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Background: Routine screening is a key component of STI prevention and control, however traditional programs often fail to effectively reach men and women in hidden communities, (e.g. those who engage in transactional sex). In order to reduce prevalence, we must understand the possible features of programs that would encourage asymptomatic men and women, especially persons in high-prevalence communities, to be screened for STI.
Objectives: To examine the acceptability of STI testing outside of a clinical setting among men and women who exchange sex for drugs and/or money.
Methods: As part of a larger study, 25 women and 20 men who engaged in transactional sex completed a face-to-face interview and provided self-collected samples that included pharyngeal and rectal swabs, vaginal swabs for women, and urine specimens for men. Data were also collected regarding STI knowledge, history of STI testing, and STI screening and treatment preferences.
Results: Respondent’s ranged from age 19-65 (mean=39), ethnicities included white (35) and African American (10), and most (84%) had recently exchanged sex for money or drugs. Most women (88%) and men (90%) said they preferred collecting their own sample and all participants indicated that they would be willing to be tested for STI again in the future. A total of 12% of women were positive for chlamydia, 16% for gonorrhea, and 52% for trichomonas. Of men, 10% were positive for chlamydia. No other pathogens were found in men.
Conclusions: The high infection rates and screening acceptance rates across the sample suggests that those engaged in transactional sex would benefit from, and be responsive to, community-based self-sampling for STI screening.
Implications for Programs, Policy, and/or Research: Interventions to increase STI screening should recognize that field collection of self-obtained samples is feasible and preferred by high risk populations that may be less likely to access routine clinic-based services.