Sexually Transmitted Infections Services Research Articles

Variations in sexually transmitted infection self-testing response rates and self-sampling submission rates among men who have sex with men recruited via different approaches: A Multi-Center Observational Study

Objective: Self-collection, self-testing, and telemedicine among high-risk population were important strategies in increase the accessibility of STI services and facilitate their expansion. However, many previous studies have showed that the self-test kit usage and response rates are not high in the MSM population. Different routes of recruitment may affect their response rates. To analyze the differences in response rates of sexually transmitted infection (STI) self-testing and submission rates of self-acquired samples from men who have sex with men recruited through an online platform, STI clinics, and non-governmental organizations (NGOs). Methods: Participants were enrolled in this observational study via three different recruitment methods from July to December 2022. Self-testing kits for human immunodeficiency virus (HIV), Treponema pallidum, and hepatitis C virus, and self-sampling kits for Chlamydia trachomatis and Neisseria gonorrhea were provided to recruited men who have sex with men. The participant’s basic information were collected by using the questionnaire and the resluts of self-testing for HIV/ syphylis and HCV and self-sampling for Chlamydia trachomatis and Neisseria gonorrhea were collected. Multivariate logistic regression analysis was used to identify factors associated with self-test response rate and sample submission rates. Results: A total of 764 participants were recruited from 28 Chinese provinces. In the final analysis data, 670 participants reported their HIV self-testing results, while 644 participants mailed their self-acquired samples to the laboratory. Among the 670 participants, there were 51 patients infected with HIV, 31 infected with syphilis, and 2 infected with the hepatitis C virus. The total prevalences of C. trachomatis and N. gonorrhea were 23.0% (176/637) and 7.6% (58/636), respectively. There were no significantly difference among the willingness of self-test among paticipants recriuted from three rouitines , while the HIV self-test response rate was significantly higher among participants recruited in STI clinics than among participants recruited through the “Aiyijian” platform (adjusted odds ratio [AOR] 0.018, 95% confidence interval [CI] 0.002–0.136) or NGOs (AOR 0.054, 95% CI 0.007 – 0.401). Comparing to the participantd recruited from STI clinics, the willingness of self-sample was significantly higher among participants recruited through the “Aiyijian” platform (AOR 4.557,95% CI 1.445-14.271) and NGO (AOR 2.391, 95% CI 1.136-5.034), but the rectal sample submission rates were significantly lower among participants recruited by the “Aiyijian” platform (AOR 0.014, 95% CI 0.003 – 0.062) or NGOs (AOR 0.062, 95% CI 0.014 – 0.262). Conclusion: MSM recriuted from Aiyijian online paltform and NGO were more willing to self sample, while participants recruited from STI clinics had a greater test result response rate and self-sample submission rate than those recruited via the “Aiyijian” online platform and NGOs. In addition to STI clinics, online platform and NGOs will play a very important role in recommending self-sampling for STIs among MSM population.

A Survey on Quality of Services, Training, and Attitude of Dermatology Trainee Residents About Sexually Transmitted Infections in Teaching Hospitals Across India

Abstract Introduction: The incidence of sexually transmitted infections (STIs) has increased disproportionately to STI services. It is uncertain how many residents trained in STI services continue them. This study assessed the self-rated quality of training and attitudes about STI services amongst residents of Indian teaching hospitals. Methods: In this descriptive cross-sectional survey study, opinions from Indian postgraduate trainee residents were sought in three domains of STIs- institutional STI management practices, quality and satisfaction with training, and attitude towards STI services. Results: A total of 225 responses were included. There was no separate area for STI services at centers of 51.6% of residents, and among those with separate STI posting, the duration was ≤2 months for 34.7%, with 59.6% wishing for its increase. Easily available bedside tests were used regularly when indicated by only 41.8%. Only 58.2% of respondents strictly ensured contact tracing and partner treatment. Only 65.8% of centers had provision of benzathine penicillin. Under-confidence in managing STIs independently was reported by 19.6%. Inadequate training was the second reason for wishing to discontinue STI services upon completion of training; with 71.5% wishing to continue STI practice. In univariate analysis, frequent point-of-care testing (P < 0.001), and >2 months of separate STI posting (P = 0.018) were associated with good satisfaction with STI training. Frequent point-of-care testing (P < 0.001), and male gender (P < 0.001) were associated with good confidence in independently managing STIs. Male gender (P = 0.038), having less reluctance in dealing with STI patients (P = 0.003), and good confidence in independently managing STIs (P = 0.008), was associated with willingness to continue STI practice. Conclusions: STI care is associated with reluctance. Current STI training in Indian teaching hospitals is less than desired and can lead to unwillingness amongst residents to practice STI services in the future. Having >2 months of separate STI posting, frequent point-of-care tests, and efforts to reduce reluctance when dealing with STI patients are steps that can improve the STI training experience of residents.

Performance and acceptability of self-collected specimens for diagnosis of rectal and pharyngeal Chlamydia trachomatis and Neisseria gonorrhoeae infections among men who have sex with men in China: a randomized controlled trial

BackgroundExtragenital Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections are prevalent among men who have sex with men (MSM). Self-sampling could potentially eliminate barriers to extragenital CT/NG testing for MSM that are hard to reach, who refuse to go for clinician-based testing, or who decline an examination. However, the required evidence to determine whether self-collected specimens are as accurate as clinician-taken specimens in terms of CT/NG diagnostic accuracy was limited in low and middle income countries. We therefore compared self-collected rectal and pharyngeal specimens with clinician-taken specimens for diagnostic accuracy among MSM in China.MethodsThis was a prospective convenience sample from 6 sexually transmitted infection (STI) clinics in China. We randomized the order of self-collected and clinician-taken specimens from the pharynx and rectum, plus first-void urine, for CT/NG detection. Self-sampling performance was compared with clinician-sampling as to agreement, sensitivity, and specificity. The acceptability of self-sampling was evaluated by questionnaire.ResultsAmong the 325 participants, prevalences of rectal CT and NG infections were 13.6% and 5.2% and pharyngeal CT and NG prevalences were 1.5% and 2.8%, respectively. The agreements between the CT tests with the self-collected and clinician-taken specimens were 98.8% (κ = 0.95, 95% CI 0.89-1.00) for rectal site and 99.4% (κ = 0.83, 95% CI 0.60-1.00) for pharyngeal site; and the agreements between NG tests were 99.4% (κ = 0.94, 95% CI 0.86-1.00) for rectal site and 98.2% (κ = 0.72, 95% CI 0.50–0.93) for pharyngeal site. The sensitivity and specificity of self-collected swabs was as follows: rectal CT: 93.0% and 99.6%; pharyngeal CT: 100.0% and 99.4%; rectal NG: 100.0% and 99.4%; pharyngeal NG: 88.9% and 98.4%. Self-collection was highly acceptable, showing that 62.0% MSM preferred self-sampling over clinician-sampling; 90.2% would use self-sampling for detection of CT and NG again.ConclusionsExtragenital screening for CT and NG should be recommended as part of STI services to MSM population. Self-collection of rectal and pharyngeal specimens had good performance for CT and NG tests and acceptability to the target population.Trial registrationThis trial was registered with the Chinese Clinical Trial Registry, ChiCTR2300073473. Registered 12/07/2023.

Prevalence of sexually transmitted infections and associated risk factors among female sex workers in Guinea-Bissau

ObjectiveTo estimate the prevalence of the curable sexually transmitted infections (STIs) Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis and Treponema pallidum, to identify associated risk factors and to assess...

An evaluation of an online STI service across London: reviewing uptake, utility and outcomes over a 4-year period

ObjectivesSince 2018, Sexual Health London (SHL) has provided remote sexually transmitted infection (STI) testing services to London residents over 16 years of age. SHL was an asymptomatic screening service. In...

Portrayal of Sexually Transmitted Infections in Popular Films.

Stigmatization of sexually transmitted infections (STIs) threatens provider-patient relationships and contributes to the underutilization of STI services. Media can shape public attitudes toward healthcare topics by perpetuating or reducing stigma. Given the high prevalence of STIs and the widespread consumption of media, it is essential for healthcare providers to be cognizant of factors influencing societal perceptions of STI symptoms, transmission, diagnosis, and treatment. This study is a scoping review of popular films depicting STIs. Full-length English-language narrative films featuring characters with confirmed or suspected STIs were included. Descriptive statistics were used to determine the proportion of characters accurately portrayed with STI symptoms, transmission, diagnosis, and treatment. The final analysis comprised 128 characters from 77 films, with human immunodeficiency virus (HIV) being the most frequently featured STI (42 films, 54.5%). The overall accuracy across all four clinical variables of symptoms, transmission, diagnosis, and treatment was 87.4%. Transmission was the most depicted clinical variable, represented in 74 characters (57.8%). All four clinical variables were simultaneously depicted in only four (3.1%) characters, with two characters portraying all four clinical variables accurately. Death occurred in 39 characters (30.5%), with HIV accounting for the majority (82.1%). Most films accurately portrayed STI clinical variables, including symptoms, transmission, diagnosis, and treatment. Rates of individual variable depiction were inconsistent, while death secondary to STIs was common. Understanding the portrayal of STIs in popular films can provide valuable insights for clinicians, enabling them to effectively address patient misconceptions and knowledge gaps.

Integrated PrEP and STI Services for Transgender Women in Uganda: Qualitative Findings from a Randomized Trial.

Tenofovir alafenamide fumarate (F/TAF) pre-exposure prophylaxis (PrEP) is understudied in sub-Saharan Africa. The Tandika PrEP study was a randomized trial that evaluated same-day F/TAF initiation, the impact of drug-level feedback on PrEP adherence, and integrated PrEP and sexually transmitted infection (STI) services for HIV-negative transgender women (TGW) in Uganda (NCT04491422). From April 2022-February 2023, a qualitative sub-study of 30 in-depth interviews explored (1) perspectives on same-day initiation of F/TAF PrEP, (2) experiences of urine tenofovir testing and drug-level feedback, and (3) descriptions of self-collection of samples for STI testing. Qualitative data were analyzed using an inductive content analytic approach. Integrated PrEP/STI services were valued by TGW because the convenience of urine testing motivated adherence and allowed for tenofovir and STI detection. (1) Preferred characteristics: F/TAF-based PrEP was easy to take and not readily identifiable as an HIV-related medication, resulting in less stigma than the better-known tenofovir disoproxil fumarate (F/TDF). Weight gain associated with F/TAF use was viewed positively by TGW as a symbol of health and prosperity in African settings. (2) Adherence motivation: PrEP adherence was motivated by a desire not to disappoint healthcare workers; TGW reciprocated adherence support and drug-level feedback by taking PrEP. (3) Facilitating adherence and STI care: Urine testing enhanced STI detection and treatment. Utilization of urine for tenofovir and STI testing motivated the uptake of HIV/STI care, emphasizing the importance of integrated PrEP and STI services. Integrating PrEP/STI services into differentiated delivery models could increase prevention uptake in this vulnerable population.

Missed opportunities for guidance on sexually transmitted infection services: a global review of national HIV PrEP guidance

ObjectivesPeople who use or would benefit from pre-exposure prophylaxis (PrEP) for HIV infection are disproportionately affected by sexually transmitted infections (STIs). Integrating STI services when offering PrEP fosters synergies and...

Early adopters of doxycycline as post-exposure prophylaxis to prevent bacterial sexually transmitted infections in a real-world clinical setting

ObjectivesDoxycycline as post-exposure prophylaxis (DoxyPEP) is a novel prevention approach which has demonstrated efficacy in preventing bacterial sexually transmitted infections (STIs) in men who have sex with men (MSM) and...

Borne of necessity: pharmacy-based harm reduction and express sexually transmitted infection services

BackgroundHIV, hepatitis C virus (HCV), Sexually Transmitted Infections (STIs), and substance use disorder are interrelated epidemics. Augmented services to respond to this “syndemic” are hampered by shortages of health care workers, especially in rural areas. In an Indian Health Service hospital in rural Minnesota, the pharmacy sought to integrate harm reduction and express STI services into its scope of practice. ObjectivesProvide pharmacy-based harm reduction and express STI services to increase access to care for community members, especially those without a primary care provider. MethodsThe program was designed with input from tribal counterparts and internal medical staff. The pharmacy window was made the intake point for services for patient education, harm reduction materials, and STI testing and treatment. Collaborative practice agreements and standing orders greatly expanded the pharmacy’s ability to deliver care. Later in the program, the pharmacy was able to introduce patient incentives. ResultsFrom October 2022 to November 2023, the program had 500 visits from 101 unique patients with a median age of 36. Among users of the service, 71% did not have a primary care provider. Once patient incentives were introduced, express STI testing increased over 10-fold. The laboratory panels had a 44% positivity rate for either an STI or HCV. ConclusionsPharmacy can be an accessible and effective means of delivering harm reduction, STI, and HCV services. Patient incentives may greatly increase testing and detection of infectious diseases among patients who may otherwise not seek care.

A study of sexually transmitted infections among men who have sex with men (MSM) in a coastal city Mangaluru, Karnataka

BackgroundSTI (Sexually Transmitted Infections) is common among ‘high-risk groups’ in India, a term used by the National AIDS Control Organization (NACO) which includes men who have sex with men (MSM) and others. Sexual transmission of HIV, most prominent STI between men could be a major cause for concern in most parts of India. HIV infection among MSM has been increasing in recent years round the world, particularly in Asia. Objectives1. To determine the sociodemographic characteristics of men who have sex with men. 2. To estimate the magnitude of sexually transmitted infections (STI) in men who have sex with men. MethodsA cross sectional study was carried out using structured, pretested questionnaire at Hind Kusht Nivaran Sangh, Mangaluru. Face to face interviews of the selected participants was done and data were recorded after obtaining their consent. ResultsA total of 102 MSM were interviewed and the data was collected. The common presenting symptoms were pain while urinating (33.33 %) and least common was bleeding while defecating (1.9 %). The most common morbidity of study population was urinary tract infection (38.23 %) and proctitis (25.4 %) and 3.92 % subjects had HIV/AIDS. ConclusionHealth sector should include safe access to information and education about HIV and other STIs, condoms, water-based lubricants, HIV testing and counselling, and STI services.

Evaluation of the Sexually Transmitted Infections Programme among Key and Priority Populations in Primary Healthcare Facilities to Inform a Targeted Response: A Protocol Paper.

Primary healthcare facilities lack routine diagnostic screening due to resource limitations and dependence on syndromic management, resulting in an unprecedented prevalence and incidence of sexually transmitted infections (STIs), particularly among key and priority populations. Specific focuses are essential to strengthen current STI control measures. Therefore, this article describes the protocol for evaluating STI programme among key and priority populations in selected primary healthcare facilities in South Africa. We will employ an exploratory, descriptive research design to assess the STI programme in terms of its facility operations, functions, scope, gaps, delivery services, STI surveillance methods, and indicators in the selected primary healthcare facilities. A purposive sample of 15-20 STI programme stakeholders will be selected from five primary healthcare facilities in Limpopo Province, South Africa. The programme evaluation will use the World Health Organization assessment checklist tool, a globally recognised and validated instrument comprising open- and closed-ended questions to assess the STI programme. This tool, known for its credibility and reliability, ensures the study's validity. Quantitative data will be captured on STATA software (College Station, TX, USA) version 18 for descriptive analysis and presented as the mean and standard deviation for continuous variables, proportions and percentages for categorical variables. A p ≤ 0.05 will demonstrate a statistically significant level. Thematic content analysis will be conducted for the qualitative data using Atlas. ti software (Technical University, Berlin, Germany) version 23.1. The study's results will inform new approaches to strengthen STI coverage, service delivery, and linkage to care.

Frequent chlamydia and gonorrhoea but very infrequent syphilis among men who have sex with men using HIV pre-exposure prophylaxis in West Africa

ObjectivesAlthough oral pre-exposure prophylaxis (PrEP) for HIV is being rolled out in West Africa, data on sexually transmitted infections (STIs) in PrEP users are scarce. We assessed the prevalence, incidence...

A Participatory Approach to Identifying Gaps in and Recommendations for Sexually Transmitted Infection and Preexposure Prophylaxis Clinical Services in Pierce County, Washington.

Pierce County, Washington, has a high burden of sexually transmitted infections (STIs) relative to Washington State and the United States. We used a participatory approach to identify gaps in STI and preexposure prophylaxis (PrEP) service provision in Pierce County and generate recommendations to address these gaps. In collaboration with the Tacoma-Pierce County Health Department (TPCHD), we conducted 14 key informant interviews with local STI/PrEP providers from varied clinical settings. Using rapid qualitative analysis, we identified key gaps and strengths in service provision. Local, state, and national HIV/STI subject matter experts (SMEs) prioritized the gaps and recommendations to address them via an online survey. The primary 6 gaps ranked by SMEs (N = 32) in order of importance included the following: (1) inadequate availability of STI and PrEP services, (2) lack of awareness of STI and PrEP services, (3) need for free/low cost STI and PrEP care, (4) need for stronger relationships among providers and TPCHD, (5) reduced accessibility related to geographically distributed population and centralized services, and (6) frequent referrals pose a service barrier. Subject matter experts prioritized recommendations for each gap as follows: (1) create an STI specialty clinic, (2) implement an STI/PrEP service availability outreach campaign, (3) strengthen referral relationships between TPCHD and free/low-cost providers, (4) develop a provider support network, (5) create a mobile STI clinic, and (6) develop an STI specialty clinic. Sexually transmitted infection specialty clinics were prioritized by SMEs to improve access to STI and PrEP care in Pierce County, and to serve as a resource for local providers.

Lasting Impact of the COVID-19 Pandemic on Care and Prevention of Sexually Transmitted Infections in the Midwest.

The COVID-19 pandemic reduced the general accessibility of health services. Many sexually transmitted infection (STI) testing and treatment sites modified services (e.g., reduced hours, limited walk-in availability, decreased testing capacity), changes that may result in permanent change in STI service availability. At the same time, systems were driven to innovate in ways that could benefit patients. This study aimed to describe how the COVID-19 pandemic changed STI clinical services, with a focus on long-term impacts. In July 2022, a phone survey was designed to assess services for STIs at the 105 STI testing and treatment providers in the St. Louis metropolitan statistical area. Sexually transmitted infection testing providers included STI clinics, primary care clinics that cater to a broad population, and community-based organizations, and excluded emergency departments and urgent care centers. In most cases, the survey was completed by a clinic manager, medical director, or nursing staff member. Of the 75 locations that were interviewed, 12 (16%) had not returned to prepandemic capacity and operations as of July 2022. Five sites had closed completely since the pandemic began, 3 of which are in the northwestern region of the metropolitan statistical area. Most (58.6%) of the open clinics had added telehealth appointments. Sexually transmitted infection testing sites decreased during the pandemic with lasting impact in one area of the Midwest. Resources to support STI infrastructure should be expanded. Maintaining updated information on STI care providers in the region can aid future assessments.

Identifying the Need for and Availability of Evidence-Based Care for Sexually Transmitted Infections in Rural Primary Care Clinics.

Increasing rates of bacterial sexually transmitted infections (STIs) may lead to increased HIV rates, as the STI and HIV epidemics are syndemic. Centers for Disease Control and Prevention guidelines recommend including extragenital (i.e., rectal and/or pharyngeal) STI screenings for certain populations at increased risk of STIs and concurrent infections with HIV. A descriptive study was conducted by interviewing staff members from 4 rural primary care clinics in areas of high need for STI and HIV services in South Carolina. Qualitative data about their clinical practices in 2021 were obtained. The primary outcome was to determine the awareness and availability of health care services associated with STI and HIV care in these locations. Clinics in target counties provided limited STI and HIV testing and treatment services, especially for populations at risk of infection, indicating the need for additional clinical training and professional development for all clinic staff. Specifically, only 1 of 4 clinics provided extragenital STI testing, and no clinics reported prescribing preexposure prophylaxis. Rural primary care clinics can fill important gaps in the availability of STI and HIV services with appropriate support and incentives. Findings from this study may aid in facilitating policy (state Medicaid agency) and program (state health department) decisions related to STI and HIV testing and treatment.

Comparing the Integration of Syndromic versus Etiological Management of Sexually Transmitted Infections Into HIV Pre-Exposure Prophylaxis Services for Adolescent Girls and Young Women, in South Africa

South Africa has a high incidence of human immunodeficiency virus and sexually transmitted infections (STIs), particularly among adolescent girls and young women. National and global guidelines recommend varied strategies for integrating STI and pre-exposure prophylaxis (PrEP) services. PurposeThis paper describes the implementation of a syndromic compared to an etiological approach to STI integration within PrEP services in South Africa. MethodsWe analysed program data from eight fixed and four mobile clinics to describe a cascade of STI care and integration of syndromic management among clients accessing PrEP services. Diagnostic testing was conducted in a subset of clients to determine the prevalence of STIs and estimate the burden of disease missed using a syndromic approach. ResultsBetween December 2018 and December 2021, 22,505 clients sought services and a high proportion (92.9%) was screened for STI symptoms. Of these, 9% of females and 3% of males had symptoms and 89.5% had recorded treatment. In a subset of PrEP clients (406 females, 70 males) screened through laboratory testing, chlamydia was identified in 25.7% of female and 20.0% of male samples, gonorrhea in 14.1% of female and 18.6% of male samples, and syphilis in 2.3% of female and 1.4% of male samples. Highest prevalence was found among females aged 18–20 years. DiscussionSyndromic STI screening and management can be integrated into routine PrEP service delivery and can identify symptomatic STIs, but misses asymptomatic infections. PrEP clients have a high prevalence of treatable STIs. Etiologic approaches can identify more infections than syndromic screening, but cheap point-of-care tests are needed.

Are we ready for a sustainable approach? A qualitative study of the readiness of the public health system to provide STI services to the key populations at risk of HIV in Bangladesh

IntroductionIn Bangladesh, sexually transmitted infection (STI) services are available for all populations in public health facilities. However, STI services for key populations (KPs) at risk of HIV need specifically designed approaches that are predominantly administered to KPs through donor-supported service centers operated by non-government organizations (NGOs) and community-based organisations (CBOs). However, the steady decline in donor funding warrants a sustainable transition of STI services for the KPs into public health facilities. This article aimed to explore the service availability and readiness of public health facilities to provide STI services for the KPs.MethodsThis qualitative study explored the service availability and readiness of public health facilities in three districts of Bangladesh by adapting the Service Availability and Readiness Assessment tool. We conducted 34 in-depth interviews,11 focus group discussions with KPs, and 29 key-informant interviews with healthcare providers, researchers, programme implementers and policy planners, in addition to series of direct observations at the public healthcare facilities. Data were analysed through thematic analysis, and categorised in relation to the WHO building blocks.ResultsThis study revealed that the public health system was generally not ready to serve the KPs’ needs in terms of providing them with quality STI services. The ‘service delivery’ component, which is the most crucial facet of the public health system, was not ready to provide STI services to KPs. Findings also indicated that health workforce availability was limited in the primary and secondary healthcare layers but adequate in the tertiary layer, but needed to be oriented on providing culturally sensitised treatment. Counseling, an essential component of STI services, was neither ready nor available. However, health information systems and a few other components were partially ready, although this warrants systematic approaches to address these challenges.ConclusionThe findings show that public health facilities are yet to be fully ready to render STI services to KPs, especially in terms of service delivery and human and health resources. Therefore, it is not only integral to mobilize communities towards the uptake of public health services, but health systems need to be prepared to cater to their needs.

Chlamydia trachomatis infection in Cuban adolescent and young populations.

In Cuba, little is known regarding the prevalence of Chlamydia trachomatis (CT) infection in adolescents and young people. We study the frequency of CT infection in these populations, and its association with clinical-epidemiological variables. A total of 496 individuals aged 12 to 24 were recruited from November 2018 to November 2019. Of them, 302 were patients attending at sexually transmitted infections (STI) services and 194 were young volunteers. CT detections were carried out by real-time PCR and IgG serology. The prevalence of CT using PCR was 9.1% (45/496); 12.3% (37/302) for subjects attending STI service and 4.1% (8/194) for young volunteers, being significantly higher in the first group (OR=3.25; p=.001). CT IgG antibodies was detected in 38.6% (81/210). Individuals from 12 to 17years old were more likely infected with CT (OR=2.21; p=.010). Infection was associated with the early onset of sexual intercourse, the frequent changing of sexual partners and black ethnicity. The results suggest that Cuban adolescents and young populations are at highest risk of acquiring CT infection and developing reproductive complications. The data obtained advise the needs of implementation of a routine CT screening strategy, for timely diagnosis, detection and treatment at the earliest ages.

Evaluation of a community-based aetiological approach for sexually transmitted infections management for youth in Zimbabwe: intervention findings from the STICH cluster randomised trial

Young people are at high risk of sexually transmitted infections (STIs). We report STI testing uptake, prevalence and incidence within a community-based integrated HIV and sexual and reproductive health service for youth, being evaluated in a cluster randomised trial in Zimbabwe. This paper reports the intervention findings of the cluster randomised trial whereby STI testing was offered to all service attendees (16-24 years) in 12 intervention clusters over 12 months between October 5, 2020, and December 17, 2021, in Zimbabwe. Testing for Chlamydia trachomatis [CT] and Neisseria gonorrhoeae [NG] was offered to males and females with results available in one week and follow-up of test-positive clients by telephone. Trichomonas vaginalis [TV] testing was offered to females only with same day results and treatment. Youth testing positive for any STI were offered partner notification slips and free treatment for partners. This trial was registered with ISRCTN Registry, ISRCTN15013425. Overall, 8549/9891 (86.1%) eligible youth accepted CT/NG testing. Prevalence of CT and NG was 14.7% (95% CI 13.6-15.8) and 2.8% (95% CI 2.2-3.6) respectively. Combined prevalence of CT, NG or TV in women was 23.2% (95% CI 21.5-25.0). After adjusting for cluster, age and sex, the odds of NG were increased in those living with HIV (aOR 3.14, 95% CI 2.21-4.47). The incidence rate among those who initially tested negative for CT or NG was 25.6/100PY (95% CI 20.6-31.8). CT/NG treatment uptake was 924/1526 (60.6%). TV treatment uptake was 483/489 (98.8%). A partner returned for treatment for 103/1807 clients (5.7%). Our findings show high acceptability of STI testing among youth. STI prevalence was high particularly among females and youth with HIV, underscoring the need for integration of HIV and STI services. MRC/ESRC/DFID/NIHR (MR/T040327/1) and Wellcome Trust (206316/Z/17/Z).