An evaluation of an express testing service for sexually transmissible infections in low-risk clients without complications

Abstract

Abstract. Background: One effective way of reducing the prevalence of sexually transmissible infections (STIs) in a population is ensuring easy access to clinical services and screening of populations at high risk of STIs, including HIV. We aimed to describe the features of clients using the express testing service (ETS) and the overall impact on the service. Methods: This retrospective cross-sectional study involved all clients attending the walk-in triage service at Melbourne Sexual Health Centre before the introduction of ETS in 2009 and after ETS (2011 and2012). Results: There were 32 720 and 82 265 consultations before and after ETS respectively. The ETS saw 4387 (9%) of 55 648 consultations (excluding appointments and results), giving rise to a fall in the proportion of lower-risk clients having full consultations (from 53% to 50% of consultations; P < 0.001). The consultations testing for HIV and chlamydia (Chlamydia trachomatis) were marginally higher (HIV: 48% v. 47%, P = 0.017; chlamydia: 70% v. 68%, P = 0.015) with ETS. Young (26 v. 27 years) females (38% v. 34%) utilised the ETS more (P < 0.001). The time taken for consultation and the total time spent in the clinic was significantly decreased during the ETS period (from 25 min to 6 min for consultation time and from 59 min to 29 min for total clinic time; P < 0.001). Conclusions: The data suggest that fast-track services such as ETS are effective in increasing access for higher-risk individuals while streamlining screening of asymptomatic low-risk clients.

Missed opportunities for HIV testing among those who accessed sexually transmitted infection (STI) services, tested for STIs and diagnosed with STIs: a systematic review and meta‐analysis

“…Fifteen studies provided 23 estimates for the meta‐analysis (Figure 3 and Table 3 ) [ 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ]. The pooled percentage of people tested for HIV among those tested for STIs independent of the type of service was 61.3% (95% CI: 53.9–68.4%, I 2 = 99.96%).…”

Increasing proportion of herpes simplex virus type 1 among women and men diagnosed with first-episode anogenital herpes: a retrospective observational study over 14 years in Melbourne, Australia

“…Herpes diagnoses were analysed as proportions instead of case numbers at each year, as the number of clinic attendees steadily increased from 2004 to 2017 due to the clinic’s expanding services over the long study period. This includes the introduction of express HIV/STI testing services for both heterosexual men and women, and MSM 11. Site was analysed in MSM only, and this analysis was restricted to the time period between 2009 and 2017 due to low numbers of recorded anatomical site prior to 2009.…”

Missed opportunities for HIV testing among those who accessed sexually transmitted infection (STI) services, tested for STIs and diagnosed with STIs: a systematic review and meta-analysis.

“…Service factors that improved ease of access to HIV testing amongst clients who were tested for STI included implementation of dual HIV and syphilis testing [29], express testing services for lower-risk individuals [30] and convenient testing locations [26]. Internet-based HIV and STI testing, either through self-collection or allowing clients to present to designated specimen collection sites, integrated with existing clinic-based services, can increase HIV testing rates [31].…”