O17.3 Maintaining Services, Responding to Need: The Kingston (Ontario) Quick Test Clinic

Stoner, B.; Prouse, J.; Nolan, E.; Wowk, C.; Guan, H.

BackgroundIn early 2020, routine STI clinical services ground to a halt across Canada as a result of COVID-19 shutdowns, yet the need for STI screening, testing, and treatment continued unabated. We report on an innovative model for maintaining high-volume, low-barrier STI services during the pandemic.ApproachThe Quick Test Clinic was established in June, 2020 by Kingston, Frontenac and Lennox & Addington (KFL&A) Public Health to facilitate nucleic acid amplification testing (NAAT) for gonorrhea (GC) and chlamydia (CT). Operating two half-days per week, the clinic invited clients to complete an intake form and submit a self-collected urine or swab specimen [rectal, meatal, vaginal, pharyngeal] without seeing a healthcare provider. Results were communicated by telephone, and persons with documented infection were promptly treated.Outcomes/ImpactDuring the first six months of operation (19 June 2020 – 18 Jan 2021), the clinic provided 383 STI screenings to 347 unique individuals (mean age 27.9 years [IQR 21.0–32.0]) and a total of 864 self-collected specimens were tested. GC was detected in 13/184 (7.0%) males vs. 4/163 (2.5%) females (p = 0.47). CT was detected in 30/184 males (16.3%) vs. 17/163 (10.4%) females (p =0.11). A total of 4 persons were co-infected with GC and CT. Overall positivity with either GC or CT was 5.8%. Sample site positivity was highest for self-collected rectal specimens (6/46, 13.0%), followed by genital (55/664, 8.3%) and pharyngeal (5/88, 5.7%) specimens.Innovation and SignificanceFindings demonstrate the ongoing need for sexual health services during the COVID crisis, and the feasibility of no-exam, drop-off testing of self-collected specimens. Gonococcal and chlamydial positivity rates exceeded that of standard pre-COVID clinic operations, supporting wider expansion of the Quick Test Clinic model. Future innovations may include text messaging and web-based applications for results notification and treatment referral.