Optimizing Screening for Sexually Transmitted Infections in Men Using Self-Collected Swabs — A Systematic Review

Abstract Background Sexually transmitted infection (STI) rates are increasing in the US while funding for prevention and treatment programs has declined. Self-collection testing for STI detection in men may provide an acceptable, easy, rapid, and potentially cost-effective method for increasing diagnosis and treatment of STIs. The purpose of this study was to systematically review articles assessing self-collection of anal, oral, or genital tests among adult men for STI detection and/or human papillomavirus (HPV)-related dysplasia. Methods We searched for English-language articles involving self-collection tests for STI detection among men aged ≥ 18 years using the following databases: MEDLINE, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials. Three coders used a screening and data abstraction form to record each study’s design, participant demographics, intervention, and primary outcome. The self-collection devices, targeted micro-organisms, and self-collection acceptability measures were also recorded. All studies were double-coded to determine final inclusion in the review. Results Self-collection methods were highly sensitive and comparable to clinician-collection for detection of multiple STI pathogens but were of less adequate quality for anorectal cytology. Self-collection was highly acceptable. Conclusion Limitations of this systematic review include the fact that studies were small, heterogeneous, and used designs providing lower levels of evidence. Nevertheless, self-collection methods were shown to be a viable option for STI testing in adult men based on their high feasibility, acceptability, and validity. Implementation of self-collection procedures in STI testing venues should be performed to expand opportunities for STI detection and treatment. Disclosures All authors: No reported disclosures.

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Contemporary Sterilization Protocols of Healing Abutments for Reusability: A Systematic Review

JDR Clinical & Translational Research ◽

10.1177/23800844211045897 ◽

2021 ◽

pp. 238008442110458

Author(s):

P. Eswaramurthy ◽

K.M. DSouza ◽

A. Nagarsekar ◽

R.B. Gaunkar

Keyword(s):

Systematic Review ◽

Dental Implant ◽

English Language ◽

Cost Effective ◽

Cochrane Central Register ◽

Effective Measure ◽

Bias Assessment ◽

Central Register ◽

Therapeutic Decisions ◽

Single Use

Introduction: Although healing abutments are designated for single use by most implant manufacturers, it is common practice for clinicians to reuse healing abutments. However, there is a lack of adequate references that describe detailed sterilization protocols for reuse of healing abutments. Objectives: The purpose of this systematic review was to compile, organize, and describe the most common techniques for the sterilization of healing abutments and their efficiency in eliminating traces of microorganisms. Methods: An electronic search in 5 different databases was performed, including the National Library of Medicine (MEDLINE via PubMed), Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar from January 2000 to December 2020. Search variables included were dental implant, healing abutment, contaminate, contamination, reuse, and sterilization. Studies reporting with a minimum sample size of 10 healing abutments (5 per group) published in the English language were evaluated. Risk of bias assessment was elaborated for included investigations. Results: In total, 812 articles were identified, of which 8 were included in the analysis. Steam autoclave was the most widely used form of resterilization. Not a single protocol, however, was able to achieve 100% virgin surface of the healing abutments. Conclusion: Although reuse of dental implant healing abutments is a cost-effective measure in dental practice, thorough surface decontamination followed by resterilization is highly recommended before reuse. Knowledge Transfer Statement: With consideration of cost and patient preference, results of this review would be useful in knowing various sterilization protocols for reusing healing abutments that could lead to more appropriate therapeutic decisions.

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Acceptability of remote prescribing and postal delivery services for contraceptive pills and treatment of uncomplicated Chlamydia trachomatis

BMJ Sexual & Reproductive Health ◽

10.1136/bmjsrh-2020-200687 ◽

2020 ◽

pp. bmjsrh-2020-200687

Author(s):

Tom Nadarzynski ◽

Ynez Symonds ◽

Robert Carroll ◽

Jo Gibbs ◽

Sally Kidsley ◽

...

Keyword(s):

Online Survey ◽

Home Delivery ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Sti Testing ◽

Contraceptive Pills ◽

Remote Management ◽

Delivery Services ◽

The Cost ◽

To Receive

ObjectivesThe digitalisation of sexual and reproductive health (SRH) services offers valuable opportunities to deliver contraceptive pills and chlamydia treatment by post. We aimed to examine the acceptability of remote prescribing and ‘medication-by-post’ in SRH.Study designAn online survey assessing attitudes towards remote management was distributed in three UK SRH clinics and via an integrated sexually transmitted infection (STI) postal self-sampling service. Logistic regressions were performed to identify potential correlates.ResultsThere were 1281 participants (74% female and 49% <25 years old). Some 8% of participants reported having received medication via post and 83% were willing to receive chlamydia treatment and contraceptive pills by post. Lower acceptability was observed among participants who were: >45 years old (OR 0.43 (95% CI 0.23–0.81)), screened for STIs less than once annually (OR 0.63 (0.42–0.93)), concerned about confidentiality (OR 0.21 (0.90–0.50)), concerned about absence during delivery (OR 0.09 (0.02–0.32)) or unwilling to provide blood pressure readings (OR 0.22 (0.04–0.97)). Higher acceptability was observed among participants who reported: previously receiving medication by post (OR 4.63 (1.44–14.8)), preference for home delivery over clinic collection (OR 24.1 (11.1–51.9)), preference for home STI testing (OR 10.3 (6.16–17.4)), ability to communicate with health advisors (OR 4.01 (1.03–15.6)) and willingness to: register their real name (OR 3.09 (1.43–10.6)), complete online health questionnaires (OR 3.09 (1.43–10.6)) and use generic contraceptive pills (OR 2.88 (1.21–6.83)).ConclusionsPostal treatment and entering information online to allow remote prescribing were acceptable methods for SRH services and should be considered alongside medication collection in pharmacies. These methods could be particularly useful for patients facing barriers in accessing SRH. The cost-effectiveness and implementation of these novel methods of service delivery should be further investigated.

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Regular STI testing amongst men who have sex with men and use social media is suboptimal – a cross-sectional study

International Journal of STD & AIDS ◽

10.1177/0956462416636780 ◽

2016 ◽

Vol 28 (6) ◽

pp. 573-583 ◽

Cited By ~ 6

Author(s):

Jamie Frankis ◽

Lisa Goodall ◽

Dan Clutterbuck ◽

Abdul-Razak Abubakari ◽

Paul Flowers

Keyword(s):

Confidence Interval ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Anal Intercourse ◽

Sex Partners ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Sti Testing ◽

Male Sex ◽

Sex With Men

Sexually transmitted infections (STIs) disproportionately affect men who have sex with men, with marked increases in most STIs in recent years. These are likely underpinned by coterminous increases in behavioural risks which have coincided with the development of Internet and geospatial sociosexual networking. Current guidelines advocate regular, annual sexually transmitted infection testing amongst sexually active men who have sex with men (MSM), as opposed to symptom-driven testing. This paper explores sexually transmitted infection testing regularity amongst MSM who use social and sociosexual media. Data were collected from 2668 men in Scotland, Wales, Northern Ireland and the Republic of Ireland, recruited via social and gay sociosexual media. Only one-third of participants report regular (yearly or more frequent) STI testing, despite relatively high levels of male sex partners, condomless anal intercourse and high-risk unprotected anal intercourse. The following variables were associated with regular STI testing; being more ‘out’ (adjusted odds ratio = 1.79; confidence interval = 1.20–2.68), HIV-positive (adjusted odds ratio = 14.11; confidence interval = 7.03–28.32); reporting ≥10 male sex partners (adjusted odds ratio = 2.15; confidence interval = 1.47–3.14) or regular HIV testing (adjusted odds ratio = 48.44; confidence interval = 28.27–83.01). Men reporting long-term sickness absence from work/carers (adjusted odds ratio = 0.03; confidence interval = 0.00–0.48) and men aged ≤25 years (adjusted odds ratio = 0.36; 95% confidence interval = 0.19–0.69) were less likely to test regularly for STIs. As such, we identify a complex interplay of social, health and behavioural factors that each contribute to men’s STI testing behaviours. In concert, these data suggest that the syndemics placing men at elevated risk may also mitigate against access to testing and prevention services. Moreover, successful reduction of STI transmission amongst MSM will necessitate a comprehensive range of approaches which address these multiple interrelated factors that underpin MSM's STI testing.

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Use of Apps to Promote Childhood Vaccination: Protocol for a Systematic Review

JMIR Research Protocols ◽

10.2196/16929 ◽

2020 ◽

Vol 9 (2) ◽

pp. e16929

Author(s):

Michelle Helena Van Velthoven ◽

Madison Milne-Ives ◽

Caroline de Cock ◽

Mary Mooney ◽

Edward Meinert

Keyword(s):

Systematic Review ◽

Systematic Reviews ◽

Health Care Professionals ◽

English Language ◽

Search Strategy ◽

Grey Literature ◽

Information Storage ◽

Childhood Vaccination ◽

Cochrane Central Register ◽

Technical Standards

Background The decline in the uptake of routine childhood vaccinations has resulted in outbreaks of vaccine-preventable diseases. Vaccination apps can be used as a tool to promote immunization through the provision of reminders, dissemination of information, peer support, and feedback. Objective The aim of this review is to systematically review the evidence on the use of apps to support childhood vaccination uptake, information storage, and record sharing. Methods We will identify relevant papers by searching the following electronic databases: PubMed, Embase by Ovid, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, and Education Resources Information Center (ERIC). We will review the reference lists of those studies that we include to identify relevant additional papers not initially identified using our search strategy. In addition to the use of electronic databases, we will search for grey literature on the topic. The search strategy will include only terms relating to or describing the intervention, which is app use. As almost all titles and abstracts are in English, 100% of these will be reviewed, but retrieval will be confined to papers written in the English language. We will record the search outcome on a specifically designed record sheet. Two reviewers will select observational and intervention studies, appraise the quality of the studies, and extract the relevant data. All studies will involve the use of apps relating to child vaccinations. The primary outcome is the uptake of vaccinations. Secondary outcomes are as follows: (1) use of app for sharing of information and providing vaccination reminders and (2) use of app for storage of vaccination information; knowledge and decision making by parents regarding vaccination (ie, risks and benefits of vaccination); costs and cost-effectiveness of vaccination apps; use of the app and measures of usability (eg, usefulness, acceptability, and experiences of different users: parents and health care professionals); use of technical standards for development of the app; and adverse events (eg, data leaks and misinformation). We will exclude studies that do not study an app. We anticipate a limited scope for meta-analysis and will provide a narrative overview of findings and tabular summaries of extracted data. Results This project was funded by the Sir David Cooksey Fellowship in Healthcare Translation at the University of Oxford, Oxford, United Kingdom. We will submit the full systematic review for publication in the Journal of Medical Internet Research. Conclusions This review will follow, where possible, the Cochrane Collaboration and the Centre for Review and Dissemination methodologies for conducting systematic reviews. We will report our findings based on guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The review results will be used to inform the development of a vaccination app. International Registered Report Identifier (IRRID) PRR1-10.2196/16929

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Sexually Transmitted Infections and Male Circumcision: A Systematic Review and Meta-Analysis

ISRN Urology ◽

10.1155/2013/109846 ◽

2013 ◽

Vol 2013 ◽

pp. 1-42 ◽

Cited By ~ 16

Author(s):

Robert S. Van Howe

Keyword(s):

Systematic Review ◽

Human Papillomavirus ◽

Sexually Transmitted Infections ◽

Sexually Transmitted Infection ◽

Positive Impact ◽

Meta Analysis ◽

Transmitted Infection ◽

Sexually Transmitted ◽

General Populations ◽

Simplex Virus

The claim that circumcision reduces the risk of sexually transmitted infections has been repeated so frequently that many believe it is true. A systematic review and meta-analyses were performed on studies of genital discharge syndrome versus genital ulcerative disease, genital discharge syndrome, nonspecific urethritis, gonorrhea, chlamydia, genital ulcerative disease, chancroid, syphilis, herpes simplex virus, human papillomavirus, and contracting a sexually transmitted infection of any type. Chlamydia, gonorrhea, genital herpes, and human papillomavirus are not significantly impacted by circumcision. Syphilis showed mixed results with studies of prevalence suggesting intact men were at great risk and studies of incidence suggesting the opposite. Intact men appear to be of greater risk for genital ulcerative disease while at lower risk for genital discharge syndrome, nonspecific urethritis, genital warts, and the overall risk of any sexually transmitted infection. In studies of general populations, there is no clear or consistent positive impact of circumcision on the risk of individual sexually transmitted infections. Consequently, the prevention of sexually transmitted infections cannot rationally be interpreted as a benefit of circumcision, and any policy of circumcision for the general population to prevent sexually transmitted infections is not supported by the evidence in the medical literature.

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1296. Potential use of Sexually Transmitted Infection (STI) Testing for Expanding HIV Pre-Exposure Prophylaxis (PrEP) at an Urban Hospital Center

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.1129 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S396-S396

Author(s):

Robert Pitts ◽

Robert Holzman ◽

Richard Greene ◽

Emily Lam ◽

Ellie Carmody ◽

...

Keyword(s):

Hiv Prevention ◽

Medical Center ◽

Positive Test ◽

Prescription Data ◽

Urban Hospital ◽

Enrichment Programs ◽

Transmitted Infection ◽

Missed Opportunities ◽

Sexually Transmitted ◽

Sti Testing

Abstract Background Despite the high efficacy of PrEP, it continues to be underutilized. We examined the extent to which patients with a documented positive test for STIs were provided PrEP at an urban municipal medical center. Methods We reviewed data of all patients seen between January 1, 2014 and July 30, 2017 who were > 18 years old and had an initial HIV negative test and ≥1 positive test for Chlamydia, Gonorrhea, or Syphilis. We examined PrEP prescription data by gender, race/ethnicity, and clinic location. Differences between groups were compared using Chi-squared analysis and logistic regression. Results Of 1,142 initially HIV− patients who were identified as having a positive STI result, 52% were female, 89% either Black or Hispanic, with a median age of 40 years (quartiles 30, 47). 58% had Medicare/Medicaid and 34% were self-pay or uninsured (Table 1). Only 25 (2.1%) of 1,142 patients who had ≥1 STI test positive were prescribed PrEP. No women received PrEP. Whites (aOR: 21.7 [95% CI:4.4, 107, P < 0.001] and Hispanics (aOR:6.64 [95% CI:1.35, 32.8, P = 0.02] were both more likely to receive PrEP than Blacks, after adjusting for age, sex, marital status, and insurance. All PrEP prescriptions originated from the Medicine, Emergency, or HIV specialty clinics although most STI testing was obtained in Emergency and Obstetrical/Gynecological clinics (Table 2). Conclusion There were significant missed opportunities for HIV prevention among patients with STIs within the medical center, particularly among Hispanic and Black patients. Enrichment programs to educate providers and increase PrEP prescriptions may have a major impact on expanding HIV prevention, especially for women. Disclosures All authors: No reported disclosures.

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College students’ preferences for information on self-initiated sexually transmitted infection testing

Health Education Journal ◽

10.1177/0017896920959690 ◽

2020 ◽

pp. 001789692095969

Author(s):

Oluwamuyiwa Winifred Adebayo ◽

Jocelyn C Anderson ◽

Britney M Wardecker

Keyword(s):

College Students ◽

Sexually Transmitted Infection ◽

Qualitative Content Analysis ◽

Low Cost ◽

Transmitted Disease ◽

Structured Interview ◽

Sexual History ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Sti Testing

Objective: The purpose of this study was to identify preferences for content, method of delivery and frequency of information to encourage self-initiated sexually transmitted infection (STI) testing. Design: Qualitative study involving individual in-depth interviews with 35 college students aged 18–24 years. Setting: A university in Central Pennsylvania, USA. Method: Data were collected using a demographic and sexual history questionnaire, Sexually Transmitted Disease Knowledge Questionnaire and a semi-structured interview guide. Transcribed interviews were analysed using qualitative content analysis. Results: Findings from the study document STI testing information preferences as they relate to self-initiated testing. The majority of participants preferred receiving STI testing information through email. Themes within their accounts included Actionable Information Content, Frequently Accessed Delivery Method, and Routine STI Testing Information. Conclusion: The high incidence of STIs among US college students is an indication of the need to increase diagnosis and treatment to reduce transmission. Study findings have implications for the development and evaluation of low-cost interventions to improve the uptake of STI testing and reduce STI burden among college students.

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Safeguarding outcomes of 16 and 17-year-old service users of Sexual Health London (SHL.uk), a pan-London online sexual health service

International Journal of STD & AIDS ◽

10.1177/0956462420933462 ◽

2020 ◽

Vol 31 (14) ◽

pp. 1373-1379

Author(s):

Sara Day ◽

Ryan Kinsella ◽

Sophie Jones ◽

Victoria Tittle ◽

Tara Suchak ◽

...

Keyword(s):

Risk Assessment ◽

Sexual Health ◽

Social Services ◽

Child Protection ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Health Clinics ◽

Sti Testing ◽

Sexual Health Service ◽

Sexual Health Clinics

Guidance around how to safeguard young people using online sexual health services (e-SHSs) is limited. Sexual Health London (SHL.uk) is an e-SHS, integrated with London’s sexual health clinics (SHCs), offering users aged 16 years and above sexually transmitted infection (STI) testing. For a safeguarding risk assessment, under 18s must complete a safeguarding e-triage, and any concern raised results in a ‘call back’ (CB) by the SHL.uk team. The safeguarding outcomes of CBs between 8 January 2018 and 18 September 2018 were reviewed; 261/454 (57.5%) users never triggered a CB on their e-triage (non-CB group) and 193/454 (42.5%) users triggered one or more CB(s) (CB group). Safeguarding concerns disclosed predominantly related to drug/alcohol use and partner's age imbalance. Successful telephonic risk assessment took place in 84.5% CB cases. Safeguarding outcomes comprised referrals to: SHC in 35.5%; child protection team in 8.5%; social services in 7%. STI positivity was 16.4% and 15.2% in the CB and non-CB groups, respectively. Although a high number of safeguarding triggers were disclosed, only a small proportion warranted referral for further support/intervention. Using e-triage with telephony support to screen and safeguard adolescents accessing an e-SHS was acceptable to users and enabled their clinical and safeguarding needs to be safely met. e-SHS integration within a network of SHCs further supported this model.

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Developing a Typology of HIV/STI Testing Patterns Among Gay, Bisexual, and Queer Men: A Framework to Guide Interventions

Qualitative Health Research ◽

10.1177/1049732319870174 ◽

2019 ◽

Vol 30 (4) ◽

pp. 610-621 ◽

Cited By ~ 2

Author(s):

Rayner Kay Jin Tan ◽

Nashwinder Kaur ◽

Mark I-Cheng Chen ◽

Chen Seong Wong

Keyword(s):

Thematic Analysis ◽

External Factors ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Factors Associated ◽

Sti Testing ◽

Semistructured Interviews ◽

Testing Patterns ◽

Purposive Sample ◽

Inductive Thematic Analysis

Although factors associated with HIV/sexually transmitted infection (STI) testing among gay, bisexual, and queer (GBQ) men are well-established in the literature, few studies have attempted to delineate the processes underlying different patterns of testing. We conducted a qualitative study involving 35 semistructured interviews with a purposive sample of GBQ men in Singapore from October 2017 to July 2018. Topics explored included formative sexual experiences, relationships, and experiences of HIV/STI testing. Interviews were audio-recorded, transcribed, coded, and analyzed through inductive thematic analysis. A typology comprising four distinct HIV/STI testing patterns was identified from the data, categorized based on the regularity of testing, relative to internal or external factors that motivate testing behaviors. These include triggered episodic testing, influenced episodic testing, institutionalized regular testing, and value-based regular testing. The typology highlights the preconditions that underlie different testing patterns and provides a framework for developing interventions that promote HIV/STI testing among GBQ men.

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