title: Expanding sexually transmitted infection screening among women and men engaging in transactional sex: the feasibility of field-based self-collection.
abstract: Routine screening is a key component of sexually transmitted infection (STI) prevention and control; however, traditional programmes often fail to effectively reach men and women in hidden communities. To reduce prevalence, we must understand the programmatic features that would encourage utilization of services among asymptomatic individuals. Using incentivized snowball sampling, 44 women and men recently engaging in transactional sex were recruited (24 women, 20 men); median age 37 years. Respondents were offered the opportunity to collect genital, oropharyngeal and rectal samples for STI testing and completed a face-to-face interview about their experience with self-obtained sampling. Interviews were analysed using qualitative methods. Participants were unaware of potential risk for STI, but found self-sampling in non-clinical settings to be acceptable and preferable to clinic-based testing. All participants collected genital specimens; 96% and 4% collected oropharyngeal and rectal specimens, respectively. The burden of disease in this population was high: 38% tested positive for at least one STI. We detected multiple concomitant infections. Incorporating field collection of self-obtained samples into STI control programmes may increase utilization among high-risk populations unlikely to access clinic-based services. High infection rates indicate that individuals engaging in transactional sex would benefit from, and be responsive to, community-based self-sampling for STI screening.
authors: Division of Global Public Health, University of California at San Diego School of Medicine, CA, USA. almroth@iupui.edu
authors: A M
authors: AM
authors: Roth
authors: J G
authors: JG
authors: Rosenberger
authors: M
authors: M
authors: Reece
authors: B
authors: B
authors: Van Der Pol
mesh_terms: D000328:Adult; D005240:Feasibility Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010358:Patient Participation; D057240:Patient Preference; D015995:Prevalence; D036301:Qualitative Research; D012648:Self Care; D011477:Sex Work; D060386:Sex Workers / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D013048:Specimen Handling; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: STI screening; diagnosis; field collection; preferences; self-administered sampling; sex workers; sexually transmitted infections; transactional sex
references: J Clin Microbiol. 2010 May;48(5):1827-32
references: 20335410
references: Sex Transm Dis. 2003 Dec;30(12):880-5
references: 14646634
references: Sex Transm Dis. 2006 Aug;33(8):491-5
references: 16547452
references: Clin Infect Dis. 2005 Jul 1;41(1):67-74
references: 15937765
references: J Urban Health. 2006 Nov;83(6 Suppl):i39-53
references: 17096189
references: J Infect Dis. 2001 Apr 1;183(7):1017-22
references: 11237825
references: Sex Transm Infect. 2006 Oct;82(5):418-22
references: 16854996
references: J Health Soc Behav. 1998 Sep;39(3):237-53
references: 9785696
references: J Clin Microbiol. 2006 Feb;44(2):366-73
references: 16455885
references: Sex Transm Dis. 2003 Aug;30(8):654-8
references: 12897689
references: Sex Transm Dis. 2008 Jan;35(1):8-13
references: 18157061
references: Int J STD AIDS. 2010 Apr;21(4):260-4
references: 20378897
references: J Health Care Poor Underserved. 2012 Feb;23(1):367-75
references: 22643484
references: Sex Transm Dis. 2001 Oct;28(10):579-97
references: 11689757
references: Sex Transm Dis. 2011 May;38(5):398-400
references: 21217417
references: Arch Gen Psychiatry. 2008 Mar;65(3):337-44
references: 18316680
references: Sex Transm Dis. 2005 Dec;32(12):729-33
references: 16314768
references: Sex Transm Dis. 2008 Oct;35(10):845-8
references: 18607315
references: Sex Transm Infect. 2009 Feb;85(1):60-4
references: 18708480
references: Sex Transm Dis. 2011 Mar;38(3):167-71
references: 20852454
references: J Adolesc Health. 2006 Mar;38(3):208-12
references: 16488817
references: Obstet Gynecol. 2000 Mar;95(3):397-402
references: 10711551
references: J Urban Health. 2006 Nov;83(6 Suppl):i6-15
references: 17109206
references: J Adolesc Health. 2006 Aug;39(2):192-8
references: 16857530
references: Sex Transm Dis. 1998 Apr;25(4):187-93
references: 9564720
references: Clin Obstet Gynecol. 2004 Dec;47(4):796-807; discussion 881-2
references: 15596934
references: AIDS Behav. 2006 Nov;10(6):731-41
references: 16779657
references: Semin Oncol Nurs. 2008 Nov;24(4):237-45
references: 19000597
references: Sex Transm Dis. 2001 Jun;28(6):321-5
references: 11403188