Longitudinal Sampling Supports STEI Research
LONGITUDINAL sampling for sexually transmitted enteric infections appeared feasible among GBMSM attending sexual health services.
A prospective cohort pilot study conducted in South East England suggests that repeated rectal swab sampling and linked data collection for sexually transmitted enteric infection research can be both feasible and acceptable in gay, bisexual, and other men who have sex with men accessing sexual health services. The findings offer a potential framework for future studies seeking to better understand how sexually transmitted enteric infection transmission is sustained over time.
Sexually Transmitted Enteric Infection Study Design
Researchers recruited 193 participants aged 16 years and older from two sexual health services between May and October 2022. Participants were asked to provide a baseline rectal swab, an optional fecal sample, and a baseline online questionnaire, followed by weekly questionnaires and rectal swabs for 11 additional weeks. Pseudonymized sexually transmitted infection surveillance data were also linked to provide extra clinical and demographic information, and selected participants took part in one to one interviews.
Half of all recruited participants, 100 out of 193, provided a baseline rectal swab. Of these, 34.0% completed all 12 swabs, while 76.0% also submitted the optional fecal sample. Questionnaire completion was lower, with 71 of 193 participants completing the baseline questionnaire and 15 of those 71 completing all follow-up questionnaires. Data linkage proved highly workable, with most participants consenting and nearly all consenting records linked successfully.
Acceptability and Barriers to Participation
Interview findings suggested that many participants were motivated by a sense of giving something back for services received, along with a perceived indirect personal benefit. The study was generally viewed as manageable, with participants describing the procedures as simple and flexible enough to fit into normal routines. Most were satisfied with the 12 week duration, and the clear end point appeared to help participants judge whether they could commit.
The main barriers involved uncertainty about what was required, especially for follow-up questionnaires. The authors noted that clearer, more concise instructions and a more obvious summary of study procedures could improve retention in future work. SMS reminders were used, but participants interpreted them in different ways and found them variably helpful.
Overall, the authors conclude that longitudinal rectal swab sampling and associated data collection are acceptable and feasible in this setting. They suggest that this approach could help close important knowledge gaps around sexually transmitted enteric infection transmission and support future public health infection control measures.
Reference
Fountain H et al. Acceptability and Feasibility of Longitudinal Sampling for Sexually Transmitted Enteric Infections in Gay, Bisexual, and Other Men Who Have Sex With Men (GBMSM): Prospective Cohort Pilot Study Conducted in 2022 in South East England. JMIR Public Health Surveill. 2026;12:e73762.
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