Studies show self-collected or clinician collected swabs for STIs is more accurate than urine samples. Yet urine samples are the most common way to collect in the United States. Continuing this could lead to >400,000 missed cases of chlamydia and gonorrhea annually.
Sexually Transmitted Infections (STIs) remain a significant public health concern globally. Accurate and timely diagnosis is crucial for effective treatment and control. Recently, the focus has shifted towards self-collected swabs, a method that promises greater accuracy and comfort for patients. However, many are still reluctant to use this method, even healthcare providers do not promote this option enough to spread awareness. This trend self-collected swabs (SCS) are backed by recent studies and expert recommendations.
STD vs. STI: Understanding the Difference
The CDC defines a sexually transmitted infection (STI) as an infection spread through sexual contact, caused by a pathogen. This infection can progress to a sexually transmitted disease (STD), a distinct and identifiable disease resulting from the infection.
Exploring STD Swabs
For certain STDs like syphilis and HIV, blood tests are necessary for confirmation. However, for conditions like gonorrhea and chlamydia, an STD swab is used to collect samples from the genitals, throat, or rectum. These swabs are designed for gentle collection without contaminating the sample. They can be used with a transport kit or sent directly to a lab for analysis. Various swab test options exist, with endocervical samples (from near the uterus opening) being ideal for women, and urethral samples (from the urethra) preferred for men or women without a cervix.
Self- Collected Swabs
SCVS offers a comfortable and less invasive alternative for women and men. This method is also beneficial for patients with trauma histories, ensuring a more patient-centric approach to STI testing. It offers privacy, ease, and a level of accuracy comparable to clinician-collected samples. The adaptability of self-swabbing can potentially increase testing among women and men, a crucial step in STI control.
What is a penile swab?
A penile swab test collects a sample outside the opening of the penis, and does not require that the swab be inserted into the penis. This form of sampling may be used to test for chlamydia, gonorrhea and human papillomavirus (HPV), among other pathogens.
What is a vaginal swab?
Vaginal swab tests may be used to diagnose the presence of chlamydia, gonorrhea, C. trachomatis, M. genitalium, bacterial vaginosis, and Trichomoniasis, among other STDs.
Research Studies
Dr. Kristal J. Aaron and her team at the University of Alabama at Birmingham, in alignment with CDC recommendations, have underscored the effectiveness of SCVS in detecting chlamydia, gonorrhea, and trichomoniasis. Their research, alongside various studies, reveals that self-collected vaginal swabs (SCVS) outperforms professional-collected endocervical swabs and first-catch urine (FCU) in accuracy.
Key Findings
A study involving 3,973 women at a sexual health center demonstrated a 97% sensitivity for chlamydia using SCVS, compared to 88% with physician-collected endocervical swabs
Similar studies echoed these findings, consistently showing the superiority of SCVS in detecting STIs
In looking at a study conducted by Dize and Barnes, 203 enrolled male participants, underwent a clinician-collected urethral swabs for gonorrhea culture in the STD clinic in Baltimore, MD, followed by a self-collected a penile-meatal swab after the urethral swab
Key Findings:
Accuracy from both testing methods returned comparable for all STI's tested
Participant feedback: 90.1% of men found self-collection of penile-meatal swabs "Very Easy" or "Easy"
Cost: A significant portion of men were willing to pay up to $20 for Over-the-Counter self-collection kits
The study concludes that self-collected penile-meatal swabs are an effective and acceptable method for STI detection in men
Take Away:
TIMING IS KEY. By removing ANY barriers between us and the test is how we will progress forward. The transition to self-collected swabs for both women and men marks a significant advancement in STI testing. It empowers patients, enhances accuracy, and could lead to better health outcomes. Healthcare providers and patients alike are encouraged to recognize the benefits of this approach.
References:
Aaron, K., et al. (2023). "Evaluation of Self-Collected versus Clinician-Collected Swabs for STI Testing." Annals of Family Medicine.
Wood, Sarah. Growing Evidence Supports an Implementation Shift Toward Vaginal Sampling for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis Screening. Annals of Family Medicine. https://www.annfammed.org/content/annalsfm/21/2/100.full.pdf
Lunny, Carole. Self-Collected versus Clinician-Collected Sampling for Chlamydia and Gonorrhea Screening: A Systemic Review and Meta-Analysis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500554/
Comments