Sullivan Stephen, Sullivan Patrick, Stephenson Rob
Center for Sexuality and Health Disparities, University of Michigan School of Nursing, Ann Arbor, MI, United States.
Rollins School of Public Health, Department of Epidemiology, Emory University, Atlanta, GA, United States.
JMIR Res Protoc. 2019 Oct 1;8(10):e14481. doi: 10.2196/14481.
Gay, bisexual, and other men who have sex with men (MSM) are at elevated risk for acquiring sexually transmitted infections (STIs) in the United States, especially chlamydia and gonorrhea. While research has indicated main partners over casual partners may play a central role in STI risk, the frequency of STI screening among MSM couples is particularly low. Self-sample collection for chlamydia and gonorrhea screening has been shown to be highly accurate, and at-home STI testing has been shown to be highly acceptable among diverse populations. However, there is little research exploring the feasibility and acceptability of at-home chlamydia and gonorrhea screening among MSM couples. Our pilot study aims to help evaluate the viability of this screening modality as an intervention tool for MSM couples.
The objective of this study was to assess the feasibility and acceptability of an at-home chlamydia and gonorrhea sample collection and remote lab testing program among a sample of 50 MSM couples living in the United States.
This pilot study enrolled 50 MSM couples, ranging from 18-40 years old and living in the United States, who participated in a larger at-home HIV testing randomized controlled trial. Participating couples completed a pretest instructional video call and then had the option of completing at-home sample collection across three bodily sites (rectal swab, pharyngeal swab, and urine sample) for remote chlamydia and gonorrhea lab testing. For participants who completed any sample collection, they received their results via a posttest video call. All participants completed an online survey examining satisfaction and acceptability of the home testing process, experience with logistics, willingness to test at home in the future, recent sexual risk behavior, STI testing history, and linkage to care. A subset of 10 couples completed an in-depth interview about their attitudes towards the sample collection process, different decisions they made while collecting their samples, and their experience accessing treatment (for those who received a positive result).
Recruitment began in September 2017, and as of March 2019 a total of 50 couples have been enrolled. Overall, 49/50 couples have returned their samples and completed the posttest delivery call, and 10 in-depth interviews have been completed and transcribed.
Screening MSM couples at home for chlamydia and gonorrhea and providing video-facilitated results delivery may offer a tailored approach to address the increasing prevalence of these STIs. By collecting data on how MSM couples experience at-home STI screening, this project will provide valuable insight into the utility of such a service delivery program to public health interventionists and researchers alike.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/14481.
在美国，男同性恋者、双性恋者以及其他与男性发生性行为的男性（MSM）感染性传播感染（STI）的风险较高，尤其是衣原体感染和淋病。虽然研究表明主要性伴侣而非临时性伴侣可能在性传播感染风险中起核心作用，但男男性行为伴侣间性传播感染筛查的频率特别低。衣原体和淋病筛查的自我样本采集已被证明高度准确，家庭性传播感染检测在不同人群中也已被证明高度可接受。然而，很少有研究探讨男男性行为伴侣在家中进行衣原体和淋病筛查的可行性和可接受性。我们的试点研究旨在帮助评估这种筛查方式作为男男性行为伴侣干预工具的可行性。
本研究的目的是评估一项针对居住在美国的50对男男性行为伴侣的家庭衣原体和淋病样本采集及远程实验室检测项目的可行性和可接受性。
这项试点研究招募了50对年龄在18至40岁之间、居住在美国的男男性行为伴侣，他们参与了一项更大规模的家庭艾滋病毒检测随机对照试验。参与的伴侣完成了一次检测前指导视频通话，然后可以选择在三个身体部位（直肠拭子、咽拭子和尿液样本）进行家庭样本采集，以便进行衣原体和淋病的远程实验室检测。对于完成任何样本采集的参与者，他们通过检测后视频通话收到检测结果。所有参与者都完成了一项在线调查，调查内容包括对家庭检测过程的满意度和可接受性、物流体验、未来在家中检测的意愿、近期性风险行为、性传播感染检测史以及与医疗服务的联系。10对伴侣的子集完成了一次关于他们对样本采集过程的态度、采集样本时做出的不同决定以及他们获得治疗的经历（对于检测结果呈阳性的人）的深入访谈。
招募工作于2017年9月开始，截至2019年3月，共招募了50对伴侣。总体而言，49/50对伴侣已返还样本并完成了检测后交付通话，10次深入访谈已完成并转录。
在家中对男男性行为伴侣进行衣原体和淋病筛查并通过视频提供检测结果，可能为应对这些性传播感染患病率不断上升的情况提供一种针对性的方法。通过收集男男性行为伴侣在家中性传播感染筛查体验的数据，该项目将为公共卫生干预人员和研究人员提供关于这种服务提供项目效用的宝贵见解。
国际注册报告识别码（IRRID）：DERR1-10.2196/14481。
