Illustrated instructions for self-collection of anorectal swab specimens and their adequacy for cytological examination.

Background: Self-collection of anorectal swab specimens would facilitate screening for anal cancer precursors and sexually transmitted rectal infections among men who have sex with men (MSM). However, pictorial guides for self-collection were not previously available. Goals: Develop and field test a set of illustrated self-collection instructions. Design: Cross-sectional study of community-recruited MSM who were naive with regard to collection of specimens for anal cytology. Results: Among 222 self- and clinician-collected swab pairs provided by mostly human immunodeficiency virus (HIV)-1 seronegative MSM (median age, 31.5 years), most specimens were adequate for cytologic evaluation, though self-collected swabs were less likely to be so (83% versus 92%, P = <0.001). The illustrated instructions were reportedly essential, but having used them, men rated their understanding of the self-collection procedure as very high. Conclusions: Provided with illustrated instructions, most MSM who are naive to the technique can self-collect anorectal swab specimens that are suitable for screening.