STI tests in the pharmacy: the next stage of the community pharmacy?

Only a few years ago the idea would have seemed unusual: a customer walks into a pharmacy, discreetly describes a risk situation or symptoms, and is advised or tested on the spot for a sexually transmitted infection (STI). Today this scenario is long since no longer a distant prospect. Internationally, pharmacies are increasingly taking on tasks in the field of sexual health, from dispensing validated HIV self-tests through counselling to rapid-test services or referral into further medical care. In Switzerland, too, the topic is gaining importance.

The need is there. According to the Federal Office of Public Health (FOPH), reported rates of chlamydia, syphilis and HIV have been at a stable level since 2022, while gonorrhoea in particular has increased markedly in recent years and only stabilised at a high level in 2025.¹ At the same time many STIs run without symptoms for long periods. Chlamydia or gonorrhoea in particular are frequently detected only when complications arise or when testing occurs by chance.¹

Which STIs can be reliably tested for today?

Not every sexually transmitted infection can be detected with the same method or at the same point in time. What matters is the pathogen, the diagnostic window and the appropriate sample material.

Between shame and a care gap

Sexual health is still among the topics many people are reluctant to talk about. A visit to the doctor’s surgery is frequently postponed – whether out of shame, fear of stigmatisation or because symptoms are judged harmless.

This is precisely where a strength of the community pharmacy lies. It is accessible at a low threshold, usually needs no appointment and enjoys high public trust. For many people it already is the first port of call for health questions. The opportunity to talk discreetly about sexual health there could help to lower inhibitions and detect infections earlier.

The pharmacy as first port of call – not as a substitute for the doctor’s surgery

Important, however, is the delimitation: the pharmacy will not in future replace full STI diagnostics either.

Rather, it could take on an important role in triage. Pharmacists can assess risk situations, explain suitable testing options, explain HIV self-tests, point out diagnostic windows and refer patients specifically to doctors or specialised testing centres. The FOPH explicitly recommends that every HIV or STI test be accompanied by a structured history as well as pre- and post-test counselling.²

Advisory competence has always been part of the pharmaceutical professional profile and could be used even more strongly in future.

HIV self-tests: a first step

HIV self-tests may already be sold freely in Switzerland today. Since their introduction in 2018, the FOPH and the then Federal Commission for Sexual Health have explicitly recommended obtaining them wherever possible from pharmacies or drugstores, since product quality is assured there and competent counselling is possible at the same time.³

The so-called diagnostic window is particularly decisive here. A negative test result immediately after a risk situation does not rule out an infection. The FOPH points out that a fourth-generation HIV rapid test can detect an HIV infection at the earliest two weeks after a risk situation, and can rule out an infection with high certainty only around six weeks after exposure.²

The correct interpretation of a test result is therefore at least as important as the test itself.

When is which test appropriate?

Risk contact

├────► 2 weeks: HIV laboratory test (4th generation) can detect early infections¹

├────────► 3–4 weeks: chlamydia and gonorrhoea PCR appropriate²

├────────────► 6 weeks: HIV can be ruled out with practical certainty¹

└────────────────► 12 weeks: syphilis and hepatitis reliably assessable²

(The time points are guide values and depend on the test method and the individual situation.)

More than HIV: where is the pharmacy heading?

Internationally, numerous pharmacies are already expanding their offering to include rapid tests for further sexually transmitted infections, or offer structured screening programmes in cooperation with medical institutions.

In Switzerland, too, there is increasing discussion as to whether the pharmacy could in future be more strongly integrated into prevention and early detection. This is less about diagnosing all STIs on the spot than about low-threshold access to counselling, initial assessment and suitable onward referral.

Such an expansion would fit seamlessly into the development of recent years. Pharmacies already carry out vaccinations, medication reviews, blood pressure and blood glucose measurements as well as numerous other preventive services. STI counselling could represent a logical addition to this service portfolio.

The right triage is decisive

Not every complaint is suitable for self-treatment or a rapid test.

Acute pain, fever, marked discharge, ulcers, skin changes or complaints during pregnancy belong in immediate medical assessment. Possible exposures must likewise be carefully evaluated. Depending on sexual practice, different sample materials may be required (for example urine samples, vaginal swabs, pharyngeal or rectal swabs). A urine test alone is therefore not sufficient in every case.²

The pharmacy’s task therefore lies above all in guiding the right person to the right place at the right time.

Prevention begins with the conversation

A substantial part of the pharmacy’s added value lies in preventive counselling. Conversations about condom use, HPV and hepatitis B vaccination, HIV pre-exposure prophylaxis (PrEP), partner notification or necessary follow-up examinations can contribute substantially to breaking chains of infection.

The National Programme “Stop HIV, hepatitis B virus, hepatitis C virus and sexually transmitted infections (NAPS)” pursues exactly this goal: infections are to be detected and treated as early as possible and further transmissions prevented.⁴ Low-threshold counselling services play a central role in this.

In STI counselling, the pharmacy’s most important service is not the rapid test but the conversation beforehand. A good history determines whether a self-test makes sense, which infection is even in question and whether immediate medical assessment is necessary.

Opportunities and challenges

Should the pharmacy’s role be expanded in future, clear quality standards would be indispensable. These include validated test systems, defined triage algorithms, data protection, discretion as well as structured documentation and connection to the existing care system.

Sound continuing education for the pharmacy team would be equally important. Conversations about sexual health require not only medical expertise but also communicative sensitivity and a high degree of empathy.