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

Area of Science:

• Public Health
• Infectious Diseases
• Urology

Background:

• Rising rates of sexually transmitted infections (STIs) in the United States coincide with decreased funding for prevention and treatment programs.
• Self-collection of samples for STI testing in men offers a potentially cost-effective strategy to improve diagnosis and treatment access.

Purpose of the Study:

• To systematically review studies evaluating the efficacy and acceptability of self-collected anal, oral, or genital swab samples for STI detection in adult men.
• To assess the performance of self-collection methods compared to clinician-collected samples for various STIs and human papillomavirus-related dysplasia.

Main Methods:

• A systematic review of English-language research articles was conducted.
• Studies included adult men (18 years or older) undergoing self-collection of swab samples for STI and/or human papillomavirus-related dysplasia detection.
• Literature search yielded 1053 citations; 20 articles met the inclusion criteria.

Main Results:

• Self-collection methods demonstrated high sensitivity, comparable to clinician collection for detecting multiple STI pathogens.
• However, self-collected samples were less likely to be of adequate quality for anorectal cytology and less sensitive for anal intraepithelial neoplasia detection.
• Self-collection was found to be highly acceptable among participants, despite study limitations including small sample sizes and heterogeneity.

Conclusions:

• Self-collection of samples for STI testing in adult men is a viable strategy due to its high feasibility, acceptability, and validity.
• Implementing self-collection procedures in STI testing settings can expand opportunities for STI detection and timely treatment.