Background STIs are a major public health concern. Screening programmes for asymptomatic users are key components of STI control. Traditional limitations of screening programmes include low population coverage and delays in treatments, thus reducing the expected impact on STI control. In our centre, the normal time from test to results was 4 days, and 7 days until treatment was established.
To reduce time to treatment and to increase population coverage, we developed ‘Drassanes Exprés’, a testing service for asymptomatic STIs. The objectives of this study were to provide a guide for the implementation of a service with these characteristics and to evaluate the results of this intervention.
Methods The Drassanes Exprés programme was launched in Spain on 07 November 2016 as a public, confidential and free-of-charge testing service for asymptomatic STIs, with same-day result notification. For this walk-in service, confidentiality was obtained by registering all information into the Laboratory Internal Software instead of the Electronic Patient Records. Samples were processed in a point-of-care laboratory and result notification was provided via mail or short message service.
Information about workflow, screening protocols and result interpretation is detailed. Additionally, demographic characteristics, STI prevalence, and time from patients’ sample collection to notification and treatment are analysed.
Results Between 07 November 2016 and 07 November 2019, 13 993 users attended the Drassanes Exprés screening programme. Of these, 0.5% were transgender people, 29.3% women, 45.2% men who have sex with men and 25.1% men who have sex with women. The median age was 31 years (range: 26–39 years). Overall, 14.6% of users tested positive for at least one STI. The most prevalent infection was Chlamydia trachomatis (8.3%), followed by Neisseria gonorrhoeae (5.7%), syphilis (1.8%), HIV (0.4%) and hepatitis C virus (0.2%). The median time from test to results was 2.4 hours (range: 2–3.1 hours). Of 2049 users diagnosed with an STI, treatment was achieved in 97.0% of cases; the average time to treatment was 2.0 days.
Conclusions Drassanes Exprés is the first public programme for rapid, asymptomatic, STI screening and treatment in Spain. Assessing high-risk practices and providing confidentiality, easy access and rapid results/treatments are key elements in the development of STI screening programmes.
- diagnostic screening programs
- neisseria gonorrhoeae
- serologic tests
- chlamydia infections
Data availability statement
Data are available upon reasonable request. All data relevant to the study are included in the article, however more detailed protocols are available upon request.
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TP and ME are joint senior authors.
Handling editor Jo Gibbs
Collaborators Statistics and Bioinformatics Unit (Santigo Pérez Hoyos); DrasExp collaborative group (Desideria Martinez Rascon, Encarnación Arellano Muñoz, M Angeles Alvarez Zaragoza, Mercedes Gosch Elcoso, Jose Ignacio Pilarte Villanueva, Edurne Ruiz Marti, Nuria Ortiz, Lourdes Rubio Rubio)
Contributors ME conceived and led the design of this programme. JE, MJB, TP, ML, MV-M and AB contributed to workflow design. ES, JS-P, LL, ML, BA and TP reviewed the initial draft. YH-M, ES, JNG, PS, FZ, MA, VD, LL, MV-M and MJB performed the data collection. YH-M analysed the results and wrote the initial draft with JNG.
Funding DrasExp programme is a public service funded by the Cataluña European Regional Development Fund (ERDF) 2014–2020 operational programme under project number SA51-006646.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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