title: A mixed methods approach to assess the likelihood of testing for STI using self-collected samples among behaviourally bisexual women.
abstract: OBJECTIVE
  Behaviourally bisexual women (women who have sex with women and men (WSWM)) are more likely to report a history of sexually transmitted infections (STI) than women who have sex exclusively with men or exclusively with women. Barriers to care may prohibit WSWM from seeking STI testing. The present study investigated participant willingness to self-collect oral, vaginal and anal samples for STI testing.
  
  
  METHODS
  Eighty WSWM were recruited from two midwestern locations. After completing an online questionnaire, a subset of the participants were interviewed (n=54) and provided the option to self-collect oral, vaginal and/or anal samples to screen for Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis.
  
  
  RESULTS
  Over two-thirds (67.5%, n=54) of the participants completed the baseline scheduled and attended the interview. The majority of these participants provided vaginal (87.0%, n=47), oral (85.2%, n=46) and/or anal (61.1%, n=33) samples. Participants with a history of anal play were significantly more likely to provide an anal sample. C. trachomatis infection was identified in the samples of 6.8% (n=3) of the participants including 4.5% (n=2) of the vaginal samples and 3.3% (n=1) of the anal samples. None of the samples were positive for N. gonorrhoeae or T. vaginalis. Participants who reported a recent history of anal sexual behaviour with a male partner were significantly more likely to self-collect an anal sample.
  
  
  CONCLUSIONS
  Given the comparatively high STI rates among WSWM, self-sampling in non-traditional settings may present a unique opportunity to provide needed care to this underserved population of women.
authors: Division of Management, Policy, and Community Health, University of Texas Health Science Center at Houston, Houston, Texas, USA.
authors: Vanessa
authors: V
authors: Schick
authors: Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors: Barbara
authors: B
authors: Van Der Pol
authors: Indiana University-Bloomington, Center for Sexual Health Promotion, Bloomington, Indiana, USA.
authors: Brian
authors: B
authors: Dodge
authors: Indiana University-Bloomington, Center for Sexual Health Promotion, Bloomington, Indiana, USA.
authors: Aleta
authors: A
authors: Baldwin
authors: Division of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors: J Dennis
authors: JD
authors: Fortenberry
mesh_terms: D000328:Adult; D001727:Bisexuality / Q000523:psychology*; D002690:Chlamydia Infections / Q000382:microbiology / Q000517:prevention & control / Q000523:psychology*; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D005260:Female; D006069:Gonorrhea / Q000382:microbiology / Q000517:prevention & control / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015146:Midwestern United States / Q000453:epidemiology; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification*; D016017:Odds Ratio; D015995:Prevalence; D012648:Self Care / Q000523:psychology* / Q000706:statistics & numerical data; D012725:Sexual Behavior; D012747:Sexual Partners / Q000523:psychology; D013048:Specimen Handling; D011795:Surveys and Questionnaires
keywords: Bisexual; STI Diagnosis; Self-Sampling; Sexual Minority; Women who have sex with Women