title: Chlamydia and gonorrhoea point-of-care testing in Australia: where should it be used?
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.
authors.affiliation: The Kirby Institute, University of New South Wales, Wallace Wurth Building, Sydney, NSW 2052, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Natoli
authors.affiliation: The Kirby Institute, University of New South Wales, Wallace Wurth Building, Sydney, NSW 2052, Australia.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Guy
authors.affiliation: 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.
authors.forename: Mark
authors.initials: M
authors.lastname: Shephard
authors.affiliation: Sydney Sexual Health Centre, Sydney Hospital, Macquarie Street, Sydney, NSW 2000, Australia.
authors.forename: Basil
authors.initials: B
authors.lastname: Donovan
authors.affiliation: Melbourne Sexual Health Centre, 580 Swanston Street, Central Clinical School, Monash University, Carlton, Vic. 3053, Australia.
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Fairley
authors.affiliation: Baker IDI, PO Box 1294, NT 0871, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Ward
authors.affiliation: The Kirby Institute, University of New South Wales, Wallace Wurth Building, Sydney, NSW 2052, Australia.
authors.forename: David G
authors.initials: DG
authors.lastname: Regan
authors.affiliation: Apunipima Cape York Health Council, PO Box 12045, Earlville, Qld 4870, Australia.
authors.forename: Belinda
authors.initials: B
authors.lastname: Hengel
authors.affiliation: The Kirby Institute, University of New South Wales, Wallace Wurth Building, Sydney, NSW 2052, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Maher