by healthcare professionals (HCPs) requires further investigation. In this prospective, multicenter cohort study in a high-income country, asymptomatic MSM with a sexual risk profile for STIs were included. Sequential swabs for STI nucleic acid-based diagnosis of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) were performed after randomization, either through self-sampling or HCP-performed sampling. Baseline demographic information, sexual risk behavior, and acceptance and feedback on self-sampling were recorded using an electronic questionnaire. Out of 236 asymptomatic MSM, 47 individuals (19.9%) tested positive for CT and/or NG through self- or HCP-performed sampling. For CT, the sensitivity was 93.3% for both sampling methods, while for NG, it was 90.0% for self-sampling and 95.0% for HCP-performed sampling. Our study demonstrates that self-sampling for asymptomatic STIs has a comparable diagnostic outcome to HCP-performed sampling, with high acceptance in high-risk MSM.

Keywords: Chlamydia trachomatis (CT) infection; Neisseria gonorrhoeae (NG); healthcare professional guided sampling; men having sex with men (MSM); self-sampling; sexually transmitted infection (STI).

Grants and funding

This study was funded by the University Hospital rechts der Isar, Department of Medicine II, Ismaninger Str. 22, 81675 Munich, Germany. All swabs used for CT/NG detection were provided free of charge by the manufacturer (Copan, Brescia, Italy). Real-time PCR cartridges were provided free of charge by Cepheid AB (Solna, Sweden). Copan and Cepheid were not involved in the design of the study; collection, analysis, and interpretation of data; or in writing the manuscript. The use of Xpert CT/NG for testing devices marked with * has not been reviewed by any regulatory body.