Evaluation of the Implementation of a New Nurse-Led Express “Test-And-Go” Human Immunodeficiency Virus/Sexually Transmitted Infection Testing Service for Men Who Have Sex With Men at a Sexual Health Center in Melbourne, Australia

Chow, Eric P F; Fortune, Ria; Dobinson, Sheranne; Wakefield, Trish; Read, Tim; Chen, Marcus Y; Bradshaw, Catriona; Fehler, Glenda; Fairley, Christopher K.

doi:10.1097/olq.0000000000000777

Cited by 6 publications

(18 citation statements)

References 18 publications

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“…The time saved could then be used to serve additional patients. Chow et al 14 implemented a test-and-go (TAG) service where a nurse collects blood and throat swabs, and the patient collects their own urine and rectal samples to drop-off and leave at the clinic. Testing results were then provided a week later.…”

Section: Resultsmentioning

confidence: 99%

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

Footman¹,

Dagama²,

Smith

et al. 2021

Sexual Trans Dis

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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.

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Section: Resultsmentioning

confidence: 99%

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

Footman¹,

Dagama²,

Smith

et al. 2021

Sexual Trans Dis

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show abstract

“… 20 , 21 , 24 However, the Food and Drug Administration approved the first NAATs for extragenital gonorrhea in 2019, and numerous clinics have successfully implemented express screening for MSM. 14 , 22 , 25 , 27 ,46s In addition, some of these clinics required that MSM patients be seen first via a traditional provider visit before using the express pathway. 22 , 25 We assumed in the express scenario that 100% of asymptomatic men were screened via the express pathway.…”

Section: Discussionmentioning

confidence: 99%

“… 14 , 22 , 25 , 27 ,46s In addition, some of these clinics required that MSM patients be seen first via a traditional provider visit before using the express pathway. 22 , 25 We assumed in the express scenario that 100% of asymptomatic men were screened via the express pathway. If we instead assumed that only some asymptomatic men received express screening, this would reduce the epidemiological impact found in our model, as fewer men would be triple-site screened and some infections would be missed.…”

Section: Discussionmentioning

confidence: 99%

“…Express clinics serving MSM communities generally provide gonorrhea and chlamydia NAAT screening via the express pathway with the option to include provider-administered HIV and syphilis blood testing afterward to meet screening recommendations for MSM. 22 , 25 , 27 We did not include chlamydia screening in the model, although our diagnostic costs were for bundled gonorrhea and chlamydia NAATs, so there are likely further benefits not realized in our model. We did not include syphilis and HIV testing, as this is generally provided as an add-on service for men being express screened for gonorrhea and chlamydia and was not the focus of our article.…”

Section: Discussionmentioning

confidence: 99%

“… 22 , 25 In addition, it is particularly important to consider opportunities to improve patient convenience and comfort while providing quality care given that the medical community is recommending that MSM be screened relatively frequently. 22 …”

mentioning

confidence: 99%

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Modeling the Cost-Effectiveness of Express Multisite Gonorrhea Screening Among Men Who Have Sex With Men in the United States

et al. 2021

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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

et al. 2023

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Introduction Of 37.7 million people living with HIV in 2020, 6.1 million still do not know their HIV status. We synthesize evidence on concurrent HIV testing among people who tested for other sexually transmitted infections (STIs). Methods We conducted a systematic review using five databases, HIV conferences and clinical trial registries. We included publications between 2010 and May 2021 that reported primary data on concurrent HIV/STI testing. We conducted a random‐effects meta‐analysis and meta‐regression of the pooled proportion for concurrent HIV/STI testing. Results We identified 96 eligible studies. Among those, 49 studies had relevant data for a meta‐analysis. The remaining studies provided data on the acceptability, feasibility, barriers, facilitators, economic evaluation and social harms of concurrent HIV/STI testing. The pooled proportion of people tested for HIV among those attending an STI service (n = 18 studies) was 71.0% (95% confidence intervals: 61.0–80.1, I2 = 99.9%), people tested for HIV among those who were tested for STIs (n = 15) was 61.3% (53.9–68.4, I2 = 99.9%), people tested for HIV among those who were diagnosed with an STI (n = 13) was 35.3% (27.1–43.9, I2 = 99.9%) and people tested for HIV among those presenting with STI symptoms (n = 3) was 27.1% (20.5–34.3, I2 = 92.0%). The meta‐regression analysis found that heterogeneity was driven mainly by identity as a sexual and gender minority, the latest year of study, country‐income level and region of the world. Discussion This review found poor concurrent HIV/STI testing among those already diagnosed with an STI (35.3%) or who had symptoms with STIs (27.1%). Additionally, concurrent HIV/STI testing among those tested for STIs varied significantly according to the testing location, country income level and region of the world. A few potential reasons for these observations include differences in national STI‐related policies, lack of standard operation procedures, clinician‐level factors, poor awareness and adherence to HIV indicator condition‐guided HIV testing and stigma associated with HIV compared to other curable STIs. Conclusions Not testing for HIV among people using STI services presents a significant missed opportunity, particularly among those diagnosed with an STI. Stronger integration of HIV and STI services is urgently needed to improve prevention, early diagnosis and linkage to care services.

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Evaluation of the Implementation of a New Nurse-Led Express “Test-And-Go” Human Immunodeficiency Virus/Sexually Transmitted Infection Testing Service for Men Who Have Sex With Men at a Sexual Health Center in Melbourne, Australia

Cited by 6 publications

References 18 publications

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

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

Modeling the Cost-Effectiveness of Express Multisite Gonorrhea Screening Among Men Who Have Sex With Men in the United States

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

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