Diagnostic accuracy, satisfaction, and acceptability of point-of-care testing for syphilis, hepatitis B, and hepatitis C infections among Thai adolescents and young adults with sexual risk behaviors.

BACKGROUND

Sexually transmitted infections (STIs) remain an important public health concern globally. This study evaluated the diagnostic performance of point-of-care tests (POCTs) for syphilis, hepatitis B virus (HBV), and hepatitis C virus (HCV) infections using capillary whole blood and venous plasma, and assessed acceptability of finger-prick-based POCTs among Thai adolescents and young adults (AYA).

METHODS

A cross-sectional diagnostic study was conducted among AYA aged 15-30 years with sexual risk behaviors attending a community sexual health clinic in Chiang Mai, Thailand. Several POCTs were evaluated for syphilis, HBV, and HCV using finger-prick capillary whole blood and venipuncture-derived plasma. Diagnostic performance was assessed against confirmatory reference assays. Participant satisfaction and acceptability of finger-prick-based POCTs were evaluated using a self-administered questionnaire.

RESULTS

Three hundred fifty high-risk Thai AYA (median age 23 years, 92% male, 71% self-identified as homosexual) were enrolled. Overall, 64% inconsistently used condoms, and 40% reported a lifetime history of STIs. The prevalence of seroactive syphilis, HBV, and HCV was 17%, 1%, and 4%, respectively. Finger-prick-based POCTs showed high diagnostic accuracy (92%-100% sensitivity and 90%-93% specificity for syphilis; 75% sensitivity and 99% specificity for HBV; 80% sensitivity and 99% specificity for HCV), comparable to venipuncture-based POCTs (87%-100% sensitivity and 92%-94% specificity for syphilis; 75% sensitivity and 99% specificity for HBV; 67%-80% sensitivity and 99% specificity for HCV). Most participants reported high satisfaction and acceptability with finger-prick POCTs.

CONCLUSION

POCTs for syphilis, HBV, and HCV showed high diagnostic performance among high-risk Thai AYA. Finger-prick-based POCTs demonstrated comparable accuracy and high acceptability, supporting their use in community-based STI screening.