Chlamydia and gonorrhoea point-of-care testing in Australia: where should it be used?
Lisa Natoli A B H , Rebecca J. Guy A , Mark Shephard C , Basil Donovan D , Christopher K. Fairley E , James Ward F , David G. Regan A , Belinda Hengel G , Lisa Maher A and on behalf of the TTANGO Investigators
+ Author Affiliations
- Author Affiliations
A The Kirby Institute, University of New South Wales, Wallace Wurth Building, Sydney, NSW 2052, Australia.
B The Burnet Institute, GPO Box 2284, Melbourne, Vic. 3001, Australia.
C Flinders University International Centre for Point of-Care Testing, Flinders University, Level 3 West Wing Sturt Campus, Sturt Road, Bedford Park, Adelaide, SA 5042, Australia.
D Sydney Sexual Health Centre, Sydney Hospital, Macquarie Street, Sydney, NSW 2000, Australia.
E Melbourne Sexual Health Centre, 580 Swanston Street, Central Clinical School, Monash University, Carlton, Vic. 3053, Australia.
F Baker IDI, PO Box 1294, NT 0871, Australia.
G Apunipima Cape York Health Council, PO Box 12045, Earlville, Qld 4870, Australia.
H Corresponding author. Email: lisan@burnet.edu.au
Sexual Health 12(1) 51-58 https://doi.org/10.1071/SH14213
Submitted: 6 November 2014 Accepted: 5 December 2014 Published: 23 February 2015
Abstract
Background: Diagnoses of chlamydia and gonorrhoea have increased steadily in Australia over the past decade. Testing and treatment is central to prevention and control but in some settings treatment may be delayed. Testing at the point of care has the potential to reduce these delays. We explored the potential utility of newly available accurate point-of-care tests in various clinical settings in Australia. Methods: In-depth qualitative interviews were conducted with a purposively selected group of 18 key informants with sexual health, primary care, remote Aboriginal health and laboratory expertise. Results: Participants reported that point-of-care testing would have greatest benefit in remote Aboriginal communities where prevalence of sexually transmissible infections is high and treatment delays are common. Some suggested that point-of-care testing could be useful in juvenile justice services where young Aboriginal people are over-represented and detention periods may be brief. Other suggested settings included outreach (where populations may be homeless, mobile or hard to access, such as sex workers in the unregulated sex industry and services that see gay, bisexual and other men who have sex with men). Point-of-care testing could also improve the consumer experience and facilitate increased testing for sexually transmissible infections among people with HIV infection between routine HIV-management visits. Some participants disagreed with the idea of introducing point-of-care testing to urban services with easy access to pathology facilities. Conclusions: Participants felt that point-of-care testing may enhance pathology service delivery in priority populations and in particular service settings. Further research is needed to assess test performance, cost, acceptability and impact.
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