Evaluation of Outcomes of a Newly Implemented Sexually Transmitted Infection Rapid Testing System

Abstract

Objectives: To evaluate the outcomes of a newly implemented express testing system for sexually transmitted infections at the Maricopa County Public Health Department. Methods: This study reviewed data that was collected by the Maricopa County Public Health Department. There are two avenues for sexually transmitted infection (STI) testing at the department. Individuals are given a questionnaire at the time of check-in to assess their possible exposure to others who might have sexually transmitted infections and their symptoms at the time of presentation. Those who are asymptomatic and deemed to be at low risk for infection are sent to the express testing system, while individuals who are determined to be at higher risk for infection or are actively symptomatic, are seen by a provider for a comprehensive visit. Testing that is offered to patients, regardless of visit type is; urine nucleic acid amplification for Chlamydia trachomatis (CT) and Neisseria gonorrhea (GC), and blood tests for syphilis and HIV. Results were evaluated from September 2008 to March 2010. Data were evaluated for difference in positivity of the express testing patients as opposed to those who saw a provider, as 5 well as the demographic differences between the two groups. Also evaluated, was the treatment obtained by individuals in the express testing group, and the time to return for treatment. Results: Between September 01, 2008 and March 31, 2010, there were 33294 visits made to the clinic for STI testing. Of these, 4232 (12.7%) were express testing visits. During this time, a total of 3268 cases of CT and 1030 cases of GC were diagnosed. Express testing had a lower incidence of CT and GC, with 204 and 24 cases respectively. Compared the provider visits, the incidence of CT and GC were lower in express testing with CT being 4.8% (vs 10.5% in provider visits), and GC 0.6% (vs 6.5% in provider visits). Of the express testing CT cases, 90.2% returned for treatment, with an average return time of 16.9 days, as compared to 92.6% treatment with an average return time of 13.8 days in the provider visit group (66% were treated the same day). Of the express testing GC cases, 87.5% returned for treatment, with an average return time of 9.8 days, as compared to 88.5% return for treatment and average return time of 13.7 days in the provider visit group (70.2% were treated the same day).