title: Use of home-obtained vaginal swabs to facilitate rescreening for Chlamydia trachomatis infections: two randomized controlled trials.
abstract: OBJECTIVE
  To determine whether the use of home-based, self-obtained vaginal swabs among women who were treated for Chlamydia infection can increase rescreening rates in comparison with clinic-based rescreening, and to identify subgroups in which rescreening could be enhanced using self-obtained vaginal swabs.
  
  
  METHODS
  Two randomized trials were conducted: one with enrollment in sexually transmitted disease (STD) clinics and the other in family planning clinics. Study participants were recruited from STD (n = 880) and family planning clinics (n = 412) in three cities. Females aged 16 years or older who were treated for Chlamydia infection were randomly assigned to the home group (swab collection kits mailed to home) or the clinic group (made clinic appointments) for rescreening at 3 months after treatment, with reminder calls about 2 weeks before the scheduled rescreening date.
  
  
  RESULTS
  Groups were similar with respect to age and other demographic characteristics. Women assigned to the home group had higher rescreening rates than those in the clinic group. In STD clinics, rescreening rates were 26.7% (home) compared with 19.1% (clinic) (P = .01). In family planning clinics, rescreening rates were 40.8% (home) compared with 20.7% (clinic) (P<.001). Among women reached by reminder calls, rescreening rates were also significantly higher in the home groups: 43.5% compared with 33.0% in STD clinic participants and 59.2% compared with 37.8% in family planning clinic participants (both P<.05). The rates of reinfection ranged from 12.9% to 19.4%, and the differences by group were not statistically significant (P ≥ .3).
  
  
  CONCLUSIONS
  In STD and family planning clinics, use of home-based, self-obtained vaginal swabs resulted in significant increases in rescreening rates compared with rescreening in the clinic. Home-based specimen collection can be an alternative to clinic-based rescreening for Chlamydia infection in women.
  
  
  BACKGROUND
  Clinicaltrials.gov, www.clinicaltrials.gov, NCT 00132457.
  
  
  METHODS
  I.
authors.affiliation: From the Centers for Disease Control and Prevention, Division of STD Prevention, Atlanta, Georgia; the Departments of Anthropology and Internal Medicine, Washington University, St. Louis, Missouri; School of Medicine, Section of Infectious Diseases, Louisiana State University Health Sciences Center, New Orleans, Louisiana; and the University of Mississippi Medical Center, Crossroads Clinics, Mississippi State Department of Health, Jackson, Mississippi.
authors.forename: Fujie
authors.initials: F
authors.lastname: Xu
authors.forename: Bradley P
authors.initials: BP
authors.lastname: Stoner
authors.forename: Stephanie N
authors.initials: SN
authors.lastname: Taylor
authors.forename: Leandro
authors.initials: L
authors.lastname: Mena
authors.forename: Lin H
authors.initials: LH
authors.lastname: Tian
authors.forename: John
authors.initials: J
authors.lastname: Papp
authors.forename: Kathleen
authors.initials: K
authors.lastname: Hutchins
authors.forename: David H
authors.initials: DH
authors.lastname: Martin
authors.forename: Lauri E
authors.initials: LE
authors.lastname: Markowitz
mesh_terms: D000554:Ambulatory Care Facilities; D002690:Chlamydia Infections / Q000175:diagnosis*; D002692:Chlamydia trachomatis; D005260:Female; D006801:Humans; D011177:Postal Service; D012648:Self Care; D015231:Sexually Transmitted Diseases, Bacterial / Q000175:diagnosis*; D014626:Vaginal Smears / Q000706:statistics & numerical data; D055815:Young Adult