What You Need to Know About Coronavirus Testing Now

Study highlights advantages of syphilis self-testing: convenience, privacy, and rapid results

In a recent study published in The Lancet Public Health, researchers performed a meta-analysis on the utility of syphilis self-testing (SST).

Study: The role of syphilis self-testing as an additional syphilis testing approach in key populations: a systematic review and meta-analysis. Image Credit: JarunOntakrai/Shutterstock.com

Syphilis, a sexually-transmitted Treponema pallidum infection, is a worldwide epidemic that predominantly affects males having sexual intercourse with males (MSM), sex workers, and transgender women.

Access to healthcare facilities is hampered by economic, structural, and social constraints, leading to delayed identification and management of syphilis, continuing spread, and increasing infection-associated morbidity and mortality.

Discrimination, stigma, prior negative healthcare experiences, gender-based abuse, confidentiality concerns, reluctance to reveal sexual behavior, and limited accessibility to health facilities all contribute to sexually transmitted diseases (STD) follow-up losses and low testing rates.

SST has the potential to expand testing and therapy coverage similarly as self-tests for human immunodeficiency virus (HIV), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and hepatitis C virus (HCV) have been shown to do.

In the present meta-analysis, researchers reviewed the scientific evidence on SST concerning its usability, accuracy, acceptability, reactivity, uptake, association with confirmatory testing, management, care services for sexual health, adverse events or social harm, cost-effectiveness, and execution factors.

Databases such as Embase, MEDLINE, Scopus, Web of Science, and CINAHL were searched for studies published between January 1, 2000, and October 13, 2022. Original research on rapid tests for syphilis, including dual syphilis-HIV testing, was included.

In addition, four electronic STD or HIV conference databases [conferences of the International acquired immunodeficiency syndrome (AIDS) Society, United States Centers for Disease Control and Prevention (US CDC), International Union Against STDs, and Retroviruses and Opportunistic Infections] were reviewed.

The World Health Organization (WHO) research group for human immunodeficiency virus self-testing guidelines’ updates provided data on syphilis-HIV dual testing.

Two researchers independently performed data screening and extraction, and discrepancies were resolved by a third researcher. Random-effects modeling was performed to determine the pooled percentage of individuals offered syphilis self-testing kits who underwent testing.

Bias risks were analyzed using Cochrane’s Risk of Bias Tool and the Johanna Briggs’ Institute (JBI) Critical Appraisal Tool for randomized controlled trials (RCTs) and non-RCTs, respectively, and certainty of evidence using the GRADE approach. SST includes tests performed by individuals who collect specimens, perform the tests, and interpret the results. Descriptive statistics were used to summarize study characteristics.

In total, 40,499 records were identified, of which 11 were eligible, including seven studies conducted in the United States of America (USA, one study), China (five studies), and Zimbabwe (one study). Among the included studies, two recruited individuals from 2015 to 2017 and nine recruited individuals from 2018 to 2020.

Four studies documented data from MSM individuals, and five utilized dual SST-HIV dual tests. All the included cross-sectional analytical studies had low bias risks. Regarding evidence certainty, the team found very low evidence certainty for adverse events and social harm; low confidence for reactivity, usability, and linkage to treatment and care; and high certainty for uptake.

Using information from three observational-type studies and one RCT, the pooled percentage of individuals who underwent SST testing was 88.0%, with medium-level heterogeneity in the study findings (I² of 46.0%). None of the studies provided information on SST specificity or sensitivity.

Provider and user SST preferences were high, with SST facilitators including privacy, convenience, autonomy, quick results, reduced contact with health facilities, time savings, and trust in hematological testing, with individuals capable of self-testing correctly.

Studies conducted in China reported the highest uptake rates (approximately 90%) and that SST was more cost-effective at an individual level than facility-based tests.

However, there were a few reported challenges, including finger prick requirements for blood trial collection, complicated and lengthy procedures (involving removal of test components from the package, pipetting buffer, and understanding SST instructions), technical problems related to phone use (e.g., SST scanning), and result interpretation difficulties.

SST implementation barriers included lack of knowledge (including SST unawareness and kit and care accessibility locations), trial collection and result interpretation challenges, poor STD awareness, and privacy, cost, and test accuracy concerns.

A study reported that 30 out of 174 males and nine out of 76 female sexual workers were pressured to perform SST due to verbal abuse, relationship termination, violent threats, and psychological pressure.

Overall, the study findings expand on self-testing data for various disease locations and show that SST can reach neglected individuals.

SST implementation proved possible and acceptable; hence, SST may be utilized as a supplementary syphilis testing strategy.

However, since SST specificity and sensitivity data were unavailable, further research is required to develop appropriate strategies and policies for delivering and scaling SST.

10 Best VPN Services Of 2023

Using a VPN at home can keep your data safe from those who want to use your data for targeted advertising. On your mobile device, a VPN can protect your login details and other data you send when you connect to public Wi-Fi. It can be especially useful for businesses that have proprietary information to protect.

Here are five of the most common VPN uses:

Because of the relationship between you and your internet service provider (ISP), it can track what you do online, such as what sites you visit, the time you spend browsing, and more. Depending on the terms of service and what you’ve agreed to, your ISP may even sell your personal data to advertisers. Your stored data is kept confidential otherwise, according to most internet providers.

In the U.S., ISPs are required to keep browsing history logs for 90 days. If the government requests your internet history, an ISP must comply. In fact, in cases of national security, the government doesn’t even need a warrant to access your internet data. Theoretically, with a warrant, local law enforcement can use your data to help convict you of a crime.

Even if you’re a law-abiding citizen, you might not want your ISP documenting every URL you visit. If you use a VPN, you can cover your tracks. At the very least, it can give you peace of mind.

Whether you’re at an airport waiting for a flight and checking your email or at a local restaurant reading news on your phone, you may be tempted to use public Wi-Fi. It seems safe enough, right? The free internet connection is offered by the airport or business and they mean well.

The good news is that browsing online has become safer in recent years, thanks to most people adopting HTTPS over HTTP. That “S” is a security protocol that comes from a secure sockets layer (SSL) certificate and helps protect internet data that’s shared to and from a site. That’s what makes it safer for you to pay for products and services online, for example.

However, most public Wi-Fi connections are open and not password protected, so you might put yourself at risk of your connection being intercepted by a hacker who is trolling the Wi-Fi network.

If you have a VPN service to log into first, you can anonymously connect to public Wi-Fi and essentially remain hidden on the network. A VPN will hide your identity on an open internet connection and encrypt active data, so even if a cybercriminal is on the same network, you’ll be safe.

Lots of retailers offer apps and free Wi-Fi to shoppers and they make it hard to not use them. For one, if you download a retailer’s app, you may get access to exclusive coupons and deals, so that’s tempting. Also, a lot of physical locations block cell phone service simply because of the metal in structures.

Businesses that offer these perks for free or incentives to use their apps and Wi-Fi are doing so to collect your data, which is extremely valuable to them. This is another good reason to use a VPN if you want to protect your personal data. Plus, you’ll still be able to safely access your apps and use free Wi-Fi while you’re shopping at malls or stores.

Many companies adopted a remote or hybrid work policy recently, which is convenient for a lot of employees. However, there is a security concern about having remote workers log into company servers from home because you don’t know how secure an employee’s connection is. They could be working from home or in a coffee shop. If a connection is intercepted, there’s a concern that active data could go from an employee to a hacker, rather than the Wi-Fi the employee is trying to use.

Providing all employees with remote access and a VPN will help keep your company’s files and projects safe.

A VPN does more than protect your data—it can unlock your access to media you can’t get to now. There are benefits here for a few different reasons.

Some citizens in countries with strict governments may not be able to visit websites with opposing views to their politicians. A VPN can make it appear as though you’re located in a different location, so you can access otherwise blocked websites or media. Your connection to the VPN can keep your actual location and IP cloaked, so you can’t be pinpointed.

Another benefit to using a VPN is that you can use it to find media you can’t get otherwise. For example, Netflix and Hulu offer different types of programming per location. If you’re in the U.S., you might not be able to watch what’s available on Netflix in the United Kingdom. A VPN can make it appear as though you’re in another country, thereby unlocking that exclusive content.

These are just a few examples of how a VPN can help protect you or help you access blocked information. There are plenty of other reasons why everyone should use a VPN.