Rectal specimen self-collection for chlamydia and gonorrhea screening: a cross-sectional feasibility study at a community health center

Abstract Background Men who have sex with men (MSM) are at increased risk for extra-genital sexually transmitted infections (STIs). Without extra-genital screening, many chlamydia and gonorrhea infections would be missed among MSM. Yet, many barriers exist to extra-genital testing, and, in particula...

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Autores principales:	Marwan S. Haddad, Lauren Bifulco, Jeannie McIntosh, Meghan Mc Clain Garcia
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Sexual and gender minorities Gonorrhea Chlamydia STI rectal self-collection Community health centers Federally qualified health center (FQHC) Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/de4444ebc1a84f6fb55548f15aa2a2a2
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spelling	oai:doaj.org-article:de4444ebc1a84f6fb55548f15aa2a2a22021-11-21T12:08:53ZRectal specimen self-collection for chlamydia and gonorrhea screening: a cross-sectional feasibility study at a community health center10.1186/s40814-021-00928-72055-5784https://doaj.org/article/de4444ebc1a84f6fb55548f15aa2a2a22021-11-01T00:00:00Zhttps://doi.org/10.1186/s40814-021-00928-7https://doaj.org/toc/2055-5784Abstract Background Men who have sex with men (MSM) are at increased risk for extra-genital sexually transmitted infections (STIs). Without extra-genital screening, many chlamydia and gonorrhea infections would be missed among MSM. Yet, many barriers exist to extra-genital testing, and, in particular, to rectal collection. Self-collection increases screening and detection of asymptomatic chlamydia and gonorrhea among at-risk MSM and transgender women. This feasibility study assessed use of rectal self-collection and its acceptance among patients and primary care providers (PCPs) at a large, general practice community health center. The primary objective of this project was to assess the feasibility of including rectal self-collection as part of an implementation study looking to embed an STI care program in a safety-net primary care setting that would shift routine screening tasks to non-provider clinical team members such as medical assistants and nurses. Methods Three PCPs identified and offered rectal self-collection to their MSM and transgender female patients who were due for routine or risk-based STI screening. For those patients who elected to participate in the study, the PCP’s medical assistant (MA) reviewed the self-collection instructions with them as part of their routine preventive care duties, and patients collected their own sample. Patients and PCPs completed brief cross-sectional surveys assessing the self-collection process. Results Of 1191 patients with sexual orientation and gender identity (SOGI) data on file who were seen for a medical visit by one of the three PCPs, 87 (7.3%) identified as MSM or transgender female. Seventy-five were due for rectal screening, of whom 33 (44%) were offered and completed rectal self-collection. Survey results indicated that self-collection was acceptable to and preferred over clinician-collection by both PCPs and patients. Conclusions This study demonstrated that rectal self-collection is feasible as part of STI screening in a high-volume primary care setting, and can be administered as part of the clinical tasks that MAs routinely conduct. The overall acceptance by both PCPs and patients will allow the inclusion of rectal self-collection in an implementation study looking to increase STI screening at a large community health center by facilitating MA-led collection during medical provider visits and by establishing standalone nurse-led STI visits.Marwan S. HaddadLauren BifulcoJeannie McIntoshMeghan Mc Clain GarciaBMCarticleSexual and gender minoritiesGonorrheaChlamydiaSTI rectal self-collectionCommunity health centersFederally qualified health center (FQHC)Medicine (General)R5-920ENPilot and Feasibility Studies, Vol 7, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Sexual and gender minorities Gonorrhea Chlamydia STI rectal self-collection Community health centers Federally qualified health center (FQHC) Medicine (General) R5-920
spellingShingle	Sexual and gender minorities Gonorrhea Chlamydia STI rectal self-collection Community health centers Federally qualified health center (FQHC) Medicine (General) R5-920 Marwan S. Haddad Lauren Bifulco Jeannie McIntosh Meghan Mc Clain Garcia Rectal specimen self-collection for chlamydia and gonorrhea screening: a cross-sectional feasibility study at a community health center
description	Abstract Background Men who have sex with men (MSM) are at increased risk for extra-genital sexually transmitted infections (STIs). Without extra-genital screening, many chlamydia and gonorrhea infections would be missed among MSM. Yet, many barriers exist to extra-genital testing, and, in particular, to rectal collection. Self-collection increases screening and detection of asymptomatic chlamydia and gonorrhea among at-risk MSM and transgender women. This feasibility study assessed use of rectal self-collection and its acceptance among patients and primary care providers (PCPs) at a large, general practice community health center. The primary objective of this project was to assess the feasibility of including rectal self-collection as part of an implementation study looking to embed an STI care program in a safety-net primary care setting that would shift routine screening tasks to non-provider clinical team members such as medical assistants and nurses. Methods Three PCPs identified and offered rectal self-collection to their MSM and transgender female patients who were due for routine or risk-based STI screening. For those patients who elected to participate in the study, the PCP’s medical assistant (MA) reviewed the self-collection instructions with them as part of their routine preventive care duties, and patients collected their own sample. Patients and PCPs completed brief cross-sectional surveys assessing the self-collection process. Results Of 1191 patients with sexual orientation and gender identity (SOGI) data on file who were seen for a medical visit by one of the three PCPs, 87 (7.3%) identified as MSM or transgender female. Seventy-five were due for rectal screening, of whom 33 (44%) were offered and completed rectal self-collection. Survey results indicated that self-collection was acceptable to and preferred over clinician-collection by both PCPs and patients. Conclusions This study demonstrated that rectal self-collection is feasible as part of STI screening in a high-volume primary care setting, and can be administered as part of the clinical tasks that MAs routinely conduct. The overall acceptance by both PCPs and patients will allow the inclusion of rectal self-collection in an implementation study looking to increase STI screening at a large community health center by facilitating MA-led collection during medical provider visits and by establishing standalone nurse-led STI visits.
format	article
author	Marwan S. Haddad Lauren Bifulco Jeannie McIntosh Meghan Mc Clain Garcia
author_facet	Marwan S. Haddad Lauren Bifulco Jeannie McIntosh Meghan Mc Clain Garcia
author_sort	Marwan S. Haddad
title	Rectal specimen self-collection for chlamydia and gonorrhea screening: a cross-sectional feasibility study at a community health center
title_short	Rectal specimen self-collection for chlamydia and gonorrhea screening: a cross-sectional feasibility study at a community health center
title_full	Rectal specimen self-collection for chlamydia and gonorrhea screening: a cross-sectional feasibility study at a community health center
title_fullStr	Rectal specimen self-collection for chlamydia and gonorrhea screening: a cross-sectional feasibility study at a community health center
title_full_unstemmed	Rectal specimen self-collection for chlamydia and gonorrhea screening: a cross-sectional feasibility study at a community health center
title_sort	rectal specimen self-collection for chlamydia and gonorrhea screening: a cross-sectional feasibility study at a community health center
publisher	BMC
publishDate	2021
url	https://doaj.org/article/de4444ebc1a84f6fb55548f15aa2a2a2
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Rectal specimen self-collection for chlamydia and gonorrhea screening: a cross-sectional feasibility study at a community health center

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