{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T17:49:35Z","timestamp":1782236975633,"version":"3.54.5"},"reference-count":29,"publisher":"BMJ","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Western Australia Government, Department of Health"},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["Centre for Research Excellence (APP1153647)"],"award-info":[{"award-number":["Centre for Research Excellence (APP1153647)"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["Partnership Project Grant (APP1092503)"],"award-info":[{"award-number":["Partnership Project Grant (APP1092503)"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Queensland Government, Department of Health"},{"DOI":"10.13039\/501100003921","name":"Department of Health and Aged Care, Australian Government","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003921","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2026,5,19]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>In remote Australia, where there is a substantial burden of sexually transmitted infections (STIs) among First Nations peoples, testing and timely treatment are key to reducing prevalence. We evaluated the impact of introducing molecular point-of-care (POC) testing for chlamydia\/gonorrhoea and later trichomonas on STI testing (including syphilis) and positive tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective interrupted time-series analysis of routinely collected data from First Nations peoples aged 15\u201354 years attending 20 remote\/regional clinics participating in the Test, Treat and GO programme (2016\u20132019). We used segmented regression models to estimate the immediate level change (first month of POC) and after-period trends in monthly tests, positive tests and proportion of concurrent syphilis tests to assess sustainability. Before and after comparisons were estimated using linear regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 17\u2009437 chlamydia\/gonorrhoea and 14\u2009173 trichomonas tests performed, mostly among women (69% and 64%) and individuals aged 15\u201334 years (72% and 68%). Following the introduction of molecular POC testing, there were immediate level increases in monthly tests: chlamydia\/gonorrhoea by 26% (+154, p&lt;0.001) and trichomonas by 21% (+116, p=0.004) and level increases of positive tests: gonorrhoea by 30% (+13, p=0.017) and trichomonas by 29% (+14, p=0.034); chlamydia was unchanged. The proportion of chlamydia\/gonorrhoea tests with concurrent syphilis tests remained unchanged (\u22121.7%; \u22120.9%; p=0.531), while the proportion increased among positive chlamydia\/gonorrhoea tests by 25% (+13%; p=0.013). Increased levels of testing were sustained for gonorrhoea\/chlamydia (+2.7, p=0.118) and trichomonas (\u22123.5, p=0.400) and syphilis among those with positive chlamydia\/gonorrhoea tests (\u22120.2%, p=0.593).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Molecular POC testing led to immediate and sustained increases in STI testing and an immediate increase in positive tests in remote primary care. The use of POC testing is likely to result in earlier diagnosis and treatment and reduced onward transmission and sequelae, supporting a broader integration of POC testing in high-burden settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/sextrans-2025-056845","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T17:20:46Z","timestamp":1782235246000},"page":"sextrans-2025-056845","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of decentralised, community-led molecular STI point-of-care testing on testing practices in remote First Nations communities in Australia"],"prefix":"10.1136","author":[{"given":"Annie","family":"Tangey","sequence":"first","affiliation":[{"name":"UNSW Sydney, The Kirby Institute, Kensington, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsty","family":"Smith","sequence":"additional","affiliation":[{"name":"UNSW Sydney, The Kirby Institute, Kensington, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belinda","family":"Hengel","sequence":"additional","affiliation":[{"name":"UNSW Sydney, The Kirby Institute, Kensington, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Andrewartha","sequence":"additional","affiliation":[{"name":"International Centre for Point of Care Testing, Flinders University, Bedford Park, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8279-7652","authenticated-orcid":false,"given":"Handan","family":"Wand","sequence":"additional","affiliation":[{"name":"UNSW Sydney, The Kirby Institute, Kensington, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Saha","sequence":"additional","affiliation":[{"name":"UNSW Sydney, The Kirby Institute, Kensington, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Leonard","sequence":"additional","affiliation":[{"name":"Aboriginal Health Council of South Australia, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoji","family":"Gunathilake","sequence":"additional","affiliation":[{"name":"Northern Territory Department of Health, Casuarina, Northern Territory, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine","family":"Anderson","sequence":"additional","affiliation":[{"name":"Kimberley Aboriginal Medical Services Council Inc, Broome, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna B","family":"Mak","sequence":"additional","affiliation":[{"name":"Communicable Disease Control Directorate, Government of Western Australia Department of Health, Perth, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Badman","sequence":"additional","affiliation":[{"name":"Cepheid, Sunnyvale, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Persing","sequence":"additional","affiliation":[{"name":"Cepheid, Sunnyvale, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basil","family":"Donovan","sequence":"additional","affiliation":[{"name":"UNSW Sydney, The Kirby Institute, Kensington, New South Wales, Australia"},{"name":"Sydney Sexual Health Centre, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Maher","sequence":"additional","affiliation":[{"name":"UNSW Sydney, The Kirby Institute, Kensington, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Matthews","sequence":"additional","affiliation":[{"name":"International Centre for Point of Care Testing, Flinders University, Bedford Park, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9081-1664","authenticated-orcid":false,"given":"Christopher K","family":"Fairley","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Carlton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Shephard","sequence":"additional","affiliation":[{"name":"International Centre for Point of Care Testing, Flinders University, Bedford Park, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Kaldor","sequence":"additional","affiliation":[{"name":"UNSW Sydney, The Kirby 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Updated 21\/3\/2023 (reference period July 2021 - June 2026). 2023. Available: https:\/\/www.abs.gov.au\/statistics\/standards\/australian-statistical-geography-standard-asgs-edition-3\/jul2021-jun2026\/remoteness-structure\/remoteness-areas [Accessed 27 Jul 2024]."},{"key":"2026062310202105000_sextrans-2025-056845v1.20","doi-asserted-by":"publisher","DOI":"10.1177\/1536867x1501500208"},{"key":"2026062310202105000_sextrans-2025-056845v1.21","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyw098"},{"key":"2026062310202105000_sextrans-2025-056845v1.22","unstructured":"Hook EW , Handsfield HH , et al . Gonococcal infections in the adult. In: Holmes KK , Sparling PF , Stamm WE , eds. Sexually transmitted diseases. 4th ed. 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