'Bish bash bosh': the experiences of men who have sex with men providing self-taken oropharyngeal, rectal, meatal and first-catch urine specimens, and pooling genital and extragenital specimens for Neisseria gonorrhoeae and Chlamydia trachomatis detection.

Richardson, D.; Wallace, H.; Wilson, J.

'Bish bash bosh': the experiences of men who have sex with men providing self-taken oropharyngeal, rectal, meatal and first-catch urine specimens, and pooling genital and extragenital specimens for Neisseria gonorrhoeae and Chlamydia trachomatis detection.

All Authors

Richardson, D.

Wallace, H.

Wilson, J.

LTHT Author

Wallace, Harriet
Wilson, Janet

LTHT Department

Specialty & Integrated Medicine
Genitourinary Medicine

Publication Date

2026

Item Type

Journal Article

Subject

CHLAMYDIA INFECTIONS , MASS SCREENING , HOMOSEXUALITY , MEN , GONORRHOEA , SEXUALLY TRANSMITTED DISEASES , SEXUAL HEALTH

Abstract

OBJECTIVE: This qualitative analysis aimed to explore the experiences of men who have sex with men (MSM) providing self-taken oropharyngeal, rectal, meatal and urine specimens, and pooling genital and extragenital specimens for Neisseria gonorrhoeae and Chlamydia trachomatis nucleic acid amplification testing (NAAT). METHOD: MSM participants from the MYSTIC study consented to participate in an online focus group. They were encouraged to share and discuss their experiences of self-taken oropharyngeal, rectal, meatal and urine specimens, and the pooling of specimens. The focus group was recorded and transcribed. Thematic analysis, using a framework approach, generated themes and highlighted their experiences. RESULTS: Seven MSM, with experience of providing self-taken specimens for gonorrhoea and chlamydia testing, consented and contributed to a focus group in April 2024. They described difficulties they experienced in producing and handling urine specimens. They had concerns about urine spilling, but believed it was more accurate than meatal specimens. They described learning how to take oropharyngeal specimens, including being shown by clinicians and using a mirror. They were unsure how deep, and for how long, to take rectal specimens, and whether the swab should be twisted. They described feeling embarrassed at providing faecally contaminated specimens. They found the meatal specimens easy to perform but were concerned whether they were taking the specimen correctly. Overall, MSM preferred meatal specimens over urine and were willing to compensate some test accuracy for meatal specimens rather than urine. Some found the pooling complicated and were concerned about having an adequate environment to do this in correctly; conversely, some found this easy and quicker. CONCLUSION: These data provide insight into the experiences of MSM providing self-taken samples and pooling them for gonorrhoea and chlamydia testing. Interestingly, MSM preferred self-taken meatal swabs to urine and would accept a slight reduction in diagnostic sensitivity with this specimen. Copyright © Author(s) (or their employer(s)) 2026. No commercial re-use. See rights and permissions. Published by BMJ Group.