An evaluation of an express testing service for sexually transmissible infections in low-risk clients without complications
Nimal Gamagedara A B C , Sheranne Dobinson A , Rosey Cummings A , Christopher K. Fairley A D and David Lee A C EA Melbourne Sexual Health Centre, Alfred Hospital, Melbourne, Vic. 3050, Australia.
B Department Health Services, Ministry of Health, Colombo CO 0100, Sri Lanka.
C Melbourne School of Population and Global Health, University of Melbourne, Vic. 3050, Australia.
D Central Clinical School, Monash University, Melbourne, Vic. 3181, Australia.
E Corresponding author. Email: dlee@mshc.org.au
Sexual Health 11(1) 37-41 https://doi.org/10.1071/SH13156
Submitted: 2 October 2013 Accepted: 30 December 2013 Published: 4 March 2014
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 and 2012). 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.
Additional keywords: accessibility, chlamydia screening, efficiency, fast-track, health service.
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