Acceptability and efficacy of vaginal self-sampling for genital infection and bacterial vaginosis: A cross-sectional study

Abstract

Background & aim Screening for genital infection (GI) such as bacterial vaginosis (BV) and yeast infection, for sexually transmitted infection (STI), and for asymptomatic carriage of group B streptococcus (GBS) in pregnant women are common reason for medical appointments. The diagnosis and control of GIs, STIs, and GBS are major issues, for fertility and overall well-being of affected women. Conventional testing is performed using vaginal/cervical classical sampling (VCS); this procedure requires pelvic examination performed by health care professionals which raises concerns among women. Vaginal-self-sampling (VSS), as an alternative to VCS, might capture more women. The aim was first to show non-inferiority of VSS compared with VCS to screen for GIs, STIs, and GBS; second to determine the feasibility of VSS. Methods VSS and VCS from 1027 women were collected by health care professionals and simultaneously carried out on each patient. GIs, STIs, and GBS were systematically screened in both paired VSS and VCS samples. Non-inferiority of VSS compared with VCS was assessed using z statistic for binomial proportions. Results Prevalence of GIs were 39.7% using VSS and 38.1% using VCS (p = 0.0016). Prevalence of STIs was 8.5% (VSS) vs 8.1% (VCS) (p = 0.0087). Prevalence of GBS was 13.4% (VSS) and 11.5% (VCS) (p = 0.0001). Most participants (84%) recommended the use of VSS. Conclusions This study shows that VSS was not inferior to VCS for the detection of GIs, STIs, and GBS. This study provides evidence that VSS can be used as a universal specimen for detection of lower genital tract infections in women. Study identification number ID-RCB 2014-A01250-4.

Bacterial Vaginosis: What Do We Currently Know?

“…The collection of a specimen for diagnosis can be performed using a speculum during the pelvic exam. When there is no reason for a pelvic exam as part of the clinical evaluation, a self-collected vaginal swab may also be provided ( Menard et al., 2012 ; Camus et al., 2021 ).…”

Self-sampling strategies (with/without digital innovations) in populations at risk ofChlamydia trachomatisandNeisseria gonorrhoeae: a systematic review and meta-analyses

“…Eighty per cent of studies (36 of 45) detected newly diagnosed positive CT/GC infections and 42.2% of studies (19 of 45) measured test accuracy 16 17 20 22–55. Seventeen studies reported 2×2 table values 22 28 30–33 35 36 38–43 51–53. We excluded four studies where reference test was unclear/not reported 22 31–33…”

“…Acceptability for SS was high (80.0%–100.0%; n=21) 28 30 32–35 41 42 44–46 49–52 55–60. Participants found SS easy (n=14) and comfortable (ie, painless; n=9), and would recommend it to others (n=3) 28 30 33 35 41 44–46 49 51 52 57–60.…”

“…Acceptability for SS was high (80.0%–100.0%; n=21) 28 30 32–35 41 42 44–46 49–52 55–60. Participants found SS easy (n=14) and comfortable (ie, painless; n=9), and would recommend it to others (n=3) 28 30 33 35 41 44–46 49 51 52 57–60. Only one study in MSM from China reported a lower acceptability for rectal SS (43.6%; 133 of 306) but 100% acceptability for urine SS (306 of 306) 55…”

“…Preference for SS over clinician sampling ranged from 23.1% (823 of 3082) to 83.7% (429 of 512) (n=13) 28 30 32 34 42–44 49 51 52 58–60. High trust in accuracy and privacy were cited as reasons for preferring SS (n=3) 44 51 60…”