Evaluation of Free STI Testing Pilot Projects in Lucerne and Zurich, Switzerland (feSTI)

feSTI: Evaluation of Free HIV and STI Testing and Counselling Services for Young and Disadvantaged Populations in Lucerne and Zurich

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 Overview

• Status: Not yet recruiting
• Conditions: Chlamydia; Gonorrhea; Syphilis; HCV; HIV (Human Immunodeficiency Virus)

• Study Type: Observational
• Enrollment (Estimated): 1800

Contacts and Locations

• Study Contact: Name: Andrea C Farnham, PhD; Phone Number: +41 44 634 60 00; Email: testi@ebpi.uzh.ch

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

People living in the cities of Lucerne and Zurich, and fullfilling the eligibility criterias of the city programmes either in age or level of income.

Description

Inclusion Criteria:

• taking part in the pilot programmes
• understand the study information
• 16 years of age or older

Exclusion Criteria:

• not eligible for the pilot programmes
• not understanding the study information
• less than 16 years old

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Participants in municipal free HIV and STI counselling and testing pilot programmes; Participants are people accessing the municipal free HIV and STI counselling and testing pilot programmes. People can be eligible by age or low income.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
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.	3 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Service capacity/utilisation	Number of completed voluntary counselling and testing visits recorded per month across participating sites.	3 years
Access timeliness	Median number of days between booking date and appointment date for VCT visits	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.	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.	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.	3 years
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.	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.	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.	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.	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.	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.	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.	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.	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.	3 years

Collaborators and Investigators

• Sponsor: University of Zurich
• Collaborators: Checkpoint Zurich; Checkpoint Lucerne; Test-In Zurich

Publications and helpful links

Helpful Links

• Study infromation

Study record dates

Study Major Dates

• Study Start (Estimated): April 7, 2026
• Primary Completion (Estimated): November 30, 2028
• Study Completion (Estimated): February 28, 2029

Study Registration Dates

• First Submitted: March 23, 2026
• First Submitted That Met QC Criteria: April 2, 2026
• First Posted (Actual): April 8, 2026

Study Record Updates

• Last Update Posted (Actual): April 8, 2026
• Last Update Submitted That Met QC Criteria: April 2, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: HIV; sexually transmitted infections; barriers to care; Voluntary counselling and testing; implementation of free testing
• Additional Relevant MeSH Terms: Blood-Borne Infections; Urogenital Diseases; Genital Diseases; Pathologic Processes; Disease Attributes; Immune System Diseases; Infections; RNA Virus Infections; Virus Diseases; Communicable Diseases; Sexually Transmitted Diseases, Viral; Lentivirus Infections; Retroviridae Infections; Immunologic Deficiency Syndromes; Slow Virus Diseases; Bacterial Infections; Bacterial Infections and Mycoses; Gram-Negative Bacterial Infections; Spirochaetales Infections; HIV Infections; Chlamydiaceae Infections; Sexually Transmitted Diseases, Bacterial; Neisseriaceae Infections; Treponemal Infections; Pathological Conditions, Signs and Symptoms; Acquired Immunodeficiency Syndrome; Sexually Transmitted Diseases; Chlamydia Infections; Gonorrhea; Syphilis
• Other Study ID Numbers: feSTI; BASEC-Nr: 2025-02292 (Other Identifier: Cantonal Ethics Commission Zurich)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be shared. Access to data is restricted to authorised project personnel. For data sharing partcipant consenst needs to be sought.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No