Factors associated with the online postal self-sampling testing cascade in England, 2022: a retrospective observational study of routinely collected service-level healthcare data
Gibbs et al.
The finding, in our words
This retrospective analysis of over 600,000 online postal self-sampling orders found that whilst return rates for urine samples were moderate to high, the return of processable blood samples was significantly lower and varied by age and deprivation level.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
The study found that self-collection of dried blood spots and other samples using at-home kits was a useful and cost-effective method for screening a large cohort for sexually transmitted infections outside a clinic. This demonstrates the feasibility of decentralised, patient-centric sampling for population-level infectious disease surveillance.
Sexual minority men found finger-stick blood and rectal swabs more challenging to self-collect than other specimens. Barriers to returning samples included low confidence in self-collection and concerns about transit delays, while motivators were status confirmation and limited clinic access; real-time video support could improve uptake in future decentralised testing programmes.
The pilot study provided evidence that a dry-stored, self-collected vaginal swab could assist detection of Chlamydia trachomatis when compared with clinician-collected discharge, first-catch urine and blood serology, potentially reducing privacy barriers and removing cold-chain requirements for screening in remote areas.
Higher engagement in regular HIV and STI testing was associated with incident STIs and health seeking behaviours, and participants rated self-sampling as convenient.
Fifty-one per cent of racially and ethnically diverse gay, bisexual, and other men who have sex with men returned at least one self-collected specimen, blood, urine, pharyngeal or rectal swabs, or hair, within six weeks when offered for remote HIV and STI screening and pre-exposure prophylaxis adherence testing; most specimens were adequate for laboratory processing. Non-return was associated with lower education, employment, and lower HIV/STI knowledge and concern, indicating that while self-collection is feasible for decentralised diagnostics, targeted engagement strategies are needed.