| Anderson et al, 199848 | The proportion of males who accepted and completed the at-home test was 68% (44/65), a higher proportion compared with males who visited their doctor with a proportion of 28% (19/68), (RR: 2.42, 95% CI 1.60 to 3.68).
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| Barbee et al, 201641 | Any site NG/CT: 670/1520 at baseline, 770/1510 during intervention; 15.0% increase (p<0.001). Pharyngeal NG/CT: 444/1520 at baseline, 586/1510 during intervention; 32.0% increase (p<0.001). Rectal NG/CT: 390/1520 at baseline, 520/1510 during intervention; 33.3% increase (p<0.001). Urethral NG/CT: 510/1520 at baseline, 697/1510 during intervention; 36.7% increase (p<0.001). All three sites (pharyngeal, rectal, urethral) NG/CT: 243/1520 at baseline, 466/1510 during intervention; 91.8% increase (p<0.001). Absolute testing coverage: 39% tested at the pharynx, 34% at the rectum and 46% at the urethra. Complete testing (testing at all three sites) completed by 31% of participants
| Detected NG infections overall: 98/1794 at baseline, 147/2706 during intervention; 50% increase. Detected CT infections overall: 96/1794 at baseline, 141/2706 during intervention; 47% increase. Test positivity for pharyngeal NG increased by 22% from 6.4% to 7.8% (p=0.292) and for pharyngeal CT by 21% from 1.4% to 1.7% (p=0.639). Test positivity for rectal infections declined by 4% (p=0.836) for NG and 16% (p=0.239) for CT. Urethral chlamydia test positivity increased by 33% (p=0.076).
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| Bradshaw et al, 200542 | Acceptance of genital examination and practitioner-collected sampling for NG/TV in the pilot study was low (5/56, 9%, 95% CI 3 to 19). If these individuals were then offered screening for CT only by urine collection, substantially more accepted testing (18/56, 32%; 95% CI 21 to 45; p<0.01). STI screening by self-collected sampling had a substantially greater level of acceptance among participants (195/258, 76%; 95% CI 70 to 81; p<0.001) compared with practitioner sampling.
| The overall prevalence of STIs in those who consented to screening for CT, NG and TV was 8% (95% CI 5 to 13). All STIs detected were from self-collected samples. CT prevalence: self: 12/195 (6%); practitioner: 0/18. TV prevalence: self: 3/195 (2%); practitioner: 0.5. NG prevalence: self: 1/195 (1%); practitioner: 0/5.
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| Cook et al, 200743 | The proportion of women who completed at least one asymptomatic (screening) STI test during the 2 years of follow-up was significantly greater among women in the intervention group (162/197 (82.2%) vs 117/191 (61.3%), p<0.001). The proportion of women who completed >2 asymptomatic STI tests was significantly greater among women in the intervention group (55.9% vs 37.2%, p<0.001). The number of CT and NG tests completed per year was significantly greater in women in the intervention group for all tests (1.94 vs 1.41 tests per woman-year, p<0.001; RR: 1.38 (95% CI 1.23 to 1.55)) and for asymptomatic tests (1.18 vs 0.75 tests per woman-year, p<0.001; RR: 1.57 (95% CI 1.34 to 1.83)). Women in the intervention group were over two times as likely to complete an STI test when asymptomatic or otherwise (RR: 2.12 (95% CI 1.70 to 2.66) vs RR: 1.18 (95% CI 1.03 to 1.35).
| No significant difference in the rate of incidence of STIs detected during follow-up in the intervention group compared with the control group (20.4 vs 24.1 infections per 100 woman-years, p=0.28). The results were similar when restricted to chlamydia only (17.6 vs 18.9 infections per 100 woman-years) or when restricted to gonorrhoea only (4.9 vs 7.9 infections per 100 woman-years).
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| Gaydos et al, 201144 | Not reported | CT positivity was 10.3% (121/1156) for females mailing swabs obtained online; prevalence ranged from 3.3% to 5.5% (total 6947/168308) in testing performed at family planning clinics. CT positivity for internet age groups was much higher than those for family planning age groups: CT positivity for internet participants ranged from a low of 4.4% in Baltimore in 2005 to a high of 15.2% Baltimore in 2007. CT positivity in family planning clinics in Baltimore and Maryland ranged from a low of 3.3% in Baltimore in 2006 to a high of 5.5% in Baltimore in 2008. Compared with age-specific positivity proportions obtained for women attending family planning clinics for the City of Baltimore and the State of Maryland for 2004–2008, CT positivity was higher among internet female participants for all age categories; statistically significant differences between programmes for age groups younger than 25 years for Baltimore and <30 years for Maryland. Although trends were similar for earlier years, in 2007, differences in prevalence in Baltimore for internet-recruited samples for age 20–24 years, was 23.5%, compared with 5.4% in family planning, (p<0.001).
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| Habel et al, 201845 | In 2013 55 male and 2711 female students used clinician testing for CT and NG. In 2015, after adding a self-testing option (and retaining clinician testing), 1303 male (28.5% increase) and 3082 female (13.7% increase) students tested for CT and NG. 18.9% of testers in 2015 opted for self-testing. 18.9% of testers opted for self-testing in 2015: 31.0% of male students and 13.6% of female students. Clinician testing from 2013 to 2015 declined by 11.3% for male students and declined by 1.8% for female students, despite overall increases in NG/CT testing.
| In 2013, 9.7% (98/1007) of male students and 5.0% (135/2700) of female students tested positive for CT/NG via clinician testing. Combined positive diagnoses over total tested before intervention: 103/823. In 2015, 1% (111/895) of male students and 4.8% (129/2656) of female students tested positive for CT/NG via clinician testing and 12.9% (52/402) of male students and 12.4% (51/412) of female students tested positive via self-testing. Combined positive diagnoses over total tested after intervention: 240/3562 In 2015, female students were more likely to test positive when electing to test via self-test vs a clinician test (χ2(1, N=3068)=36.54, p<0.01). No such significant difference in testing type was observed for male students (χ2 = χ2(1, N=1297)=0.072, p=0.79).
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| Holland-Hall et al, 200246 | Not reported | The prevalence of any STI (NG, CT, TV) was not significantly higher among those who had pelvic exams (5/25) than among those who underwent self-testing only (21/133) (p=0.173). NG: self: 8/94; clinician: 2/25 CT: self: 15/133; clinician: 4/25 TV (culture): self: 12/133; clinician: 2/25 TV (PCR): self: 11/94; clinician: 2/25
Only 30% of subjects with infections had pelvic examinations; therefore, 70% of girls with infections would have been missed in the absence of the self-testing option.
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| Knight et al, 201347 | After implementing Xpress clinic (with self-collection of samples for STI testing), 5335 patients were seen (705 in Xpress clinic) compared with 4804 before. The ratio of total patients seen to clinical staff hours rostered after implementing Xpress was 1.49 (1.7 in the Xpress clinic and 1.4 in other clinics) compared with 1.52 before. (OR: 1.02; 95% CI 0.96 to 1.09; p<0.44) Total clinic capacity with Xpress was 8007 patients, compared with 6301 before. Utilisation rates were lower after implementing Xpress (67%), compared with 76% before (p<0.01).
| Not reported. |
| Ostergaard et al, 199850 | The proportion of females who completed the at home sampling was 67.9% (1254/2603), compared with females in the control group with a proportion of 19.1% (1097/2884) (RR: 3.54). The proportion of males who completed the at home sampling was 57.0% (590/1733), compared with males in the control group with a proportion of 30.4% (316/1689) (RR: 1.87).
| The proportion of females diagnosed positive for CT was 4.6% (43/1254) for those who did home sampling and 0.456% (5/1097) for those in the control group (RR: 7.52). The proportion of males diagnosed positive for CT was 1.86% (11/590) for those who did home sampling and 0.316% (1/316) for those in the control group (RR: 5.89). The proportion of eligible (sexually experienced) females diagnosed positive for CT was 4.63% (43/928) for those who did home sampling and 0.600% (5/833) for those in the control group (RR: 7.72). The proportion of eligible (sexually experienced) males diagnosed positive for CT was 2.49% (11/442) for those who did home sampling and 0.407% (1/246) for those in the control group (RR: 6.12).
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| Ostergaard et al, 200349 | The proportion of females who were contacted and completed the at home sampling was 67.9% (38/56), compared with females who completed office testing with a proportion of 19.1% (9/47) (RR: 3.54). The proportion of males who were contacted and completed the at home sampling was 57.0% (195/342), compared with males who completed office testing with a proportion of 30.4% (88/289) (RR: 1.87).
| The proportion of females diagnosed positive for CT was 44.7% (17/38) for those who did home sampling and 55.6% (5/9) for those who did office testing (RR: 0.805). The proportion of males diagnosed positive for CT was 37.9% (74/195) for those who did home sampling and 51.1% (45/88) for those who office testing (RR: 0.742).
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| Xu et al, 201151 | The proportion of women recruited from the STI clinic who were tested for CT was 26.7% (109/408) after 7 weeks and 31.4% (128/408) after 3 months for self-testing and 19.1% (77/403) after 7 weeks (RR: 1.40) and 25.1% (101/403) after 3 months for clinic testing (RR: 1.251). The proportion of women recruited from the family planning clinic who were tested for CT was 40.8% (80/196) after 7 weeks and 49% (96/196) after 3 months for self-testing and 20.7% (43/208) after 7 weeks (RR: 1.97) and 27.9% (58/208) after 3 months for clinic testing (RR: 1.756).
| The proportion of women recruited from the STI clinic who were diagnosed positive for CT was 13.9% (17/122) for self-testing and 19.4% (19/98) for clinic testing (RR: 0.719). The proportion of women recruited from the family planning clinic who were diagnosed positive for CT was 12.9% (12/93) for self-testing and 14.5% (8/55) for clinic testing (RR: 0.887).
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