Division of Infectious Diseases, University of Alabama, Birmingham, AL.
Sex Transm Dis. 2018 Jun;45(6):417-421. doi: 10.1097/OLQ.0000000000000769.
Sexually transmitted infections (STIs) disproportionately affect men who have sex with men. Although clinical practice guidelines recommend routine STI screening of men who have sex with men who have high-risk behaviors, extragenital STI testing rates have been low in HIV clinics across the nation. The University of Washington STD Prevention Training Center implemented an STI self-testing program at a large HIV primary care clinic in Seattle, WA, to facilitate extragenital STI testing.
We performed a mixed-methods program evaluation to assess health care provider acceptability of the program at 9 months after implementation. Twenty-eight clinicians were invited to complete an online survey. We conducted one-on-one, semistructured interviews with 6 clinicians and a focus group with 7 members of the clinic nursing staff. Survey responses were tallied. Conventional content analysis was performed on survey comments and transcripts from the interviews and focus group.
Ninety-one percent of clinicians were either satisfied or very satisfied with the program. Perceived advantages of the program included saving time for clinicians, overcoming patient discomfort, and increasing patient access to testing. Perceived program disadvantages included unclear responsibility of directing patients through the self-testing process and incorrect sample collection and labeling.
Despite perceived disadvantages, the self-testing program was acceptable to clinicians and nursing staff, key population for successful program adoption. Implementation of STI self-testing programs in clinic settings could help to increase extragenital STI testing rates by removing provider and patient barriers to testing.
性传播感染（STIs）在男男性行为者中不成比例地高发。尽管临床实践指南建议对有高危行为的男男性行为者进行常规 STI 筛查，但全国范围内的 HIV 诊所的外生殖器 STI 检测率一直较低。华盛顿大学 STD 预防培训中心在西雅图的一家大型 HIV 初级保健诊所实施了 STI 自我检测计划，以促进外生殖器 STI 检测。
我们进行了一项混合方法的计划评估，以评估该计划在实施 9 个月后医疗服务提供者的接受程度。邀请了 28 名临床医生完成在线调查。我们对 6 名临床医生进行了一对一的半结构化访谈，并对 7 名诊所护理人员进行了焦点小组讨论。对调查回复进行了统计。对调查评论和访谈及焦点小组的转录内容进行了常规内容分析。
91%的临床医生对该计划表示满意或非常满意。该计划的优势包括为临床医生节省时间、克服患者的不适、以及增加患者获得检测的机会。该计划的劣势包括对患者通过自我检测过程的指导责任不明确，以及样本采集和标记不正确。
尽管存在劣势，但自我检测计划得到了临床医生和护理人员的认可，这是成功实施该计划的关键人群。在诊所环境中实施 STI 自我检测计划可以帮助通过消除检测的提供者和患者障碍来提高外生殖器 STI 检测率。
