Evaluation of an Intervention to Improve Rectal Screening Rates for Neisseria gonorrhoeae and Chlamydia trachomatis Among Human Immunodeficiency Virus (HIV)-Positive Men Who Have Sex With Men
Bibliographic record
Abstract
Background. The prevalence of rectal Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) among HIV-positive men who have sex with men (MSM) in the US is nearly twice as high as HIV-negative MSM. Although CDC recommends annual screening for sexually active MSM at exposed sites, rectal GC/CT screening rates in HIV clinics are low. We evaluated an intervention utilizing routine self-collected rectal swabs among MSM at the University of Alabama at Birmingham HIV clinic. Methods. MSM attending HIV visits on Mondays and Wednesdays (M/W) April 8–September 22, 2015 (the intervention group) were invited to self-collect a rectal swab for GC/CT nucleic acid amplification testing if they had history of anal receptive intercourse in the prior 12 months. Eligible participants received an anonymous survey to elicit acceptability or reasons for declining the swab collection. These participants were compared with a control group of MSM attending Tuesday/Thursday (T/Th) visits who received usual care (screening by HIV provider). Cumulative incidence of rectal GC/CT screening was compared between the two groups; comparison was also made to screening incidence during the same period in 2014. Results. During the 24 week study period, 668 MSM with HIV-infection attended M/W visits and 112 (17%) received GC/CT rectal screening compared to 89/729 (12%) MSM with T/Th visits. This represented an 8% increase in M/W and 1% decrease in T/Th screening compared to the same period in 2014. Incidence of rectal GC and CT was 10% for M/W and 4% for T/Th. Among 79/668 (12%) MSM who responded to the survey, 59 (75%) collected swabs, 11 (14%) declined, and 9 (11%) of surveys were invalid. Most men who self-collected swabs indicated a willingness to self-collect in the future (83% definitely and 14% probably willing). Conclusion. Patient uptake of an intervention to increase GC/CT screening rates among MSM at our HIV clinic using self-collected rectal swabs was low. Screening rates were increased on the days the intervention was offered but the overall difference was small. Reasons for lack of participation could not be determined due to a low number of MSM completing the survey. Elevated incidence of rectal GC/CT on intervention days suggests high risk patients may have been more likely to participate. Disclosures. All authors: No reported disclosures
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".