title: Self-collection of vaginal swabs for the detection of Chlamydia, gonorrhea, and trichomoniasis: opportunity to encourage sexually transmitted disease testing among adolescents.
abstract: BACKGROUND
  Many sexually transmitted diseases (STDs) are prevalent among adolescents, yet compliance to undergo STD testing by this population is suboptimal. Efforts to enhance compliance with testing among at-risk youth are needed.
  
  
  OBJECTIVE
  To determine the feasibility and acceptability of self-collection of vaginal swabs for the detection of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis among high-school students attending a school health clinic.
  
  
  METHODS
  Enrolled in the study were 228 female students between the ages of 15 and 19 years. Each student self-collected a single vaginal swab that was tested for C trachomatis, N gonorrhoeae, and T vaginalis by polymerase chain reaction amplification. Acceptability of self-collection of vaginal swabs was assessed.
  
  
  RESULTS
  The prevalence of any STD was 18%. Trichomoniasis, chlamydia, and gonorrhea were diagnosed in 10%, 8%, and 2% of students, respectively. Nearly 13% of females who had never previously had a gynecologic examination tested positive for an STD, and 51% of infected students would not have pursued testing by traditional gynecologic examination if self-collection was not offered. Self-collection of vaginal swabs was almost uniformly reported as easy to perform (99%) and preferable to a gynecologic examination (84%). Nearly all (97%) stated that they would undergo testing at frequent intervals if self-testing were available.
  
  
  CONCLUSIONS
  Self-collected vaginal swabs for STD testing can be easily implemented in a high-school setting with high acceptability among students, enabling the detection of many STDs that would otherwise remain undetected and untreated.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pennsylvania, USA.
authors.forename: H C
authors.initials: HC
authors.lastname: Wiesenfeld
authors.forename: D L
authors.initials: DL
authors.lastname: Lowry
authors.forename: R P
authors.initials: RP
authors.lastname: Heine
authors.forename: M A
authors.initials: MA
authors.lastname: Krohn
authors.forename: H
authors.initials: H
authors.lastname: Bittner
authors.forename: K
authors.initials: K
authors.lastname: Kellinger
authors.forename: M
authors.initials: M
authors.lastname: Shultz
authors.forename: R L
authors.initials: RL
authors.lastname: Sweet
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services; D000328:Adult; D002648:Child; D002690:Chlamydia Infections / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008403:Mass Screening / Q000379:methods; D010349:Patient Compliance; D010414:Pennsylvania / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012648:Self Care; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D014247:Trichomonas Vaginitis / Q000175:diagnosis / Q000453:epidemiology; D014621:Vagina / Q000382:microbiology*; D014626:Vaginal Smears / Q000379:methods*