Public acceptability of self-sampling and self-testing for infections: a rapid systematic review

Problem

Self-sampling and self-testing (SS/ST) by the members of the public in the community have been increasingly used for sexually transmitted infections (STIs) and recently for COVID-19. They offer an important strategy for preventing and managing infections, especially during outbreaks of infectious diseases. Many factors, including public views and experiences of SS/ST, affect the use and implementation of SS/ST. We aim to synthesise the public users’ views and experiences related to the acceptability of SS/ST for infections to inform future public health approaches to SS/ST.

Approach

A rapid systematic review (PROSPERO CRD42024507656). We searched five databases, conducted manual citation searches and searched for grey literature. We included qualitative, mixed-method and survey studies reporting public users’ views on SS/ST for infections or infectious pathogens. We focused on studies conducted in Europe and published since 2014 in English. We used structured forms to extract data on study characteristics, characteristics of SS/ST devices, details of SS/ST procedures, and public views on SS/ST. We are synthesising the data narratively.

Findings

We identified 6500 records and screened 2729 abstracts and 368 full texts. We included 44 studies published in Europe (22 in the UK; 8 qualitative, 14 mixed-methods, and 22 surveys). Twenty-six studies explored SS/ST for respiratory infections/pathogens (mostly COVID-19), 16 for STIs, and 2 for hepatitis C. Data synthesis is ongoing (to be completed by April 2024). Preliminary analysis suggests that studies report high levels of public users’ acceptability of SS/ST across infections/pathogens (particularly for swabs and saliva/gargle fluids SS), ease of performing SS/ST, and preferences for SS/ST at home over testing by health professionals. Participants reported many perceived benefits of and motivations for SS/ST (e.g., related to convenience and privacy), and some barriers/challenges (e.g., related to unclear instructions and difficulties collecting samples).

Consequences

Self-sampling/self-testing appears to be an acceptable approach to testing for infections. It might be a useful public health strategy to increase testing, especially to prevent and control infectious outbreaks in the community. However, key barriers to performing SS/ST will need addressing if SS/ST were to be successfully implemented.