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Implementing STI point-of-care testing using a whole-system programme model: the ProSPiRO implementation research

Sebastian Suarez Fuller1,2, Valeska Padovese3, S Tariq Sadiq2,4

  • 1Nuffield Department of Medicine, University of Oxford, Oxford, UK sebastian.fuller@ndm.ox.ac.uk.

Sexually Transmitted Infections
|June 5, 2026
PubMed
Summary
This summary is machine-generated.

This study introduces a whole-system program model to integrate point-of-care tests (POCTs) for sexually transmitted infections (STIs) into healthcare. The research evaluates its effectiveness in improving timely diagnosis and treatment access.

Keywords:
HEALTH SERVICES RESEARCHImplementation SciencePoint-of-Care TestingSEXUAL HEALTH

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Area of Science:

  • Public Health
  • Implementation Science
  • Infectious Disease Control

Background:

  • Sexually transmitted infections (STIs) remain a significant global health burden, often managed without timely laboratory confirmation.
  • Point-of-care tests (POCTs) offer potential for rapid diagnosis and treatment, but their integration into health systems is inconsistent.
  • Existing health systems require effective models to support the widespread adoption of STI POCTs.

Purpose of the Study:

  • To develop and evaluate a collaborative whole-system program model for implementing STI POCTs.
  • To generate evidence on the acceptability, feasibility, and suitability of this model across diverse settings.
  • To improve access to STI testing and treatment through enhanced healthcare delivery.

Main Methods:

  • A mixed-methods implementation research protocol involving structured workshops and a 1-year intervention at various healthcare sites.
  • POCTs for Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and/or HIV/syphilis were implemented.
  • Evaluation included patient clinical outcomes, health system capacity, economic costs, and acceptability using quantitative and qualitative data.

Main Results:

  • The study assessed changes in same-day diagnosis, appropriate treatment, patient/provider acceptability, and service delivery capacity.
  • Economic costs and consequences compared to usual care were analyzed.
  • Realist case-study approach identified mechanisms influencing POCT implementation.

Conclusions:

  • The study addresses a critical evidence gap in sustainable integration of STI POCTs into health systems.
  • The proposed model, combining local co-design and knowledge exchange, can support equitable scale-up.
  • Findings will inform national policy and service delivery for improved STI management.