{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T23:49:03Z","timestamp":1782863343039,"version":"3.54.5"},"reference-count":66,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2023,3,29]],"date-time":"2023-03-29T00:00:00Z","timestamp":1680048000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000156","name":"Fonds de Recherche du Qu\u00e9bec - Sant\u00e9","doi-asserted-by":"publisher","award":["324154"],"award-info":[{"award-number":["324154"]}],"id":[{"id":"10.13039\/501100000156","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Foundation for Innovative New Diagnostics","award":["CNO: 8647"],"award-info":[{"award-number":["CNO: 8647"]}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["PJT 153149"],"award-info":[{"award-number":["PJT 153149"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"name":"India-Canada Centre for Innovative Multidisciplinary Partnerships to Accelerate Community Transformation and Sustainability","award":["CNO: 3072"],"award-info":[{"award-number":["CNO: 3072"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2023,2,24]]},"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p><jats:italic>Chlamydia trachomatis<\/jats:italic>(CT) and<jats:italic>Neisseria gonorrhoeae<\/jats:italic>(GC) resulted in over 200\u2009million new sexually transmitted infections last year. Self-sampling strategies alone or combined with digital innovations (ie, online, mobile or computing technologies supporting self-sampling) could improve screening methods. Evidence on all outcomes has not yet been synthesised, so we conducted a systematic review and meta-analysis to address this limitation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched three databases (period: 1 January 2000\u20136 January 2023) for reports on self-sampling for CT\/GC testing. Outcomes considered for inclusion were: accuracy, feasibility, patient-centred and impact (ie, changes in linkage to care, first-time testers, uptake, turnaround time or referrals attributable to self-sampling).<\/jats:p><jats:p>We used bivariate regression models to meta-analyse accuracy measures from self-sampled CT\/GC tests and obtain pooled sensitivity\/specificity estimates. We assessed quality with Cochrane Risk of Bias Tool-2, Newcastle\u2013Ottawa Scale and Quality Assessment of Diagnostic Accuracy Studies-2 tool.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We summarised results from 45 studies reporting self-sampling alone (73.3%; 33 of 45) or combined with digital innovations (26.7%; 12 of 45) conducted in 10 high-income (HICs; n=34) and 8 low\/middle-income countries (LMICs; n=11). 95.6% (43 of 45) were observational, while 4.4% (2 of 45) were randomised clinical trials.<\/jats:p><jats:p>We noted that pooled sensitivity (n=13) for CT\/GC was higher in extragenital self-sampling (&gt;91.6% (86.0%\u201395.1%)) than in vaginal self-sampling (79.6% (62.1%\u201390.3%)), while pooled specificity remained high (&gt;99.0% (98.2%\u201399.5%)).<\/jats:p><jats:p>Participants found self-sampling highly acceptable (80.0%\u2013100.0%; n=24), but preference varied (23.1%\u201383.0%; n=16).<\/jats:p><jats:p>Self-sampling reached 51.0%\u201370.0% (n=3) of first-time testers and resulted in 89.0%\u2013100.0% (n=3) linkages to care. Digital innovations led to 65.0%\u201392% engagement and 43.8%\u201357.1% kit return rates (n=3).<\/jats:p><jats:p>Quality of studies varied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Self-sampling had mixed sensitivity, reached first-time testers and was accepted with high linkages to care. We recommend self-sampling for CT\/GC in HICs but additional evaluations in LMICs. Digital innovations impacted engagement and may reduce disease burden in hard-to-reach populations.<\/jats:p><\/jats:sec><jats:sec><jats:title>PROSPERO registration number<\/jats:title><jats:p>CRD42021262950.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2022-055557","type":"journal-article","created":{"date-parts":[[2023,3,29]],"date-time":"2023-03-29T17:35:05Z","timestamp":1680111305000},"page":"420-428","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Self-sampling strategies (with\/without digital innovations) in populations at risk of<i>Chlamydia trachomatis<\/i>and<i>Neisseria gonorrhoeae<\/i>: a systematic review and meta-analyses"],"prefix":"10.1136","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8575-436X","authenticated-orcid":false,"given":"Fiorella","family":"Vialard","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apoorva","family":"Anand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy","family":"Leung Soo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6431-4656","authenticated-orcid":false,"given":"Anna","family":"de Waal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madison","family":"McGuire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Carmona","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Fern\u00e1ndez-Su\u00e1rez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice Anne","family":"Zwerling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4672-0500","authenticated-orcid":false,"given":"Nitika","family":"Pant Pai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,3,29]]},"reference":[{"key":"2024102610500805000_99.6.420.1","unstructured":"Global progress report on HIV, viral hepatitis and sexually transmitted infections: world health organization. 2021."},{"key":"2024102610500805000_99.6.420.2","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1586\/14737159.2013.820543","article-title":"Hiv self-testing strategy: the middle road","volume":"13","author":"Pai","year":"2013","journal-title":"Expert Rev Mol Diagn"},{"key":"2024102610500805000_99.6.420.3","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2016-052841"},{"key":"2024102610500805000_99.6.420.4","unstructured":"Recommendations on digital interventions for health system strengthening: world health organization. 2019."},{"key":"2024102610500805000_99.6.420.5","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.5858\/arpa.2020-0118-RA","article-title":"Point-Of-Care testing for sexually transmitted infections: a review of recent developments","volume":"144","author":"Adamson","year":"2020","journal-title":"Arch Pathol Lab Med"},{"key":"2024102610500805000_99.6.420.6","doi-asserted-by":"crossref","first-page":"101059","DOI":"10.1016\/j.eclinm.2021.101059","article-title":"HIV self-testing with digital supports as the new paradigm: a systematic review of global evidence (2010-2021)","volume":"39","author":"McGuire","year":"2021","journal-title":"EClinicalMedicine"},{"key":"2024102610500805000_99.6.420.7","doi-asserted-by":"crossref","first-page":"100961","DOI":"10.1016\/j.eclinm.2021.100961","article-title":"Performance of point-of-care tests for the detection of chlamydia trachomatis infections: a systematic review and meta-analysis","volume":"37","author":"Zhou","year":"2021","journal-title":"EClinicalMedicine"},{"key":"2024102610500805000_99.6.420.8","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0132776","article-title":"Self-collected versus clinician-collected sampling for chlamydia and gonorrhea screening: a systemic review and meta-analysis","volume":"10","author":"Lunny","year":"2015","journal-title":"PLoS One"},{"key":"2024102610500805000_99.6.420.9","unstructured":"R: A language and environment for statistical computing. 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