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

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.