JMIR Publications

ABSTRACT

Background:

Chlamydia trachomatis remains highly prevalent, and declining testing rates alongside rising positivity in Denmark highlight the need for accessible testing solutions. Self-test technologies (STTs) may reduce stigma and improve testing uptake.

Objective:

Chlamydia trachomatis remains highly prevalent, and declining testing rates alongside rising positivity in Denmark highlight the need for accessible testing solutions. Self-test technologies (STTs) may reduce stigma and improve testing uptake.

Methods:

A retrospective before-and-after study at a University Hospital evaluated the implementation of a STT across three phases: pre-implementation (Phase 0), self-test with booking (Phase 1), and drop-in self-test (Phase 2). Outcomes included testing volume, frequency, positivity rates, staff resource use, and costs, using descriptive statistics and χ²-tests.

Results:

The monthly testing increased from a mean of 163 pre-implementation to 246 and 283 in Phases 0, 1 and 2, respectively. The proportion of patients tested multiple times increased significantly (p=0.001). Positivity rates declined from 15.7% to approximately 12–12.6% (p=0.003). Weekly staff time decreased from 102 to 63.75 hours, and annual personnel costs declined by 37%. Cost per test decreased from DKK 1,179 to DKK 501 despite increased testing volume.

Conclusions:

Implementation of STT increased testing activity and efficiency while reducing costs and staff resource use, suggesting that self-testing is a scalable and resource-efficient strategy for STI diagnostics in clinical settings.