Improving Capacity and Access to Sexual Health Care through Addition of Express Testing

Purpose: To evaluate the addition of express testing over a two year period in a comprehensive drop-in youth center, as a way to increase STI testing capacity and in particular increase testing for an MSM population. 

Method: Asymptomatic men and women were offered express testing over a two year period. All MSM were offered screening with urine, pharynx and rectal NAAT GC/CT testing.   

Results: From 2012 to 2014 screening rates for all STDs increased significantly for men and in particular MSM.  Urine screens for Chlamydia/Gonorrhea increased by 28% from 2168 to 2782 total screens , while screens for extra genital Chlamydia/Gonorrhea increased by 151% and 177% respectively.   Males preferred express testing. In the past 2 years out of 1726 males, 1167 accessed testing through the express option.   Of those, 422 men had at least one positive test.  Of those who were positive, 35% self-identified as MSM.  For this population, extra genital screening was performed.  Detection of Gonorrhea in the pharynx increased by 110% (21 cases to 44 cases); detection of rectal Gonorrhea increased 96% (23 cases to 45 cases).  Detection of pharyngeal Chlamydia increased 150% , while detection of rectal chlamydia increased 180% over the same time period.  Positive RPR testing for males increased 100% over the time period, and confirmatory HIV tests doubled. 

Conclusion: Express testing increased the number of youth screened with a notable increase in men and in particular MSM.  Express testing is a useful strategy to engage high risk youth populations in STI/HIV testing.