医学
麦克内马尔试验
淋病
一致性
衣原体
沙眼衣原体
和男人发生性关系的男人
淋病奈瑟菌
内科学
性传播疾病
妇科
家庭医学
梅毒
免疫学
人类免疫缺陷病毒(HIV)
统计
微生物学
生物
数学
作者
Mary Elizabeth Sexton,Joseph Baker,Keisuke Nakagawa,Ying Liu,R C Perkins,Rebecca Slack,Daniel C. Baker,Brian Jucha,Sameer Arora,Michael Plankey
出处
期刊:PubMed
日期:2013-02-01
卷期号:62 (2): 70-8
被引量:17
摘要
Recent studies have demonstrated a high prevalence of pharyngeal (P) and rectal (R) Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) infections among men who have sex with men (MSM). Guidelines by the Centers for Disease Control and Prevention recommend testing at least annually. But surveys of medical providers suggest that adherence to these guidelines is minimal as a result of limited time and staff. Because of these concerns, we evaluated the feasibility and accuracy of patient self-testing.Three-hundred seventy-four patients at a Washington, DC clinic who identified themselves as MSM and requested testing for sexually transmitted infections (STIs) participated in the study. Patients performed self-screening using the Gen-Probe APTIMA Combo 2 (AC2) kit after viewing written and pictorial instructions. Trained providers also screened patients. We randomized the order in which patients or providers performed testing.Among those receiving specific tests, 8% of patients tested positive for R-GC, 9.3% for P-GC, 12.7% for R-CT, and 1.3% for P-CT. We performed McNemar tests, stratified by infection type and anatomic site to evaluate concordance. Self-administered testing was significantly better at identifying P-GC (discordant: 3%) and R-GC (discordant: 2.9%) (P ≤.01), and had results similar to provider- administered testing for P-CT (discordant: 0.5%) and R-CT (discordant: 1.1%) detection.The equivalent or better detection rates for rectal and oral gonorrhea and chlamydia among patients suggest that patients are capable of performing their own screening for STIs, which may increase infection detection and treatment.
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