Overcoming Analytical and Preanalytical Challenges Associated with Extragenital Home Collected STI Specimens

Overview

Journal J Clin Microbiol

Specialty Microbiology

Date 2024 Jun 5

PMID 38836570

Authors

B E Hockman

M Qi

H Rotblatt

L Borenstein

R A Flynn

R A Muldrow

S Rajagopalan

D N Greene

Affiliations

Soon will be listed here.

Abstract

Importance: There is a clinical need for expanded extragenital bacterial sexually transmitted infection (STI) testing options, but the current regulatory landscape limits the wide-spread promotion and adoption of such services. Improved access, particularly for the LGBTQ+ community, can be achieved by validating testing for specimens that are self-collected at a remote location and arrive at the laboratory via a postal carrier or other intermediary route. Here we provide valuable data showing that self-collected samples for anal and oropharyngeal STI testing are equally or increasingly sensitive compared with those collected by a provider. We systematically consider the effects of storage time, exposure to temperature extremes, and the addition of common toiletries on results.

Citing Articles

Blood self-sampling: friend or foe?.

Plebani M Clin Chem Lab Med. 2024; 63(1):1-2.

PMID: 39383107 DOI: 10.1515/cclm-2024-1162.

References

Sevelius J, Patouhas E, Keatley J, Johnson M . Barriers and facilitators to engagement and retention in care among transgender women living with human immunodeficiency virus. Ann Behav Med. 2013; 47(1):5-16. PMC: 3925767. DOI: 10.1007/s12160-013-9565-8. View

Frommell G, Rothenberg R, Wang S, McIntosh K . Chlamydial infection of mothers and their infants. J Pediatr. 1979; 95(1):28-32. DOI: 10.1016/s0022-3476(79)80077-3. View

Pitasi M, Kerani R, Kohn R, Murphy R, Pathela P, Schumacher C . Chlamydia, Gonorrhea, and Human Immunodeficiency Virus Infection Among Transgender Women and Transgender Men Attending Clinics that Provide Sexually Transmitted Disease Services in Six US Cities: Results From the Sexually Transmitted Disease.... Sex Transm Dis. 2018; 46(2):112-117. PMC: 11155260. DOI: 10.1097/OLQ.0000000000000917. View

BEEM M, Saxon E . Respiratory-tract colonization and a distinctive pneumonia syndrome in infants infected with Chlamydia trachomatis. N Engl J Med. 1977; 296(6):306-10. DOI: 10.1056/NEJM197702102960604. View

Hughto J, Reisner S, Pachankis J . Transgender stigma and health: A critical review of stigma determinants, mechanisms, and interventions. Soc Sci Med. 2015; 147:222-31. PMC: 4689648. DOI: 10.1016/j.socscimed.2015.11.010. View

Workowski K, Bachmann L, Chan P, Johnston C, Muzny C, Park I . Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep. 2021; 70(4):1-187. PMC: 8344968. DOI: 10.15585/mmwr.rr7004a1. View

Kersh E, Shukla M, Raphael B, Habel M, Park I . At-Home Specimen Self-Collection and Self-Testing for Sexually Transmitted Infection Screening Demand Accelerated by the COVID-19 Pandemic: a Review of Laboratory Implementation Issues. J Clin Microbiol. 2021; 59(11):e0264620. PMC: 8525576. DOI: 10.1128/JCM.02646-20. View

Allan-Blitz L, Konda K, Calvo G, Vargas S, Leon S, Segura E . High incidence of extra-genital gonorrheal and chlamydial infections among high-risk men who have sex with men and transgender women in Peru. Int J STD AIDS. 2017; 29(6):568-576. DOI: 10.1177/0956462417744098. View

Dewart C, Bernstein K, DeGroote N, Romaguera R, Norris Turner A . Prevalence of Rectal Chlamydial and Gonococcal Infections: A Systematic Review. Sex Transm Dis. 2018; 45(5):287-293. PMC: 6737334. DOI: 10.1097/OLQ.0000000000000754. View

10.

Kojima N, Park H, Konda K, Davey D, Bristow C, Brown B . The PICASSO Cohort: baseline characteristics of a cohort of men who have sex with men and male-to-female transgender women at high risk for syphilis infection in Lima, Peru. BMC Infect Dis. 2017; 17(1):255. PMC: 5387233. DOI: 10.1186/s12879-017-2332-x. View

11.

Van der Helm J, Hoebe C, S van Rooijen M, Brouwers E, Fennema H, Thiesbrummel H . High performance and acceptability of self-collected rectal swabs for diagnosis of Chlamydia trachomatis and Neisseria gonorrhoeae in men who have sex with men and women. Sex Transm Dis. 2009; 36(8):493-7. DOI: 10.1097/OLQ.0b013e3181a44b8c. View

12.

Schachter J, Grossman M . Chlamydial infections. Annu Rev Med. 1981; 32:45-61. DOI: 10.1146/annurev.me.32.020181.000401. View

13.

Rapues J, Wilson E, Packer T, Colfax G, Raymond H . Correlates of HIV infection among transfemales, San Francisco, 2010: results from a respondent-driven sampling study. Am J Public Health. 2013; 103(8):1485-92. PMC: 4007863. DOI: 10.2105/AJPH.2012.301109. View

14.

Edwards A . Note on the correction for continuity in testing the significance of the difference between correlated proportions. Psychometrika. 1948; 13(3):185-7. DOI: 10.1007/BF02289261. View

15.

McHugh M . Interrater reliability: the kappa statistic. Biochem Med (Zagreb). 2012; 22(3):276-82. PMC: 3900052. View

16.

Radix A, Lelutiu-Weinberger C, Gamarel K . Satisfaction and Healthcare Utilization of Transgender and Gender Non-Conforming Individuals in NYC: A Community-Based Participatory Study. LGBT Health. 2016; 1(4):302-8. DOI: 10.1089/lgbt.2013.0042. View

17.

Sexton M, Baker J, Nakagawa K, Li Y, Perkins R, Slack R . How reliable is self-testing for gonorrhea and chlamydia among men who have sex with men?. J Fam Pract. 2013; 62(2):70-8. View

18.

Chan P, Robinette A, Montgomery M, Almonte A, Cu-Uvin S, Lonks J . Extragenital Infections Caused by Chlamydia trachomatis and Neisseria gonorrhoeae: A Review of the Literature. Infect Dis Obstet Gynecol. 2016; 2016:5758387. PMC: 4913006. DOI: 10.1155/2016/5758387. View

19.

Danby C, Cosentino L, Rabe L, Priest C, Damare K, Macio I . Patterns of Extragenital Chlamydia and Gonorrhea in Women and Men Who Have Sex With Men Reporting a History of Receptive Anal Intercourse. Sex Transm Dis. 2016; 43(2):105-9. PMC: 4955797. DOI: 10.1097/OLQ.0000000000000384. View

20.

Kent C, Chaw J, Wong W, Liska S, Gibson S, Hubbard G . Prevalence of rectal, urethral, and pharyngeal chlamydia and gonorrhea detected in 2 clinical settings among men who have sex with men: San Francisco, California, 2003. Clin Infect Dis. 2005; 41(1):67-74. DOI: 10.1086/430704. View