Description of included studies
| Study | Location, population and STI(s) tested | Intervention | Study methods |
| Anderson et al, 199848 | Location: Aarhus, Denmark Population: Index patient CT-positive women attending general practice clinic; their male sexual partners received the intervention STI(s) tested: CT | Intervention: Index patients completed a questionnaire about numbers of sexual partners and contacted their partners to collect a first-void urine sample at home for CT testing. Then they returned the sample to laboratory in a prepaid envelope. Control: Index patients were given an envelope containing a contact slip and a request for their partner to visit his doctor for a urethral swab sample for CT testing (not reported if index patients completed the questionnaire about number of sexual partners). The doctor returned the sample to study laboratory in a prepaid envelope. | Study design: Randomised controlled trial Sample size: Total n=133 Intervention n=65 Control n=68 |
| Barbee et al, 201641 | Location: Seattle, Washington, USA Population: MSM attending HIV care clinic who were asymptomatic for STIs STI(s) tested: CT, NG | Intervention: A new programme included clinic-based, unsupervised, self-initiated self-collection of pharyngeal, rectal and urethral samples by swab for CT and NG testing. Comparison: Provider or triage nurse would ensure patient was asymptomatic for STIs (and thus eligible for screening); clinician-collected pharyngeal and rectal swabs for CT and NG testing | Study design: Serial cross-sectional Sample size: Total n=3030 Intervention n=1520 Comparison n=1510 |
| Bradshaw et al, 200542 | Location: Melbourne central business district, Australia Population: People who inject drugs, ages 17–45 years, attending a weekly outreach service of The Melbourne Sexual Health Centre who had not been recently screened for STIs STI(s) tested: CT, NG, TV | Intervention: Participants were approached on foot by research staff in known injecting and dealing locations and encouraged to accompany staff back to nearby clinic for STI testing. Participants self-collected vaginal swab (tampon) samples for CT, NG and TV (for women) or urine samples for CT and NG (for men or women who declined the swab method). Comparison: In the pilot programme, participants provided clinician-collected endocervical and vaginal samples for CT, NG and TV for women and clinician-collected urethral samples for CT and NG for men. | Study design: Serial cross-sectional Sample size: Total n=314 Intervention n=258 Comparison n=56 |
| Cook et al, 200743 Study name: Detection Acceptability Intervention for STDs in Youth (DAISY) study | Location: Western Pennsylvania, USA Population: Sexually active young women, ages 15–24 years, including: (1) women recently diagnosed with CT, NG or TV, recruited from clinic and (2) women from same communities as clinics with less frequent use of health services, meeting at least three of the following five criteria: young age, black race, monthly douching,>1 sexual partner in the past year or living in a high-risk neighbourhood STI(s) tested: CT, NG | Intervention: Participants received a vaginal swab self-collection kit for CT and NG testing at home at 6, 12 and 18 months after enrolment (either mailed to address or picked up at clinic), which included a cover letter, instruction sheet, questionnaire, Dacron-tipped swab, prelabelled swab container and postage-paid mailing carton. Control: Participants received an invitation to attend an assigned clinic for a free, routine test for CT and NG via clinician-collected vaginal and cervical swabs. | Study design: Randomised controlled trial Sample size: Total n=420 Intervention n=211 Control n=209 |
| Gaydos et al, 201144 | Location: Baltimore City and the State of Maryland, USA Population: Females, ages 14+ years, median age: 23 (range: 14–63) STI(s) tested: CT | Intervention: An internet-based website (advertised on radio and free community magazines) was designed to promote CT home self-sampling (vaginal swab) among young women. For the first 2 years of the programme, participants were able to obtain self-sampling kits via community pickup locations as well as by mail; in the last 3 years of the programme, kits were mailed only. Comparison: Participants underwent CT screening in National Infertility Prevention Project family planning clinic, with clinician-collected cervical swab specimens. | Study design: Cross-sectional Sample size: Total n=169 531 Intervention n=1171 Comparison n=168 360 |
| Habel et al, 201845 | Location: Pennsylvania State University, University Park campus (State College), Pennsylvania, USA Population: Males and female students, ages 18+years, attending Pennsylvania State University and using University Health Services STI(s) tested: CT, NG | Intervention: Participants used a CT and NG self-testing walk-in clinic service with self-collected vaginal swabs (for women) or urine samples (for men), which eliminated scheduling barriers and allowed for STI testing without seeing a clinician (but could consult a clinician if the student wanted). Comparison: Participants scheduled an STI testing appointment with a clinician. Clinician collected cervical specimens during the examination (for women); men were examined by a clinician and provided urine specimens for lab testing (urethral swabs not offered). | Study design: Serial cross-sectional Sample size: Total n=8110 Intervention n=4385 Comparison n=3725 |
| Holland-Hall et al, 200246 | Location: Juvenile correctional facility, Allegheny County, Pennsylvania, USA Population: New female detainees, ages 12–17 years STI(s) tested: CT, NG, TV (TV-related outcome data not reported) | Intervention: Newly admitted girls to the juvenile detention centre were invited to self-collect samples and were provided with a self-sampling kit (containing a Dacron-tipped swab, PCR transport tube, cotton-tipped swab, empty sterile test tube and instructions for vaginal swab collection) to test for CT, NG and TV. Comparison: As standard of care for new detainees, physicians performed a pelvic examination and endocervical swab sampling for CT and NG testing and vaginal swab sampling for TV testing. (These participants also provided self-collected samples for the intervention group.) | Study design: Cross-sectional Sample size: Total n=133 Intervention n=133 Comparison n=25 |
| Knight et al, 201347 Study name: Xpress | Location: Sydney, Australia Population: Patients attending Sydney Sexual Health who were asymptomatic for STIs and from a priority population (MSM, Aboriginal people, sex workers, people who use drugs, HIV-positive people and youth younger than 25 years). STI(s) tested: not specified, but bacterial STIs (likely CT, NG, TV) | Intervention: A fast-track STI testing service (Xpress) for drop-in clients was implemented in a large sexual health clinic, which included a computer-assisted self-interview for sexual history and risk assessment followed by a 15 min consultation with an enrolled nurse and self-collected genital and rectal swabs for STI testing (STIs not specified). Comparison: Participants underwent the routine triage system by an experienced sexual health registered nurse at the sexual health clinic and, if they met inclusion criteria, were allocated a 30 min consultation with a registered nurse which included a pen-and-paper sexual history and risk assessment, genital examination and clinician-collected genital and rectal specimens for STI testing. | Study design: Serial cross-sectional Sample size: Total n=10 139 Intervention n=5335 Comparison n=4804 |
| Ostergaard et al, 199850 | Location: Aarhus, Denmark Population: Male and female high school students, mean age: 18 (female), 18.2 (male) STI(s) tested: CT | Intervention: Students completed a questionnaire and received information regarding CT infection. Female students were asked to collect two urine samples and one vaginal flush sample using saline and males were asked to collect one first-void urine sample. Participants mailed samples from home to the laboratory. Control: Students completed a questionnaire and received information regarding CT infection; they were offered free STI testing from their doctor or at the local clinic. | Study design: Randomised controlled trial Sample size: Total n=8909 Intervention n=4336 Control n=4573 |
| Ostergaard et al, 200349 | Location: Four counties in Denmark Population: Male and female index patients identified as CT-positive in routine lab testing at General Practitioner offices; sexual partners received intervention, mean age: 23.7 (control, female), 22.7 (intervention, female); 25.1 (control, male), 25.6 (intervention, male) STI(s) tested: CT | Intervention: Index patients gave or mailed a package of five specimen collection kits to their partners to be used over the next 12 months. The partners mailed the self-collected samples (first-void urine for male partners; vaginal pipette flush for female partners) to the laboratory for CT testing in postage‐paid, preaddressed envelopes. Control: Partners of index patients needed to go to a medical office to obtain a sample for CT testing, using the provided specimen collection kit. | Study design: Randomised controlled trial Sample size: Total N=734 Intervention n=398 Control n=336 |
| Xu et al, 201151 | Location: New Orleans, Louisiana; St Louis, Missouri and Jackson, Mississippi, USA Population: CT-positive women at STI or family planning clinics, ages 16+years, mean age: 22.4 (STI clinic, control), 22.5 (STI clinic, intervention), 21.8 (family planning clinic, control): 21.4 (family planning clinic, intervention) STI(s) tested: CT | Intervention: Participants were mailed (or could pick up from the clinic) a self-collection vaginal swab kit for CT testing; after self-collecting at home, they returned the sample in postage-paid, preaddressed envelopes. Control: Participants were given an appointment to return to STI or family planning clinics for rescreening for CT infection. | Study design: Randomised controlled trial Sample size: Total n=1292 Intervention n=639 Control n=653 |
CT, Chlamydia trachomatis;MSM, men who have sex with men;NG, Neisseria gonorrhoeae;STI, sexually transmitted infection;TV, Trichomonas vaginalis.