Detection of chlamydia trachomatis cervical infections in inner city women by self-collected vaginal introital sampling
Many women, at high risk for C. trachomatis infection have poor access to health clinics or arc reluctant to undergo a speculum examination. The efficacy of self-collected vaginal introital sampling for detection of C. irachomatis was evaluated in 97 inner city women. Their mean age was 19.1 ± 5,2 yrs with 10.8 ± 1.9 yr schooling; 81% received Medicaid and 37% had never looked at their own genitals. With the aid of an illustrated booklet, subjects were instructed how to collect an introital sample in private. A second introital sample was then collected by the clinician as was an cndocervical sample. All samples were tested for C. trachomatis by Amplicor PCR (Roche Diagnostics). Thirty (31%) of the self-introital samples were positive; all but one of the clinician-collected introital samples from these same women, but none of the others, was also C. trachomatis positive. Endocervical samples from 26 of the self-introital-positive women, and none of the introital-negative women, were also positive. Thus, all clinician-collected samples were also positive by self-testing. The four introital-positive, cervical-negative samples could have been due to the presence of C. trachomatis onh in the urethra. These four cervical samples did not contain a PCR inhibitor, Thus, self-collected vaginal introital sampling is a sensitive non-invasive method for C. trachomatis screening among inner city women.