An evaluation of an express testing service for sexually transmissible infections in low-risk clients without complications

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 32720 and 82265 consultations before and after ETS respectively. The ETS saw 4387 (9%) of 55648 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 25min to 6min for consultation time and from 59min to 29min 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.