On-site testing for sexually-transmitted diseases saves time and reduces spread

Highly accurate sexually-transmitted infection testing with same-day results improves outcomes for Aboriginal and Torres Strait Islander women living in remote communities.

Glen Duncan and Stacey Foster-Rampant who work as part of the team to scale up point-of-care testing for infectious diseases in Remote Aboriginal and Torres Strait Islander communities

Highly accurate sexually- transmitted infection testing with same-day results has been estimated to lead to a 33 per cent reduction in pelvic inflammatory disease and a 17 per cent reduction in preterm births and low birth weight babies for Aboriginal and Torres Strait Islander women living in remote communities.

Epidemiologist and physician Louise Causer, who leads the Kirby Institute’s Decentralised Diagnostics Implementation Research Group at the UNSW Sydney, says without the specialised point-of-care testing, specimens such as urine samples and vaginal swabs would have to be sent to a central reference lab in a large city, which could mean a delay of a week or more before results are available to a clinician and treatment is offered to the patient.

“If the result is not available rapidly, the person might move on and it would be much more difficult to follow up and offer treatment,” Causer says. “The delay is exacerbated in these more remote communities.”

Indigenous communities have high rates of certain infections, including sexually-transmitted infections. Exacerbated by the communities’ remoteness, lack of access to health services, and various other social determinants, these contagious infections require rapid testing and treatment to slow their spread.

As accurate as a lab test, the rapid point-of-care testing means clients have to wait only about 90 minutes for the results of chlamydia and gonorrhoea tests, and about 60 minutes for trichomoniasis results. Similar tests with even faster results are in the pipeline, foreshadowing a revolution in better and faster healthcare.

One of the testing sites, Pipalyatjara in South Australia.

“Identifying people who are infected and treating them more quickly ensures the disease is not passed on, leading to fewer infections and limiting transmission within the community,” Causer says. “An individual who is treated more quickly is less likely to develop consequences of infection, such as pelvic inflammatory disease, ectopic pregnancy and infertility.”

The testing is facilitated by state-of -the-art technology, made available in communities providing care to the most vulnerable and disadvantaged, Causer says. A community-led initiative, the program entails health service staff learning how to use the testing device and then integrating the procedures into clinic practice.

“The program provides wraparound support to ensure quality of the testing is maintained,” Causer says. “There’s a help desk that service staff can call if they need any assistance or if there are any issues.

“Health service staff are provided with lots of training to make sure there’s always one or two trained staff on hand. It’s not fly-in-fly-out technicians coming in to do the testing.”

More than 60,000 tests have been performed since the program was launched in 2013. A Medicare rebate approved in the 2024 budget was an “excellent step forward” Causer says, even though along with most experts in the field, she would prefer the rebate to be more broadly available for rapid testing in a wider range of geographic areas.

“There are certainly regional settings with large populations of Aboriginal and Torres Strait Islander people who would benefit from more rapid testing,” she says. “We’re interested in exploring the benefits in other settings as well – urban, and peri-urban; places where people are easily lost to follow-up.”