Client, health care provider, and policymaker perspectives on point-of-care/near-point-of-care testing for sexually transmitted infections in community pharmacies in Uganda

INTRODUCTION: Point-of-care or near-point-of-care (POC/near-POC) tests for sexually transmitted infections (STIs) are often unavailable and unaffordable in low-resource settings, despite the World Health Organization's (WHO) recommendation that such testing be offered, leading to empiric treatment. Private community pharmacies (CPs) are often the first point of contact for people with symptoms of STIs, where pharmacists dispense treatment without diagnostic testing or prescriptions. This study evaluated clients,' providers,' and policymakers' perspectives on POC/near-POC STI testing in community pharmacies for targeted management. METHODS: Between June and September 2022, we nested a qualitative study into a prospective cohort of clients seeking both STI and non-STI treatments in community pharmacies in Kampala and Wakiso districts in Uganda. They were tested for HIV, syphilis, trichomonas, chlamydia, and gonorrhea using POC/near-POC tests. A purposive sample of 50 participants consented to participate in in-depth and key informant interviews. Data were analyzed thematically using NVivo version 14 with an inductive approach, with results reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ). RESULTS: Clients (n = 35), health care providers (n = 9), and policymakers (n = 6) described the benefits of POC/near-POC tests for HIV/STIs at community pharmacies, citing affordability, accessibility, and convenience. Participants noted that such testing could promote behavioral change, shorten turnaround time for results, speed access to treatment relative to conventional laboratory methods, and support sustainable antimicrobial resistance control. Reported barriers included limited awareness among clients and health workers, inadequate privacy and space, long waiting times, unclear self-sample collection instructions, stigma around HIV testing, and reluctance to test for non-HIV STIs. Participants recommended raising STI awareness, offering clearer explanations of test results, expanding test access, reducing stigma, provider training, and ensuring a sustainable supply chain for testing kits. CONCLUSIONS: POC/near-POC testing for HIV/STIs was highly acceptable to both pharmacy clients and providers in this study. Integrating such testing into community pharmacy settings could strengthen national HIV/STI management programs, and addressing the identified barriers could improve access to HIV/STI diagnostics and strengthen linkage to care.