Sexually transmitted infections care service provision in Spain: Characteristics, diagnostic capabilities, and training.

Objective: The incidence of sexually transmitted infections (STI) has been steadily increasing in Spain over the last decade, but knowledge of health resources for STI management at the national level is still unknown. The aim of this study is to describe the territorial distribution, operational characteristics, allocation and profile of health care personnel, as well as and diagnostic capabilities of dedicated STI care facilities in Spain. Methods: Descriptive cross-sectional study. A survey was distributed between June 2021 and December 2022 through the Spanish HIV/STI coordinators in the autonomous regions of Spain. The operational characteristics of STI care facilities, STI diagnostic capacity, allocation and profile of health care personnel were recorded. Results: A total of 72 STI care facilities and 133 physicians were identified, of which 46 and 90 responded respectively (64 % and 68 % response rate). 78 % of STI care facilities were only open in the mornings, and only 2 % had 24-h care available. Likewise, 21 % of facilities offered assistance on weekends and 56 % required an appointment. In-house diagnosis percentages in STI care facilities were 56 % for gonorrhea, 42 % for chlamydia, 51 % for syphilis, and 60 % for HIV. 96 % of STI facilities had a physician (42 % internal medicine specialist), with an average of 2.9 specialists (SD = 3.1) per centre. Conclusions: The diagnostic capabilities of STI centres in Spain is heterogeneous. Key areas for improvement include accessibility to STI care, efficient resource allocation, strengthening the diagnostic capacity of STI care facilities across the country and training of health professionals.