Rapid testing and treatment for sexually transmitted infections improve patient care and yield public health benefits

Int J STD AIDS. 2018 Apr;29(5):474-482. doi: 10.1177/0956462417736431. Epub 2017 Oct 23.

Abstract

A service evaluation of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) testing and result notification in patients attending a rapid testing service (Dean Street Express [DSE]) compared with those attending an existing 'standard' sexual health clinic (56 Dean Street [56DS]), and modelling the impact of the new service from 1 June 2014 to 31 May 2015.

Primary outcome: time from patients' sample collection to notification of test results at DSE compared with 56DS. Secondary outcomes estimated using a model: number of transmissions prevented and the number of new partner visits avoided and associated cost savings achieved due to rapid testing at DSE. In 2014/15, there were a total of 81,352 visits for CT/NG testing across 56DS (21,086) and DSE (60,266). Rapid testing resulted in a reduced mean time to notification of 8.68 days: 8.95 days for 56DS (95% CI 8.91-8.99) compared to 0.27 days for DSE (95% CI 0.26-0.28). Our model estimates that rapid testing at DSE would lead to 196 CT and/or NG transmissions prevented (2.5-97.5% centile range = 6-956) and lead to annual savings attributable to reduced numbers of partner attendances of £124,283 (2.5-97.5% centile range = £4260-590,331). DSE, a rapid testing service for asymptomatic infections, delivers faster time to result notification for CT and/or NG which enables faster treatment, reduces infectious periods and leads to fewer transmissions, partner attendances and clinic costs.

Keywords: Chlamydia (Chlamydia trachomatis); gonorrhoea (Neisseria gonorrhoeae); sexual behaviour.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chlamydia Infections / diagnosis*
  • Chlamydia Infections / prevention & control
  • Chlamydia Infections / transmission
  • Chlamydia trachomatis / isolation & purification*
  • Female
  • Gonorrhea / diagnosis*
  • Gonorrhea / prevention & control
  • Gonorrhea / transmission
  • Humans
  • Male
  • Neisseria gonorrhoeae / isolation & purification*
  • Patient Care
  • Point-of-Care Testing
  • Public Health
  • Sexual Behavior*
  • Sexual Partners
  • Sexually Transmitted Diseases / diagnosis
  • Sexually Transmitted Diseases / prevention & control
  • Sexually Transmitted Diseases / transmission
  • United Kingdom