Optimizing Screening for Sexually Transmitted Infections in Men Using Self-Collected Swabs — A Systematic Review

BACKGROUND Sexually transmitted infection (STI) rates are increasing in the U.S. while funding for prevention and treatment programs has declined. Sample self-collection for STI testing in men may provide an acceptable, easy, rapid and potentially cost-effective method for increasing diagnosis and treatment of STIs. METHODS We conducted a systematic review of articles assessing self-collection of anal, oral, or genital swab samples among adult men for detection of STIs and/or human papillomavirus (HPV)-related dysplasia. We searched for English-language articles in which men aged ≥ 18 years were recruited to participate. RESULTS Our literature search resulted in 1053 citations, with 20 meeting inclusion criteria. Self-collection methods were highly sensitive and comparable to clinician-collection for detection of multiple STI pathogens. However, self-collected samples were less likely to be of adequate quality for anorectal cytology and less sensitive for detection of anal intraepithelial neoplasia (AIN) than clinician-collected samples. Self-collection was highly acceptable. Overall, studies were small, heterogeneous, and used designs providing lower levels of evidence. CONCLUSION Self-collection methods are a viable option for collecting samples for STI testing in adult men based on their high feasibility, acceptability, and validity. Implementation of self-collection procedures in STI testing venues should be performed to expand opportunities for STI detection and treatment.