A Systematic Review of New Approaches to Sexually Transmitted Infection Screening Framed in the Capability, Opportunity, Motivation, and Behavior Model of Implementation Science

Abstract

Chlamydia and gonorrhea are 2 of the most common bacterial sexually transmitted infections (STIs) worldwide. Rising chlamydia and gonorrhea rates along with increased closing of STI clinics has led many to seek STI testing in clinical settings such as urgent cares and walk-in clinics. However, with competing priorities, providing effective and efficient STI care can be difficult in these settings. This has left a growing need for the implementation of novel STI screening programs in other clinical settings. This review summarizes previous studies that have evaluated the clinical implementation of chlamydia and gonorrhea screening programs in these settings. Literature from January 2015 to February 2020 regarding the implementation or evaluation of STI screening programs in clinical settings was reviewed. Constructs from the Capability, Opportunity, Motivation, and Behavior model were used to organize results, as this model can aid in identifying specific strategies for behavior/process change interventions. We found that multiple STI screening programs have been implemented and evaluated in 5 different countries and multiple health care facilities including sexual health clinics, urgent cares, walk-in clinics, and university health clinics. When implementing new STI screening programs, sample-first, test-and-go services and molecular point-of-care (POC) testing approaches were found to be effective in increasing screening and reducing costs and time to treatment. At the health care systems level, these programs can help reduce STI screening costs and generate additional revenue for clinics. At the provider level, clear communication and guidance can help clinical and administrative staff in adopting new screening programs. Finally, at the patient level, new programs can reduce time to treatment and travel costs in visiting clinics multiple times for testing and treatment services.

2020 STD Prevention Conference: Disrupting Epidemics and Dismantling Disparities in the Time of COVID-19

“…“self-testing”); however, regulatory waivers that allow such tests to be performed outside of the traditional clinical laboratory could substantially improve access to testing. Footman et al 14 in their article “A Systematic Review of New Approaches to Sexually Transmitted Infection Screening Framed in the Capability, Opportunity, Motivation, and Behavior Model of Implementation Science,” describe a decision tree for use by clinics and laboratories to assess the implementation of POC tests versus tests that occur in higher complexity laboratories. An understanding of patient populations and testing logistics underpin the decisions to implement POC tests for clinical use.…”

Preferences for pre-exposure prophylaxis for HIV among men who have sex with men and transgender women in 15 countries in Asia and Australia: a discrete choice experiment

“…4 Pre-exposure prophylaxis (PrEP) is a safe and highly effective HIV prevention method. 5,6 Within the Asia-Paci c region, PrEP was rst introduced in Thailand in 2014, 7 and subsidised PrEP was rst offered in Australia in 2018 8 as an approach to rapid and sustainable PrEP scale-up. 9 This approach signi cantly reduced HIV incidence at a population level.…”

Are sexually transmitted infections associated with male infertility? A systematic review and in-depth evaluation of the evidence and mechanisms of action of 11 pathogens

“…Sexually transmitted infections (STIs) are common clinical conditions with major implications for the patient and healthcare system [ 1 ]. The World Health Organization’s (WHO) report on global STI surveillance in 2018 indicated a worldwide incidence of almost a million new cases per day [ 2 ].…”