Testing for Chlamydial and gonorrheal infections outside of clinic settings - A summary of the literature

Background: Nucleic acid amplification tests (NAATs) provide new technology that makes it feasible to initiate testing for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) infection outside of clinic settings. Methods: We summarized the English-language literature describing chlamydial or gonorrheal testing with self-collection of urine or vaginal specimens outside of clinic settings in developed countries published between January 1995 and August 2002. Results: Testing for CT or GC infection has been initiated in school, community, and home settings. Purposes include screening of asymptomatic populations, improving quality of clinic-based health care, and research. Challenges include defining and reaching target populations, overcoming logistic issues, developing communication and counseling strategies, and determining whether alternative testing strategies are effectively reducing infection rates. Conclusions: The use of NAATs to detect CT and GC infection outside of clinic settings will undoubtedly continue. Future research should focus on how to best use this technology to reduce rates of infection.