Updated recommendations for the treatment of Neisseria gonorrhoeae, Chlamydia trachomatis and Treponema pallidum (syphilis), and new recommendations on syphilis testing and partner services: web annex E: evidence-to-decision framework and summary of findings tables for syphilis self-testing
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World Health Organization
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iii, 20 p.
This web annex presents the evidence-to-decision framework and summary of findings that informed WHO recommendations on syphilis self-testing as part of updated guidance on the management of sexually transmitted infections and syphilis testing services. Drawing on a systematic review and meta-analysis of studies conducted primarily among key populations, including men who have sex with men, transgender women and female sex workers, the document assesses the benefits, harms, acceptability, feasibility, resource implications and equity considerations associated with syphilis self-testing. The evidence indicates that syphilis self-testing can substantially increase testing uptake and expand access to testing among underserved populations. Reported advantages include convenience, privacy, autonomy, rapid results and lower testing costs compared with some facility-based approaches. Available data suggest little difference in linkage to confirmatory testing and treatment or in test positivity compared with standard testing services. While some users experienced challenges with blood collection and isolated reports of social harms were identified, overall acceptability and feasibility were high. Based on the balance of evidence, WHO suggests offering syphilis self-testing as an additional testing approach within comprehensive programmes that ensure access to confirmatory testing, treatment and appropriate support services.
This web annex presents the evidence-to-decision framework and summary of findings that informed WHO recommendations on syphilis self-testing as part of updated guidance on the management of sexually transmitted infections and syphilis testing services. Drawing on a systematic review and meta-analysis of studies conducted primarily among key populations, including men who have sex with men, transgender women and female sex workers, the document assesses the benefits, harms, acceptability, feasibility, resource implications and equity considerations associated with syphilis self-testing. The evidence indicates that syphilis self-testing can substantially increase testing uptake and expand access to testing among underserved populations. Reported advantages include convenience, privacy, autonomy, rapid results and lower testing costs compared with some facility-based approaches. Available data suggest little difference in linkage to confirmatory testing and treatment or in test positivity compared with standard testing services. While some users experienced challenges with blood collection and isolated reports of social harms were identified, overall acceptability and feasibility were high. Based on the balance of evidence, WHO suggests offering syphilis self-testing as an additional testing approach within comprehensive programmes that ensure access to confirmatory testing, treatment and appropriate support services.