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A point-of-care test (POCT) for Chlamydia trachomatis detection is an urgent public health need. Technological advances in diagnostics have made solutions possible. Yet no reliable POCT exists. Our goal was to address the gap between Chlamydia POCT needs and successful POCT development by determining which characteristics of POCTs are most critical and if any flexibility in the attributes assigned those characteristics exists between technology developer and end user. Methods: We used a process known as warfare analysis laboratory exercise (WALEX) in combination with design of experiment method- ology using discrete choice experiments to describe the attributes of the most realistic rather than the most ideal POCT. The WALEX was con- ducted as an interactive oral and simultaneous electronic discussion among experts with differing expertise but linked by a common interest in the development of a Chlamydia POCT. Results: Our studies demonstrated which features of the ideal Chlamydia POCT were considered critical to test acceptance by users and which were open to negotiation. In particular, end users were more lenient on the re- quirement for the fastest ideal test and the lowest 1-time instrument costs, if the requirement for higher throughput, lowest cost, and vaginal sample source collection was preserved. Design of experiment methods used in forced choice question design provided confirmation of opinions derived from oral and electronic WALEX comments. Conclusions: The WALEX in combination with discrete choice ex- periment helped us achieve our goal in identifying the gaps in the Chlamydia POCT and in determining the most realistic solutions to bridge those gaps.

Point-of-care (POC) tests are an important strategy to address the epidemic of sexually transmitted infections (STIs) among both adolescents and young adults. While access to care and confidentiality are major barriers to STI care, POC tests allow the clinician to provide immediate and confidential test results and treatment. In addition, POC test results constitute a “teachable moment”; that is, an opportunity to provide immediate feedback to the patient that may impact his/her risk behaviors. This paper reviews published data and manufacturer’s product literature describing current point-of-care STI tests, including studies of test performance as well as impact on treatment intervals and disease spread. It presents theoretical and proposed pitfalls and solutions of implementing POC tests in clinical settings, non-traditional settings, and home care venues. We reviewed the available STI tests according to the World Health Organization (WHO) criteria for judging POC tests: the “ASSURRED” criteria (Affordable, Sensitive, Specific, User-friendly, Rapid and Robust, Equipment-free, Delivered).