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

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