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IntroductionAdvances in Point of Care Tests (POCTs), including the capacity to test for multiple Sexually Transmitted Infections (mSTIs) and Antimicrobial Resistance (AMR), have potential to transform sexual health clinic (SHC) services. Patient opinions of POCT implementation are needed to inform the redesign of SHC pathways to accommodate these new technologies.MethodsWe conducted semi-structured interviews with a purposive sample of patients aged ≥16–44 in three SHCs across England. Analysis was based on the Framework method (NVivo 10).Patients were asked to describe their recent clinic visit and were then presented with different POCT designs and associated SHC pathway changes. Some proposed designs included potential to spend more time in clinic than currently, e.g. waiting for AMR results after a positive diagnosis.ResultsFrom June 2015 - February 2016, 11 women, 12 heterosexual men and 8 men who have sex with men participated. Most patients were enthusiastic about receiving an accurate diagnosis and AMR result within one clinic visit. Women were more likely to question new technologies, report more previous visits and have higher expectations for their SHC experiences. Men and women strongly indicated willingness to wait in clinic for results if they perceived themselves at risk for infection (self-assessed as sexual risk-taking and/or having symptoms). All patients were willing to wait for AMR results following a positive result. Patient suggestions for POCT pathway implementation included: targeting POCTs to those concerned they are infected and providing information on steps and time involved for new pathways. ConclusionPatients’ willingness to wait in clinic, explained as dependent on a self-assessed risk for infection, provides nuanced understanding of patients’ priorities for care. Patient suggestions that specific, directed messaging from SHCs may allow acceptability of various changes related to POCT adoption gives guidance for implementation. We recommend further research when these tests are made available, to assess these theories in practice.

IntroductionPatient and Public Involvement (PPI) is increasingly seen as necessary for conduct of high-impact ethical research, but when focused on short-term treatable sexually transmitted infections (STIs) it can be challenging to gain participants. The Precise Study is a collaboration to develop and evaluate point of care tests (POCTs) for short-term STI infection and Antimicrobial Resistance (AMR) detection. We explored patient opinions concurrent to POCT development, through qualitative interviews and PPI activities. MethodsQualitative 1-on-1 interviews were conducted with a purposive sample of patients in three sexual health clinics (SHCs) in England. PPI activities included development of a patient and public advisory group (PAG). Interview topics were presented for discussion at one PAG meeting. Members were unaware of qualitative interview results until after they gave their opinions. Findings from qualitative interviews were compared with PAG meeting notes to better understand results of the two approaches. Results31 patient interviews were conducted in SHCs: 11 women, 12 heterosexual men and 8 men who have sex with men. Most patients felt POCTs were preferable to standard care, and many suggested ways to implement the tests in new clinical pathways. Our PAG had 4 members of the public: 3 women and 1 man, all with previous experience in healthcare settings. PAG member opinions of the POCTs and importance of the AMR test mirrored key themes found in patient interviews, however, PAG members focused on the potential for advocacy that POCTs provide, and suggested publicising rapid turnaround of results to encourage testing in high-risk groups with low clinic attendance. ConclusionWe have demonstrated that PPI is possible for stigmatised, treatable short-term STIs, provides new insights into care and utility and allows for continued dialogue on implementing solutions to meet patient concerns. We suggest that where possible, qualitative research is used to iterate the diversity of patient opinions, and is complemented by PPI to build patient-centred solutions.