Peer-delivered point-of-care testing for Chlamydia trachomatis and Neisseria gonorrhoeae within an urban community setting: a cross-sectional analysis
Sara F. E. Bell A , Luke Coffey B , Joseph Debattista C , Steven G. Badman D , Andrew M. Redmond B E , David M. Whiley F G , Jime Lemoire B , Owain D. Williams A , Chris Howard B , Charles F. Gilks A and Judith A. Dean
A H
+ Author Affiliations
- Author Affiliations
A School of Public Health, The University of Queensland, Herston Campus, 288 Herston Road, Herston, Qld 4006, Australia.
B RAPID, Queensland Positive People, 21 Manilla Street, East Brisbane, Qld 4169, Australia.
C Metro North Public Health Unit, Metro North Hospital and Health Service, Bryden Street, Windsor, Qld 4030, Australia.
D Kirby Institute, L6, Wallace Wurth Building, High Street, The University of New South Wales Sydney, Randwick, NSW 2032, Australia.
E Royal Brisbane and Women’s Hospital, Metro North Hospital and Health Service, Butterfield St, Herston, Qld 4029, Australia.
F Centre for Clinical Research, The University of Queensland, Building 71/918, Royal Brisbane and Women’s Hospital Campus, Herston, Qld 4029, Australia.
G Pathology Queensland, Block 7, Royal Brisbane and Women's Hospital, Herston, Qld 4029, Australia.
H Corresponding author. Email: j.dean4@uq.edu.au
Sexual Health 17(4) 359-367 https://doi.org/10.1071/SH19233
Submitted: 6 January 2020 Accepted: 11 June 2020 Published: 31 July 2020
Journal Compilation © CSIRO 2020 Open Access CC BY
Abstract
Background: The advent of fully automated nucleic acid amplification test (NAAT) technology brings new public health opportunities to provide Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) point-of-care testing (POCT) in non-traditional settings. Methods: This pilot study evaluated the integration of the CT/NG Xpert diagnostic assay into an urban peer-led community setting providing HIV and syphilis POCT. A comprehensive protocol of testing, result notification, referral and follow up, managed by peer test facilitators, was undertaken. Results: Over 67 weeks, there were 4523 occasions of CT/NG testing using urine, oropharyngeal and anorectal samples with 25.7% (803) of the 3123 unique participants returning for repeat testing. The prevalence of CT and NG was 9.5% and 5.4% respectively. Where CT and or NG infection was detected, 98.4% (604/614) of participants were successfully notified of detected infection and referred for treatment. Evaluation Survey responses (11.4%, 516/4523) indicated a substantial proportion of respondents (27.1%, 140/516) ‘would not have tested anywhere else’. Of note, 17.8% (92/516) of participants reported no previous CT/NG test and an additional 17.8% (92/516) reported testing more than 12 months ago. A total of 95.9% (495/516) of participants ‘Strongly agreed’ or ‘Agreed’ to being satisfied with the service. Conclusion: The project successfully demonstrated an acceptable and feasible model for a peer-delivered community-led service to provide targeted molecular CT/NG POCT. This model offers capacity to move beyond the traditional pathology and STI testing services and establish community-led models that build trust and increase testing rates for key populations of epidemiological significance.
Additional keywords: Australia, chlamydia, GeneXpert, gonorrhoea, men who have sex with men, peer testing, point-of-care testing.
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