Internet-based self-sampling for Chlamydia trachomatis testing

Söderqvist JGullsby KStark L, et al
Internet-based self-sampling for Chlamydia trachomatis testing: a national evaluation in Sweden

Abstract:

Objective Internet-based testing for Chlamydia trachomatis (CT) with self-sampling at home has gradually been implemented in Sweden since 2006 as a free-of-charge service within the public healthcare system. This study evaluated the national diagnostic outcome of this service.

Methods Requests for data on both self-sampling at home and clinic-based sampling for CT testing were sent to the laboratories in 18 of 21 counties. Four laboratories were also asked to provide data on testing patterns at the individual level for the years 2013–2017.

Results The proportion of self-sampling increased gradually from 2013, comprising 22.0% of all CT tests in Sweden in 2017. In an analysis of 14 counties (representing 83% of the population), self-sampling increased by 115% between 2013 and 2017 for women, compared with 71% for men, while test volumes for clinic-based sampling were fairly constant for both sexes (1.8% increase for women, 15% increase for men). In 2017 self-sampling accounted for 20.3% of all detected CT cases, and the detection rate was higher than, but similar to, clinic-based testing (5.5% vs 5.1%). The proportion of self-sampling men was also higher, but similar (33.7% vs 30.8%). Analysis of individual testing patterns in four counties over 5 years showed a higher proportion of men using self-sampling only (67%, n=10 533) compared with women (40%, n=8885).

Conclusions Self-sampling has increased substantially in recent years, especially among women. This service is at least as beneficial as clinic-based screening for detection of CT, and self-sampling reaches men more than clinic-based testing.

Updated Guidelines: Australian STI & HIV Testing Guidelines 2019 for Asymptomatic MSM

Sexually Transmissible Infections in Gay Men Action Group (STIGMA), September 2019

Most sexually transmitted infections (STIs) are asymptomatic. Testing and treatment of asymptomatic men who have sex with men (MSM) is the most effective method to interrupt transmission and reduce the burden of illness. In particular, syphilis is increasingly common, is often asymptomatic, and can cause significant morbidity.

The main barriers to STI control are insufficient frequency of testing in MSM, and incomplete testing. For example, chlamydia and gonorrhoea tests should be performed at all three sites (swab of oropharynx and anorectum, and first
pass urine), and syphilis serology should be performed every time a HIV test or HIV treatment monitoring is performed.

HIV is now a medically preventable infection. All men who are eligible under the Australian HIV Pre-Exposure guidelines should be actively offered PrEP: www.ashm.org.au/HIV/PrEP All people with HIV should be advised to commence treatment and, where possible, have an undetectable viral load.
These guidelines are intended for all MSM, including trans men who have sex with other men .

This current version is endorsed by the Australasian Society for HIV, Viral Hepatitis, and Sexual Health Medicine, Australasian Sexual Health Alliance, Australasian Chapter of Sexual Health Medicine of the Royal Australasian College of Physicians and is approved as an accepted clinical resource by the Royal Australian College of General Practitioners.

Cervical cancer self-tests helping to break down barriers and increase screening rates

ABC Health & Wellbeing, Posted Friday 8th March 2019 at 14:54

In Australia, 80 per cent of cervical cancers are found in women who are overdue for screening or have never been screened.

“We know there’s an equity issue in our cervical screening program,” said Dr Saville, executive director of the VCS Foundation, a cervical screening not-for-profit.

“Women from lower socio-economic settings, Aboriginal and Torres Strait Islander women, and women from culturally and linguistically diverse backgrounds do not screen as often … and are more likely to get cancer.”

In a bid to overcome these barriers, a self-testing process was introduced to Australia’s National Cervical Screening Program in 2017.