Department of Psychology, University of Southampton, Southampton, UK.
Solent NHS Sexual Health Services, Southampton, UK.
Sex Transm Infect. 2023 May;99(3):195-197. doi: 10.1136/sextrans-2021-055243. Epub 2022 Jun 2.
Among men who have sex with men (MSM) in the UK, (CT) and (NG) infections commonly occur asymptomatically at extragenital sites. Therefore, MSM seeking sexual health services are offered three-site (oropharyngeal, rectal and urogenital) STI screening. To increase access to screening, some UK sexual health services enable asymptomatic service users to order free STI screening kits online for self-sampling at home. We sought to assess prevalence of overall and extragenital CT/NG infection among asymptomatic MSM who used online self-testing in Hampshire, UK.
We assessed prevalence of CT/NG infections from non-pooled samples among asymptomatic cisgender MSM using an administrative database with results from 5601 STI screening kits returned between 20 December 2016 and 31 January 2020. We compared number of diagnoses of extragenital infection with urogenital results of the same individuals to determine prevalence of infection that would have been missed with urine testing alone.
Among 5051 valid CT and 5040 valid NG asymptomatic test results, overall prevalence was 5.9% (298/5051) and 4.5% (228/5040), respectively. Among MSM with asymptomatic CT, 71.8% (214/298) had extragenital infection only, χ (1, n=298)=56.71, p<0.001. Among those with asymptomatic NG, 89.9% (205/228) had extragenital infection only, χ (1, n=228)=145.281, p<0.001.
Overall, most CT/NG infections among asymptomatic MSM who used online self-testing were extragenital. Given this and the likelihood of onward transmission from asymptomatic infection, it is recommended that three-site testing remain standard for MSM and free screening services be expanded in easily accessible ways.
在英国男男性行为者（MSM）中，（CT）和（NG）感染通常在生殖器外部位无症状发生。因此，向寻求性健康服务的 MSM 提供三处（口咽、直肠和泌尿生殖道）性传播感染筛查。为了增加筛查机会，一些英国性健康服务允许无症状的服务使用者在线订购免费的性传播感染筛查套件，在家中进行自我采样。我们旨在评估在英国汉普郡使用在线自我检测的无症状 MSM 中，总体和生殖器外 CT/NG 感染的流行率。
我们使用包含 2016 年 12 月 20 日至 2020 年 1 月 31 日期间 5601 份性传播感染筛查套件结果的行政数据库，评估无症状顺性别 MSM 中 CT/NG 感染的流行率。我们比较了相同个体的泌尿生殖道结果与外生殖器感染的诊断数量，以确定仅使用尿液检测可能会错过的感染率。
在 5051 份有效的 CT 和 5040 份有效的 NG 无症状检测结果中，总体流行率分别为 5.9%（298/5051）和 4.5%（228/5040）。在无症状 CT 的 MSM 中，71.8%（214/298）仅有外生殖器感染，χ（1，n=298）=56.71，p<0.001。在无症状 NG 的个体中，89.9%（205/228）仅有外生殖器感染，χ（1，n=228）=145.281，p<0.001。
总体而言，使用在线自我检测的无症状 MSM 中大多数 CT/NG 感染是外生殖器的。鉴于这一点以及无症状感染可能会传播的可能性，建议继续将三处检测作为 MSM 的标准检测方法，并以易于获得的方式扩大免费筛查服务。
