Dr. med. Kerstin Wissel is Leading Physician at Checkpoint Zurich (CPZH) - one of the largest STI testing centers in Switzerland. She provide extensive knowledge through their daily experience with patient care and testing methods, ranging from STI testing to counseling and awareness-raising. We contacted CPZH to learn about their role in combating STIs—from facilitating access to testing to supporting patients with results and follow-up. Additionally, we wanted to assess if and how our test could potentially be integrated into their system or complement some of their current workflows.
Dr. Wissel explained that the testing procedure depends on whether patients show symptoms. She noted that individuals without symptoms first receive a consultation to identify personal risk factors and are then tested accordingly. Patients with specific symptoms are tested more targeted (e.g., discharge suggesting Gonorrhea, or fever with rash and swollen lymph nodes suggesting HIV). She emphasized that classical STI testing for Chlamydia and/or Gonorrhea is carried out with swabs. Positive results are usually communicated automatically via SMS, along with a link to book a therapy appointment. She noted that a reactive HIV screening test is treated differently: results are communicated personally by phone, followed by a prompt invitation to the clinic. Negative results are sent automatically via SMS or email for both HIV and other STIs. Dr. Wissel highlighted that the main goal is to treat positive cases as quickly as possible, including asymptomatic ones, to reduce transmission and break infection chains. For symptomatic patients, she stressed that timely testing and treatment are especially important to avoid the untargeted use of antibiotics.
She explained that patients can choose to test anonymously. Most provide their name, phone number, or email to receive results, but every patient is assigned a code and number for identification. She noted that fully anonymous testing is also possible, in which case patients must call the center themselves to receive results. We were surprised to learn that not many patients make use of this option.
Dr. Wissel said that the center has in-house PCR technology that can theoretically diagnose Chlamydia and Gonorrhea within 90 minutes. In practice, she noted, samples are usually processed within 24 hours, unless urgent circumstances require prioritization. She gave the example of patients with strong symptoms or those who need to travel, who may receive results and treatment the same day. She mentioned that blood-based tests, such as HIV and Syphilis, generally take longer. Rapid HIV tests provide results in 15 minutes, while standard laboratory blood tests may require up to 48 hours.
She explained that in Switzerland, reporting obligations vary by infection. For Chlamydia, only laboratories must report positive results. For Gonorrhea, Syphilis, and HIV, both laboratories and physicians must notify authorities. She noted that laboratory reporting is usually handled by central facilities such as UniLabs, and only positive results are reported; negative results remain confidential.
Dr. Wissel noted that barriers to testing include financial and social factors. She explained that many young people are still on their parents’ insurance and may not want their parents to know they are being tested. She highlighted a pilot program run by the city of Zurich, allowing residents under 25 to test for free, which has been well utilized. She emphasized that stigma remains a significant barrier, as many people feel uncomfortable discussing their sexuality or sex life. She also noted that location can be an issue; people living far from cities may have difficulty reaching test centers. While all STI tests can be performed by a regular clinician (Hausarzt), she observed that some patients prefer providers who are comfortable and experienced discussing sexual health. Regarding the reduction of barriers, Dr. Wissel noted: “It depends on where you distribute it [probably online] and who collects the samples. The idea is very good.” She also mentioned potential regulatory challenges with self-sampling, noting that Aids Hilfe Schweiz wanted to distribute self-sampling kits, but these were prohibited at the time because home self-sampling was not allowed according to Swissmedic.
She noted that most patients (about 90%) prefer to take swabs themselves, although doctors always offer to perform the procedure if patients cannot or do not want to do it. She explained that in the clinic setting, this is not considered problematic because patients can always ask questions or get assistance if needed. She described that patients perform the procedure in dedicated “swab boxes,” and if they become unsure, they can return to staff for further instructions. She emphasized that this provides more control and support compared to at-home sampling, but in practice, self-sampling works very well for almost all patients.
Dr. Wissel explained that the program makes testing more accessible for young people under 25 years and encourages them to reflect on their sexual risks, often for the first time. She noted that appointments are designed to allow more time: while a standard consultation lasts about 15 minutes, b25 appointments are scheduled for around 40 minutes. She emphasized that this extended format goes beyond STI prevention, providing space for broader discussions about sexual health.
She observed that the testing center sees a diverse group of patients, from teenagers (starting at 16) to people over 80. Visitors include cis men and women, trans individuals, sex workers, and heterosexual couples starting new relationships. She noted that the largest group is men who have sex with men (MSM), due to higher overall STI risk. She pointed out that certain groups are not equally supported by existing programs. Male and trans sex workers can access free testing and treatment through city initiatives, while female sex workers must pay for services themselves—at least at this testing facility.
Dr. Wissel noted that the main issue with self-testing at home is that it is not currently allowed by Swissmedic. She added that otherwise, handling the test is feasible for most people. She highlighted two main concerns: 1. Patients might not perform the test correctly, which can be addressed by making the test as simple as possible. 2. It is unclear who actually performs the test, though this is less of a concern since anonymous testing in the clinic also lacks control. She emphasized that for practicality, a test should be easy to use, fast, and ideally a point-of-care test (results within 30 minutes). She also noted that high sensitivity and specificity are essential.
She noted that the test panel is generally comprehensive: gonorrhea, chlamydia, HPV, syphilis, and trichomoniasis. She pointed out one gap is Syphilis, for which a rapid point-of-care test is not yet available. She explained that HPV testing is more complex, mainly relevant for cervical screening, suspect lesions in proctoscopy or visible genital warts, but routine swabs without symptoms are less meaningful.
Dr. Wissel explained that the center introduced regular testing of asymptomatic individuals primarily in the context of HIV PrEP. She noted that the goal was to identify infections such as Chlamydia and Gonorrhea early and reduce transmission. She added that despite several years of experience, overall infection rates did not decrease significantly, highlighting ongoing questions in STI research about the impact of asymptomatic testing on infection chains.
She emphasized that self-tests could help reduce workload for asymptomatic cases, but patients with questions or concerns about sexual health should still visit clinics for guidance. She noted that any self-test should provide a clear point of contact, such as a phone line, for support if results are positive. She stressed that self-tests would not make clinics redundant, as most patients value direct consultation and guidance.
We implemented this by:
The input from Dr. med. Wissel guided us to refine our strategy: prioritizing pathogens with the highest clinical importance, emphasizing post-test counseling, and providing clear instructions to support users. We also addressed gaps in access, such as for female sex workers, and ensured our approach aligns with Swiss regulatory standards. These adjustments make our test more practical, patient-focused, and aligned with real-world needs.