Preferred Methods of HIV and Sexually Transmissible Infection Screening Delivery Among a Rural Sample of Men Who Have Sex with Men

Hubach, Randolph D.; O’Neil, Andrew M.; Stowe, Mollie; Hamrick, Justin; Giano, Zachary; Currin, Joseph M.

doi:10.1089/apc.2020.0170

Cited by 22 publications

(20 citation statements)

References 63 publications

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“…While prior studies of rectal self-collection have assessed feasibility from a cost-effectiveness or specimen collection accuracy perspective [ 19 , 24 , 25 ], our study is unique in that we included patient-provided responses in our assessment of feasibility. Our findings also contribute to the body of qualitative knowledge on patients’ perception of pain or discomfort and ease of compliance with rectal self-collection procedure [ 26 , 27 ] and corroborate what is known about the acceptability of the self-collection process [ 17 ]. Self-collection in FQHCs, which care for patients in the healthcare safety net, many of whom are racial and ethnic minorities who are disproportionately affected by STIs relative to non-Hispanic White patients [ 1 ], is a potential strategy to overcome access barriers.…”

Section: Discussionsupporting

confidence: 81%

Rectal specimen self-collection for chlamydia and gonorrhea screening: a cross-sectional feasibility study at a community health center

Haddad

Bifulco

McIntosh

et al. 2021

Pilot Feasibility Stud

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Background Men who have sex with men (MSM) are at increased risk for extra-genital sexually transmitted infections (STIs). Without extra-genital screening, many chlamydia and gonorrhea infections would be missed among MSM. Yet, many barriers exist to extra-genital testing, and, in particular, to rectal collection. Self-collection increases screening and detection of asymptomatic chlamydia and gonorrhea among at-risk MSM and transgender women. This feasibility study assessed use of rectal self-collection and its acceptance among patients and primary care providers (PCPs) at a large, general practice community health center. The primary objective of this project was to assess the feasibility of including rectal self-collection as part of an implementation study looking to embed an STI care program in a safety-net primary care setting that would shift routine screening tasks to non-provider clinical team members such as medical assistants and nurses. Methods Three PCPs identified and offered rectal self-collection to their MSM and transgender female patients who were due for routine or risk-based STI screening. For those patients who elected to participate in the study, the PCP’s medical assistant (MA) reviewed the self-collection instructions with them as part of their routine preventive care duties, and patients collected their own sample. Patients and PCPs completed brief cross-sectional surveys assessing the self-collection process. Results Of 1191 patients with sexual orientation and gender identity (SOGI) data on file who were seen for a medical visit by one of the three PCPs, 87 (7.3%) identified as MSM or transgender female. Seventy-five were due for rectal screening, of whom 33 (44%) were offered and completed rectal self-collection. Survey results indicated that self-collection was acceptable to and preferred over clinician-collection by both PCPs and patients. Conclusions This study demonstrated that rectal self-collection is feasible as part of STI screening in a high-volume primary care setting, and can be administered as part of the clinical tasks that MAs routinely conduct. The overall acceptance by both PCPs and patients will allow the inclusion of rectal self-collection in an implementation study looking to increase STI screening at a large community health center by facilitating MA-led collection during medical provider visits and by establishing standalone nurse-led STI visits.

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Section: Discussionsupporting

confidence: 81%

Rectal specimen self-collection for chlamydia and gonorrhea screening: a cross-sectional feasibility study at a community health center

Haddad

Bifulco

McIntosh

et al. 2021

Pilot Feasibility Stud

View full text Add to dashboard Cite

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“…The typical scarcity of nearby health care sources increases the odds of patient identifiability in small communities. In a qualitative sample of MSM living in rural sections of Oklahoma and Arkansas, respondents noted a lack of medical providers, privacy, and confidentiality and perceived stigma as overlapping barriers to accessing HIV or STI screening and care [85]. Respondents in the study spoke favorably of at-home testing and medical consultation, a paradigm that is gaining significant ground during the COVID-19 pandemic.…”

Section: Attitudes and Community Norms Regarding Sexual Healthmentioning

confidence: 94%

Improving Sexual Health in U.S. Rural Communities: Reducing the Impact of Stigma

et al. 2021

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Sexually transmitted infections (STI), including HIV, are among the most reported diseases in the U.S. and represent some of America's most significant health disparities. The growing scarcity of health care services in rural settings limits STI prevention and treatment for rural Americans. Local health departments are the primary source for STI care in rural communities; however, these providers experience two main challenges, also known as a double disparity: (1) inadequate capacity and (2) poor health in rural populations. Moreover, in rural communities the interaction of rural status and key determinants of health increase STI disparities. These key determinants can include structural, behavioral, and interpersonal factors, one of which is stigma. Engaging the expertise and involvement of affected community members in decisions regarding the needs, barriers, and opportunities for better sexual health is an asset and offers a gateway to sustainable, successful, and non-stigmatizing STI prevention programs. Keywords Sexually transmitted infections • Stigma • Rural populations • Community engagement ResumenLas infecciones de transmisión sexual (ITS), incluyendo al VIH, se encuentran entre las enfermedades más diagnosticadas en los Estados Unidos y representan algunas de las disparidades de salud más significativas. La creciente escasez de servicios de atención médica en entornos rurales limita la prevención y el tratamiento de las ITS para los estadounidenses de zonas rurales. Los departamentos locales de salud son las fuentes principales para el cuidado de las ITS en las comunidades rurales, pero estos proveedores confrontan dos desafíos principales, o una doble disparidad: (1) capacidad inadecuada y (2) malas condiciones de salud entre las poblaciones rurales. Además, en las comunidades rurales la interacción entre el estatus rural y determinantes claves de la salud aumentan las disparidades asociadas a las ITS. Estos determinantes clave pueden incluir factores estructurales, de comportamiento y interpersonales, como el estigma. El involucrar la experiencia y la participación de los miembros de la comunidad afectados en las decisiones sobre las necesidades, barreras y oportunidades para una mejor salud sexual es beneficioso y ofrece una puerta de entrada a programas de prevención de ITS sostenibles, exitosos y no estigmatizantes. Palabras ClaveInfecciones de transmisión sexual • Estigma • Poblaciones rurales • Participación comunitaria

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“…Convenience was a key attribute for MSM who preferred home self-sampling [ 14 , 15 ] or self-testing [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ] ( Table 1 ). A study conducted in the UK used focus groups and interviews with 44 MSM to explore the acceptability of home self-sampling kits [ 14 ].…”

Section: Resultsmentioning

confidence: 99%

“…Thirty-three studies identified home-based self-testing or self-sampling as the preferred method of testing [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 22 , 23 , 24 , 26 , 29 , 31 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ] ( Table 2 ). Three randomised controlled trials (RCT) found that HIVST increased testing frequency, and therefore was preferred by MSM compared to usual testing [ 17 , 21 , 54 ].…”

Section: Resultsmentioning

confidence: 99%

HIV and STI Testing Preferences for Men Who Have Sex with Men in High-Income Countries: A Scoping Review

Kularadhan

Gan

Chow

et al. 2022

IJERPH

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Background: Regular testing for HIV and other sexually transmitted infections (STI) is recommended at least annually for sexually active men who have sex with men (MSM) in most high-income countries. To encourage regular use of HIV and STI testing and treatment services for MSM, we reviewed the literature to summarise the attributes of an HIV/STI testing service that MSM prefer. Method: We conducted a scoping review, searching PubMed, EMBASE, PsycINFO and CINAHL in January 2020 for articles reporting primary data on the preferences of MSM (living in high-income countries) for HIV/STI testing services. Two reviewers independently screened titles and abstracts and any discrepancies were resolved by a third reviewer. We extracted data on the service attributes that MSM preferred and summarised these thematically using a socioecological framework. Results: In total, 1464 publications were identified, 220 full texts were read and 57 were included in the final analysis. We found 21 articles addressing ‘individual’ attributes, 50 articles addressing ‘service’ attributes and 17 articles addressing ‘societal’ attributes. The key themes of preferences for HIV/STI testing services were: (1) the appeal of self-testing due to convenience and privacy; (2) the need to provide a variety of testing options; and (3) the influence of the testing experience, including confidentiality and privacy, tester characteristics and stigma. There were distinct patterns of preferences for subpopulations of MSM across studies, such as the preference of self-testing for young MSM, and of in-clinic testing for those who perceived themselves as high risk (i.e., with symptoms of STIs or exposed to a partner living with HIV). Conclusion: To make HIV/STI testing more accessible for MSM and encourage regular screening, it is important to address ‘individual’, ‘service’ and ‘societal’ attributes, such as enhancing the convenience of testing through self-testing, and providing a service that men feel comfortable and safe accessing. Furthermore, services should accommodate the preferences of diverse sub-populations within the MSM community.

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Preferred Methods of HIV and Sexually Transmissible Infection Screening Delivery Among a Rural Sample of Men Who Have Sex with Men

Cited by 22 publications

References 63 publications

Rectal specimen self-collection for chlamydia and gonorrhea screening: a cross-sectional feasibility study at a community health center

Rectal specimen self-collection for chlamydia and gonorrhea screening: a cross-sectional feasibility study at a community health center

Improving Sexual Health in U.S. Rural Communities: Reducing the Impact of Stigma

HIV and STI Testing Preferences for Men Who Have Sex with Men in High-Income Countries: A Scoping Review

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