The main goal of the observational study is to evaluate participants' satisfaction with free HIV and sexually transmitted infection (STI) testing and counselling offered by the cities of Lucerne and Zurich, Switzerland to young people and people with low incomes. Counselling and testing can be accessed without participating in the study arm of the project.
Study Type
OBSERVATIONAL
Enrollment
1,800
Participants' satisfaction (study-specific satisfaction scale)
Participants' satisfaction is measured as the proportion of participants who "agree" or "strongly agree" with satisfaction statements in the post-visit questionnaire. 5-point Likert scale (1 = strongly disagree, 5 = strongly agree); higher scores indicate greater agreement, thus higher satisfaction.
Time frame: 3 years
Service capacity/utilisation
Number of completed voluntary counselling and testing visits recorded per month across participating sites.
Time frame: 3 years
Access timeliness
Median number of days between booking date and appointment date for VCT visits
Time frame: 3 years
Workload healthcare providers
Healthcare provider workload assessed via a short survey measuring perceived workload and time burden, assessed using a standardised Likert-type scale (1-5); higher scores indicate greater perceived workload.
Time frame: 3 years
Count diagnosed HIV/STI cases
Number of newly diagnosed HIV and STI cases identified through the free voluntary counselling and testing visits across participating sites per reporting period.
Time frame: 3 years
Number of treated STI cases
Number of participants who received an STI or HIV diagnosis during the pilot project and subsequently received treatment, defined as antibiotics dispensed at a pharmacy or attendance at a medical appointment at Maihof Praxis Lucerne or Checkpoint Zurich.
Time frame: 3 years
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Participants' perception of comfort regarding sexual health
Participant-reported comfort regarding sexual health (encompassing physical, emotional, and social wellbeing related to sexuality and relationships), measured on a visual analogue scale from 0 (not comfortable) to 100 (very comfortable). Filled in at clinic while waiting for appointment and again approximately 1 week after the appointment.
Time frame: 3 years
Testing behaviour
Testing behaviour assessed via administrative data and self-report. Participants indicate whether this is their first STI/HIV test and, for HIV testing, time since last HIV test. Trends in testing frequency are monitored over the study period.
Time frame: 3 years
Changes in sexual health topics familiarity
Participants rate 12 topics on a scale from 1 to 5 (1=never heard of it, 5=very familiar); higher scores indicate greater knowledge. Participants rate their familiarity at the clinic prior to the appointment and approximately 1 week after the appointment. The measure is the change between pre- and post-appointment rating.
Time frame: 3 years
Changes in sexual health knowledge
Knowledge assessed using 8 true/false items (total score range: 0-8), administered at the clinic prior to the appointment and again approximately one week post-appointment. Higher scores indicate greater knowledge. The measure is the change in score from pre- to post-appointment.
Time frame: 3 years
Changes in self-efficacy/attitudes
Self-efficacy and attitudes assessed using 13 items rated on a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree), administered at the clinic prior to the appointment and again approximately one week post-appointment. Higher scores indicate greater self-efficacy and more positive attitudes. The measure is the change in score from pre- to post-appointment.
Time frame: 3 years
Information-seeking behaviour
Information-seeking behaviour is assessed using a multiple-choice question identifying sources of sexual health information (e.g., internet, healthcare provider, peers). Reported descriptively as frequency and distribution of sources selected; administered at the clinic prior to the appointment only.
Time frame: 3 years
Proportion of low-income eligible participants
Proportion of participants holding a KulturLegi card (indicating low-income eligibility) among all enrolled participants; reported descriptively.
Time frame: 3 years
Reach Among Low-Income Eligible Population
Proportion of KulturLegi card holders enrolled in the study relative to the total number of KulturLegi cards issued in the catchment area during the study period. Assessed by comparing observed reach against a pre-specified target of ≥5% of the eligible low-income population.
Time frame: 3 years
Comparative Outcomes by Eligibility Group
STI/HIV positivity rates, re-testing rates, and knowledge scores compared between low-income eligible participants (KulturLegi card holders) and age-eligible participants. Differences between groups are reported descriptively; regression modelling may be applied to explore associations and inform policy decisions.
Time frame: 3 years