Screening for STI pathogens in vulnerable groups outside of healthcaare facilities: anal canal self-swabbing

Objective. To investigate the possibility of using an individual kit of consumables for anal canal biological material self-sampling PCR testing when screening for pathogens of sexually transmitted infections (STIs) in persons from vulnerable groups outside the therapeutic and preventive facilities. Subjects and methods. The investigation involved 251 people. (88.4% were men) living in Moscow and the Moscow Region. All the investigation participants took independently their biological material from the anal canal, by using an individual kit of consumables (Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being). The ease of using the kit was assessed using a questionnaire. The DNA of STIpathogens (N. gonorrhoeae, C. trachomatis, M. genitalium, T. vaginalis, and T. pallidum) was detected by real-time polymerase chain reaction with fluorescence signal detection. Results. In 23.5% of the participants, the anal canal mucosal samples exhibited DNA of N. gonorrhoeae [42.4% (25/59)], C. trachomatis [37.3% (22/59)], M. genitalium [30.5% (18/59)], and T. pallidum [3.4% (2/59)]. The survey results showed that the investigation participants rated the ease of taking biological material at an average score of 9.4 (difficult = 0, easy = 10), the availability of understanding and the ease of following the instructions at an average score of 9.7 (diff icult = 0, easy = 10), ease of use at an average score of 8. 9 (very uncomfortable = 0, very comfortable = 10). An assessment of the personal preferences of the patents in choosing a method for taking biological material indicated that only 4.7% of the respondents would prefer traditional visits to their physician in the future; 37.1% would prefer the use of a tested approach and 56.6% would not exclude both methods. Conclusion. Testing the anal canal mucosal samples showed that the prevalence of STI pathogens (N. gonorrhoeae, C. trachomatis, M. genitalium, T. vaginalis, and T. pallidum) among the representatives of vulnerable groups in the Moscow Region was 23.5%. The investigation participants rated the individual kit of consumables as comfortable and easy to use, the use instructions for use as easy to understand. 93.7% of respondents considered that the personalized kit was the best fitfor their application, whereas 37.1% would choose the kit rather than their traditional doctor’s visit. The use of a kit for anal canal biological material self-sampling for PCR testing will be able to significantly increase the coverage of the vulnerable population as part of screening for STI pathogens.

STI, individual kit for biological material self-sampling, screening, anal canal