title: Home sampling for sexually transmitted infections and HIV in men who have sex with men: a prospective observational study.
abstract: To determine uptake of home sampling kit (HSK) for STI/HIV compared to clinic-based testing, whether the availability of HSK would increase STI testing rates amongst HIV infected MSM, and those attending a community-based HIV testing clinic compared to historical control. Prospective observational study in three facilities providing STI/HIV testing services in Brighton, UK was conducted. Adult MSM attending/contacting a GUM clinic requesting an STI screen (group 1), HIV infected MSM attending routine outpatient clinic (group 2), and MSM attending a community-based rapid HIV testing service (group 3) were eligible. Participants were required to have no symptomatology consistent with STI and known to be immune to hepatitis A and B (group 1). Eligible men were offered a HSK to obtain self-collected specimens as an alternative to routine testing. HSK uptake compared to conventional clinic-based STI/HIV testing in group 1, increase in STI testing rates due to availability of HSK compared to historical controls in group 2 and 3, and HSK return rates in all settings were calculated. Among the 128 eligible men in group 1, HSK acceptance was higher (62.5% (95% CI: 53.5-70.9)) compared to GUM clinic-based testing (37.5% (95% CI: 29.1-46.5)), (p = 0.0004). Two thirds of eligible MSM offered an HSK in all three groups accepted it, but HSK return rates varied (highest in group 1, 77.5%, lowest in group 3, 16%). HSK for HIV testing was acceptable to 81% of men in group 1. Compared to historical controls, availability of HSK increased the proportion of MSM testing for STIs in group 2 but not in group 3. HSK for STI/HIV offers an alternative to conventional clinic-based testing for MSM seeking STI screening. It significantly increases STI testing uptake in HIV infected MSM. HSK could be considered as an adjunct to clinic-based services to further improve STI/HIV testing in MSM.
authors.affiliation: Department of Genitourinary/HIV Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom.
authors.forename: Martin
authors.initials: M
authors.lastname: Fisher
authors.affiliation: Division of Primary Care and Public Health, Brighton and Sussex Medical School, Falmer, United Kingdom.
authors.forename: Sonali
authors.initials: S
authors.lastname: Wayal
authors.affiliation: Division of Primary Care and Public Health, Brighton and Sussex Medical School, Falmer, United Kingdom.
authors.forename: Helen
authors.initials: H
authors.lastname: Smith
authors.affiliation: Division of Primary Care and Public Health, Brighton and Sussex Medical School, Falmer, United Kingdom.
authors.forename: Carrie
authors.initials: C
authors.lastname: Llewellyn
authors.affiliation: Public Health England, Sexually Transmitted Bacteria Reference Laboratory and Virus Reference Department, London, United Kingdom.
authors.forename: Sarah
authors.initials: S
authors.lastname: Alexander
authors.affiliation: Public Health England, Sexually Transmitted Bacteria Reference Laboratory and Virus Reference Department, London, United Kingdom.
authors.forename: Catherine
authors.initials: C
authors.lastname: Ison
authors.affiliation: Public Health England, Sexually Transmitted Bacteria Reference Laboratory and Virus Reference Department, London, United Kingdom.
authors.forename: John V
authors.initials: JV
authors.lastname: Parry
authors.affiliation: Institute of Development Studies, University of Sussex, Brighton, United Kingdom.
authors.forename: Garth
authors.initials: G
authors.lastname: Singleton
authors.affiliation: Department of Genitourinary/HIV Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom.
authors.forename: Nicky
authors.initials: N
authors.lastname: Perry
authors.affiliation: Department of Genitourinary/HIV Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom.
authors.forename: Daniel
authors.initials: D
authors.lastname: Richardson
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D059026:Diagnostic Self Evaluation; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control* / Q000523:psychology; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011446:Prospective Studies; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000517:prevention & control* / Q000523:psychology; D013048:Specimen Handling / Q000379:methods*; D055815:Young Adult
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