2256. Self-Testing is a Feasible and Acceptable Option for Identifying Extra-genital Gonorrhea (GC) and Chlamydia (CT) infections in HIV Infected Persons
Session: Poster Abstract Session: HIV: Sexually Transmitted Infections
Saturday, October 7, 2017
Room: Poster Hall CD
Posters
  • selftestingfinalforupload.pdf (687.7 kB)
  • Background:

    Compliance with guidelines recommending extra-genital testing for GC/CT in HIV-infected men who have sex with men is variable. Proposed barriers to testing, such as patient reluctance and provider discomfort, could be eliminated by self-testing. =In this study, we evaluate the feasibility and acceptability of extra-genital self-testing and assess the adequacy of an oral rinse for the diagnosis of GC/CT infections.

    Methods:

    HIV-infected subjects receiving care at one of three military treatment facilities participated in this study. Subjects received standardized instructions on sample collection and participated in a questionnaire designed to evaluate acceptability of this method. In addition, all subjects underwent testing by their provider. Gen Probe Aptima Combo 2 assay was used for testing the swabs and the rinse.

    Results:

    A total of 148 HIV-infected subjects (median age-43 years, 40% African-Americans and 35% Caucasians) enrolled in the study. Test results are tabulated below. Of the 126 oral rinses tested, 6 (4.7%) tested positive for GC and 1 for CT (0.8%). Of the 6 rinses testing positive for GC, 2 tested negative on concomitantly collected swabs, and 1 swab testing positive for GC was negative on the rinse. Of note, 2 swabs testing positive for GC on self-collection but negative on provider swabs tested positive on the rinse. Over 95% of the subjects indicated that they understood the instructions and had collected the swabs as instructed. Most subjects (≥90%) indicated that they were comfortable collecting the swabs and oral rinses at home. Approximately15% of the subjects preferred that their providers collected the swabs.

    Conclusion:

    In this study, self-collected samples yielded more positive results than provider collected samples, and the performance of oral rinses and pharyngeal swabs were similar. Our results suggest self-testing is a feasible and acceptable method for collecting extra-genital samples. Adoption of self-testing could improve compliance with the guidelines.

    Test Results By Anatomical Site and Collection Method

    Provider

    Self

    Self

    Provider

    Rectal GC

    5 (3.4%)

    5 (3.4%)

    Concordant

    Pharyngeal GC

    8 (5.4%)

    6 (4.1%)

    Discordant

    Rectal CT

    4 (2.7%)

    6 (4.1%)

    Discordant

    Pharyngeal CT

    1 (0.7%)

    2 (1.3%)

    Discordant

    Anuradha Ganesan, MD, MPH1,2,3, Dana Golden, BS4, Robert Deiss, MD5,6,7, Thomas O'Bryan, MD1,4,8, Ryan Maves, MD, FCCP, FIDSA9, Jason M. Blaylock, MD10, Jason Okulicz, MD11 and Eric Garges, MD, MPH4, (1)Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, (2)Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Rock, MD, (3)Walter Reed National Military Medical Center, Bethesda, MD, (4)Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, (5)Naval Medical Center San Diego, San Diego, CA, (6)Infectious Diseases Clinical Research Program, Uniformed Services University, Bethesda, MD, (7)Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, (8)San Antonio Military Medical Center, Fort Sam Houston, TX, (9)Infectious Diseases, Naval Medical Center San Diego, San Diego, CA, (10)Walter Reed Military Medical Center, Bethesda, MD, (11)Infectious Disease, San Antonio Military Medical Center, Fort Sam Houston, TX

    Disclosures:

    A. Ganesan, None

    D. Golden, None

    R. Deiss, None

    T. O'Bryan, None

    R. Maves, None

    J. M. Blaylock, None

    J. Okulicz, None

    E. Garges, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 4th with the exception of research findings presented at the IDWeek press conferences.