Accuracy and Trust of Self-Testing for Bacterial Vaginosis

作者：Huppert Jill S^*; Hesse Elizabeth A; Bernard Marianne Claire; Bates Justin R; Gaydos Charlotte A; Kahn Jessica A

来源：Journal of Adolescent Health, 2012, 51(4): 400-405.

DOI：10.1016/j.jadohealth.2012.01.017

• Adolescent
• Vaginosis
• Bacterial
• Point-of-care systems
• Patient acceptance of health care
• Genital diseases
• Female

Purpose: Two point-of-care tests are available to detect bacterial vaginosis (BV), a common vaginal condition. This study aimed to (1) compare the accuracy of two self-performed BV tests with clinician-performed BV tests and with clinical diagnosis of BV; and (2) compare trust of results for self-performed BV testing with clinician-performed BV testing.
Methods: Participants (14-22 years old) in a study assessing self-testing for Trichomonas vaginalis were also asked to perform a self-test for BV (using a pH or sialidase test). Results were compared with clinician-performed tests and with clinical diagnosis of BV (defined by modified Amsel criteria). A two-item subscale from a larger acceptability scale was used to assess trust at baseline, after testing, and after discussion of results.
Results: All 131 women performed self-BV testing correctly. Agreement between self- and clinician-performed tests was good (kappa: .5-.7) Compared with clinical diagnosis of BV, self-pH was 73% sensitive and 67% specific, and self-sialidase was 40% sensitive and 90% specific. Trust in self-performed BV testing was lower than trust in clinician-performed BV testing at baseline, but increased after testing and discussion of results.
Conclusions: Young women can perform self-tests for BV with reasonable accuracy, which could increase testing when pelvic examinations are not feasible. Trust in self-testing increased after experience and after discussion of test results. Although the pH test is available over the counter, young women may continue to rely on clinicians for testing.

• 出版日期2012-10