Longitudinal rectal swab sampling and data collection for research purposes are feasible and acceptable among GBMSM attending sexual health services, with this pilot providing tangible insights to inform the design of similar studies.
Overall recruitment achieved 193 participants from two sexual health services in Brighton and Sussex over a five-month period.
Approximately half of recruited participants provided a baseline rectal swab, and one-third of those completed all 12 swabs over the study period.
The majority of participants who provided a baseline rectal swab also provided the optional fecal sample.
Questionnaire completion rates were lower than swab completion rates, with just over a third completing the baseline questionnaire and a fifth completing all follow-up questionnaires.
Qualitative interviews identified feeling of giving something back for services received and perceived indirect benefit to self as primary motivations for participation.
SMS text messaging reminders were sent but had variable utility and were interpreted in different ways by participants.
Participants identified several barriers to completing study procedures, and suggested improvements to study design communications.
The study was designed to address gaps in understanding of how sexually transmissible enteric infection (STEI) transmission is sustained among GBMSM.
This research suggests that it is both practical and acceptable to ask gay, bisexual, and other men who have sex with men (GBMSM) to provide repeated rectal swabs and stool samples over a 12-week period as part of a research study on sexually transmitted gut infections. Conducted at two sexual health clinics in Brighton and Sussex in 2022, the pilot study recruited 193 men and found that about half provided an initial swab, and three-quarters of those also provided an optional stool sample. However, only about one in three participants who started the study completed all 12 weekly swabs, and questionnaire completion was even lower, highlighting that while the concept is feasible, keeping participants engaged over time remains a challenge. Interviews with 21 participants revealed that men were largely willing to take part because they wanted to give back to services they had received and saw some personal benefit in contributing to research on infections that affect their community. Participants generally found the tasks manageable and liked that the study had a clear end date. The main barriers were confusion about what was required, particularly for follow-up questionnaires, and mixed responses to text message reminders—some found them helpful while others found them impersonal or unclear. This research matters because sexually transmitted gut infections have been increasingly common among GBMSM over the past two decades, yet there are still significant gaps in understanding how these infections spread within communities. Longitudinal studies—where the same people provide samples repeatedly over time—are a powerful tool for tracking transmission, but they only work if people are willing and able to participate consistently. This pilot provides a practical blueprint, including specific suggestions like clearer instructions and better-designed reminders, for designing larger studies that could ultimately improve public health responses to these infections.
H. Fountain, K. Thorley, D. Reid, D. Ogaz, D. Richardson, H. Charles, et al.. (2026). Acceptability and Feasibility of Longitudinal Sampling for Sexually Transmitted Enteric Infections in Gay, Bisexual, and Other Men Who Have Sex With Men (GBMSM): Prospective Cohort Pilot Study Conducted in 2022 in South East England. JMIR Public Health and Surveillance. https://doi.org/10.2196/73762