Acceptability and feasibility of recruiting women to collect a self-administered vaginal swab at a pharmacy clinic for sexually transmissible infection screening
C. A. Gaydos A C , M. Barnes A , J. Holden A , B. Silver A , R. Smith A , J. Hardick A and T. C. Quinn A BA Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, 211 Preclinical Teaching Building, Fisher Center, 725 North Wolfe Street, Baltimore, MD 21205, USA.
B Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, USA.
C Corresponding author. Email: cgaydos@jhmi.edu
Sexual Health 17(4) 392-394 https://doi.org/10.1071/SH20077
Submitted: 1 May 2020 Accepted: 26 June 2020 Published: 24 August 2020
Abstract
Willingness to self-collect vaginal swabs at a pharmacy clinic is of interest as a venue to increase sexually transmissible infections (STIs) screening for chlamydia, gonorrhoea and trichomonas. Women self-collected vaginal swabs at the pharmacy, completed questionnaires and received STI results within 2 h. Women with STIs were offered free treatment. A total of 313 of 777 (40.3%) women consented and prevalence for any STI was 3.9%. Questionnaires demonstrated acceptability for self-collection at the pharmacy, with 63% (95% CI 57.3–68) and 32.3% (95% CI 27.4–37.8) indicating they ‘strongly agreed’ or ‘agreed’ that they felt comfortable with pharmacy collection, respectively. Self-collected vaginal swabs for STI testing for women who were at a pharmacy were feasible and acceptable to women.
Additional keywords: chlamydia, gonorrhoea, home collection, pharmacy collection, point-of-care tests, self-administered swabs, self-sampling, trichomonas.
References
[1] Shafer M-A, Moncada J, Boyer CB, Betsinger K, Flinn SD, Schachter J. Comparing first-void urine specimens, self-collected vaginal swabs, and endocervical specimens to detect Chlamydia trachomatis and Neisseria gonorrhoeae by a nucleic acid amplification test. J Clin Microbiol 2003; 41 4395–9.| Comparing first-void urine specimens, self-collected vaginal swabs, and endocervical specimens to detect Chlamydia trachomatis and Neisseria gonorrhoeae by a nucleic acid amplification test.Crossref | GoogleScholarGoogle Scholar | 12958275PubMed |
[2] Schachter J, Chernesky MA, Willis DE, Fine PM, Martin DH, Fuller D, et al. Vaginal swabs are the specimens of choice when screening for Chlamydia trachomatis and Neisseria gonorrhoeae: results of a multicenter evaluation of the APTIMA assays for both infections. Sex Transm Dis 2005; 32 725–8.
| Vaginal swabs are the specimens of choice when screening for Chlamydia trachomatis and Neisseria gonorrhoeae: results of a multicenter evaluation of the APTIMA assays for both infections.Crossref | GoogleScholarGoogle Scholar | 16314767PubMed |
[3] Papp JR, Schachter J, Gaydos CA, Van Der Pol B. Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae – 2014. MMWR Recomm Rep 2014; 63 1–19.
[4] Chernesky MA, Hook EW, Martin DH, Lane J, Johnson R, Jordan JA, et al. Women find it easy and prefer to collect their own vaginal swabs to diagnose Chlamydia trachomatis and Neisseria gonorrhoeae infections. Sex Transm Dis 2005; 32 729–33.
| Women find it easy and prefer to collect their own vaginal swabs to diagnose Chlamydia trachomatis and Neisseria gonorrhoeae infections.Crossref | GoogleScholarGoogle Scholar | 16314768PubMed |
[5] Paudyal P, Llewellyn C, Lau J, Mahmud M, Smith H. Obtaining self-samples to diagnose curable sexually transmitted infections: a systematic review of patients’ experiences. PLoS One 2015; 10 e0124310
| Obtaining self-samples to diagnose curable sexually transmitted infections: a systematic review of patients’ experiences.Crossref | GoogleScholarGoogle Scholar | 25909508PubMed |
[6] Widdice LE, Hsieh Y-H, Silver B, Barnes M, Barnes P, Gaydos CA. Performance of the Atlas genetics rapid test for Chlamydia trachomatis and women’s attitudes toward point-of-care testing. Sex Transm Dis 2018; 45 723–7.
| Performance of the Atlas genetics rapid test for Chlamydia trachomatis and women’s attitudes toward point-of-care testing.Crossref | GoogleScholarGoogle Scholar | 29771869PubMed |
[7] Lunny C, Taylor D, Hoang L, Wong T, Gilbert M, Lester R, et al. Self-collected versus clinician collected sampling for chlamydia and gonorrhea screening: a systemic review and meta-analysis. PLoS One 2015; 10 e0132776
| Self-collected versus clinician collected sampling for chlamydia and gonorrhea screening: a systemic review and meta-analysis.Crossref | GoogleScholarGoogle Scholar | 26168051PubMed |
[8] Hobbs MM, van der Pol B, Totten P, Gaydos CA, Wald A, Warren T, et al. From the NIH: proceedings of a workshop on the importance of self-obtained vaginal specimens for detection of sexually transmitted infections. Sex Transm Dis 2008; 35 8–13.
| From the NIH: proceedings of a workshop on the importance of self-obtained vaginal specimens for detection of sexually transmitted infections.Crossref | GoogleScholarGoogle Scholar | 18157061PubMed |
[9] Gaydos CA, Barnes M, Aumakhan B, Quinn N, Agreda P, Whittle P, et al. Can e-technology through the Internet be used as a new tool to address the Chlamydia trachomatis epidemic by home sampling and vaginal swabs? Sex Transm Dis 2009; 36 577–80.
| Can e-technology through the Internet be used as a new tool to address the Chlamydia trachomatis epidemic by home sampling and vaginal swabs?Crossref | GoogleScholarGoogle Scholar | 19543145PubMed |
[10] Kuder M, Jett-Goheen M, Dize L, Barnes M, Gaydos CA. Evaluation of a new website design for Iwantthekit for chlamydia, gonorrhea, and trichomonas screening. Sex Transm Dis 2015; 42 243–5.
| Evaluation of a new website design for Iwantthekit for chlamydia, gonorrhea, and trichomonas screening.Crossref | GoogleScholarGoogle Scholar | 25868135PubMed |
[11] Spielberg F, Levy V, Lensing S, Kapur I, Venkatasubramanian L, Acevedo N, et al. Fully integrated e-services for prevention, diagnosis and treatment of STIs: results of a 4-county study in California. Am J Public Health 2014; 104 2313–20.
| Fully integrated e-services for prevention, diagnosis and treatment of STIs: results of a 4-county study in California.Crossref | GoogleScholarGoogle Scholar | 25320878PubMed |
[12] van Rooijen MS, Koekenbier RH, Hendriks A, de Vries HJC, van Leeuwen P, van Veen MG. Young low-risk heterosexual clients prefer a chlamydia home collection test to a sexually transmitted infection clinic visit in Amsterdam, The Netherlands, a cross-sectional study. Sex Transm Dis 2016; 43 710–6.
| Young low-risk heterosexual clients prefer a chlamydia home collection test to a sexually transmitted infection clinic visit in Amsterdam, The Netherlands, a cross-sectional study.Crossref | GoogleScholarGoogle Scholar | 27893603PubMed |
[13] Gaydos CA, Van Der Pol B, Jett-Goheen M, Barnes M, Quinn N, Clark C, et al. Performance of the Cepheid CT/NG Xpert rapid PCR test for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae. J Clin Microbiol 2013; 51 1666–72.
| Performance of the Cepheid CT/NG Xpert rapid PCR test for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae.Crossref | GoogleScholarGoogle Scholar | 23467600PubMed |
[14] Schwebke JR, Gaydos CA, Davis T, Marrazzo J, Furgerson D, Taylor SN, et al. Clinical evaluation of the Cepheid Xpert® TV assay for detection of Trichomonas vaginalis with prospectively collected specimens from men and women. J Clin Microbiol 2018; 56 e01091-17
| 29643195PubMed |
[15] Ogale Y, Yeh PT, Kennedy CK, Toskin I, Narasimhan M. Self-collection of samples as an additional approach to deliver testing services for sexually transmitted infections: a systematic review and meta-analysis. BMJ Glob Health 2019; 4 e001349
| Self-collection of samples as an additional approach to deliver testing services for sexually transmitted infections: a systematic review and meta-analysis.Crossref | GoogleScholarGoogle Scholar | 31139454PubMed |
[16] Taylor D, Lunny C, Wong T, Gilbert M, Li N, Lester R, et al. Self-collected versus clinician-collected sampling for sexually transmitted infections: a systematic review and meta-analysis protocol. Syst Rev 2013; 2 93
| Self-collected versus clinician-collected sampling for sexually transmitted infections: a systematic review and meta-analysis protocol.Crossref | GoogleScholarGoogle Scholar | 24112441PubMed |
[17] Graseck AS, Shih SL, Peipert JF. Home versus clinic-based specimen collection for Chlamydia trachomatis and Neisseria gonorrhoeae. Expert Rev Anti Infect Ther 2011; 9 183–94.
| Home versus clinic-based specimen collection for Chlamydia trachomatis and Neisseria gonorrhoeae.Crossref | GoogleScholarGoogle Scholar | 21342066PubMed |
[18] Cook RL, Østergaard L, Hillier SL, Murray PJ, Chang C-CH, Comer DM, et al. Home screening for sexually transmitted diseases in high-risk young women: randomised controlled trial. Sex Transm Infect 2007; 83 286–91.
| Home screening for sexually transmitted diseases in high-risk young women: randomised controlled trial.Crossref | GoogleScholarGoogle Scholar | 17301105PubMed |
[19] Xu F, Stoner BP, Taylor SN, Mena L, Tian LH, Papp J, et al. Use of home-obtained vaginal swabs to facilitate rescreening for Chlamydia trachomatis infections: two randomized controlled trials. Obstet Gynecol 2011; 118 231–9.
| Use of home-obtained vaginal swabs to facilitate rescreening for Chlamydia trachomatis infections: two randomized controlled trials.Crossref | GoogleScholarGoogle Scholar | 21775837PubMed |
[20] Habel MA, Scheinmann R, Verdesoto E, Gaydos C, Bertisch M, Chiasson MA. Exploring pharmacy and home-based sexually transmissible infection testing. Sex Health 2015; 12 472–9.
| Exploring pharmacy and home-based sexually transmissible infection testing.Crossref | GoogleScholarGoogle Scholar | 26409484PubMed |
[21] Gronowski AM, Adams A, Ball C, Gaydos CA, Klepser M. Pharmacists in the laboratory space: friends or foes? Clin Chem 2016; 62 679–83.
| Pharmacists in the laboratory space: friends or foes?Crossref | GoogleScholarGoogle Scholar | 26747446PubMed |
[22] Deppe SJ, Nyberg CR, Patterson BY, Dietz CA, Sawkin MT. Expanding the role of a pharmacist as a sexually transmitted infection provider in the setting of an urban free clinic. Sex Transm Dis 2013; 40 685–8.
| Expanding the role of a pharmacist as a sexually transmitted infection provider in the setting of an urban free clinic.Crossref | GoogleScholarGoogle Scholar | 23945423PubMed |
[23] Centers for Medicare and Medicaid Services (CMS). Clinical laboratory improvement amendments (CLIA). Baltimore: CMS; 2020. Available online at: https://www.cms.gov/Regulations-and-Guidance/Legislation/CLIA/ [verified 29 July 2020].
[24] US Food and Drug Administration (FDA). CLIA – clinical laboratory improvement amendments – currently waived analyses. Silver Spring: FDA; 2020. Available online at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfClia/analyteswaived.cfm [verified 29 July 2020].
[25] Blake DR, Spielberg F, Levy V. Could home STI specimen collection with e-prescription be a cost-effective strategy for clinical trials and clinical care? Sex Transm Dis 2015; 42 13–9.
| Could home STI specimen collection with e-prescription be a cost-effective strategy for clinical trials and clinical care?Crossref | GoogleScholarGoogle Scholar | 25504295PubMed |
[26] Odesanmi TY, Wasti SP, Odesanmi OS, Adegbola O, Oguntuase OO, Mahmood S. Comparative effectiveness and acceptability of home-based and clinic-based sampling methods for sexually transmissible infections screening in females aged 14–50 years: a systematic review and meta-analysis. Sex Health 2013; 10 559–69.
| Comparative effectiveness and acceptability of home-based and clinic-based sampling methods for sexually transmissible infections screening in females aged 14–50 years: a systematic review and meta-analysis.Crossref | GoogleScholarGoogle Scholar | 24160747PubMed |