Table 1

Potential advantages and disadvantages of sexually transmitted infection (STI) point of care testing (POCT) strategies10–12

Earlier diagnosis and treatment implementation leading to improved clinical outcomesPerformance claims: limitations, validation, evaluation in the hands of users, reliability and device failure
Greater patient convenience and involvementSpecimens: appropriate sample collection, need for sample preparation prior to testing
Smaller sample and reagent volumes, may be less invasiveQuality assurance and control: adequate training, tests performed by staff from a non-analytical background
Easier access to service for those with limited mobility and for those who live in more remote areas with limited access to laboratory facilitiesOperator-dependent steps:
  • Interpretation of instructions

  • Inappropriate, insufficient or contaminated sample

  • Use of test outside its specification

  • Use of damaged, inappropriately stored or out-of-date reagents

  • Incorrect interpretation of results

  • Lack of awareness of limitations or interferences

Elimination of specimen transportation reducing time and costsIncompatibility with laboratory results: reference ranges and results may differ, making comparisons difficult or absent
Economic benefits with reduced number of clinic visits, reduced length of hospital stay and fewer admissionsGreater availability may encourage inappropriate or unnecessary testing
Potential for earlier diagnosis may avoid some of the costs associated with undiagnosed infectionsPatient anxiety:
  • Absence of expert explanation and discussion

  • Misinterpretation of the meaning of positive and negative results

  • Psychological impact

Economic benefits could accrue with over-the-counter tests, allowing part of the financial burden of diagnosing STIs to be shifted from the public to the private purse for those who choose to buy a self-testCost:
  • Initial purchase

  • Site alterations

  • Training

  • Maintenance

  • Waste disposal