Organisational models for equitable STI prevention: a national mapping study
M Crudele, A Colucci, V Mazzotta, M Maffeo, R Ranieri, B Pellizzari, M Ubbiali, M Farinella, N Albano, D MartinelliAbstract
Background
In Italy, sexually transmitted infections(STIs) generate a sustained public health burden, mostly in vulnerabilised populations such as migrants, people who use drugs, people in prison, sex workers, and MSM and other LGBTQIA+ persons. Access to prevention, diagnosis and care is shaped by fragmented and heterogeneous regional governance models in which health services and community-based organisations(CBOs) often lack formal integration. This results in access gaps and discontinuities in linkage to care.
Methods
Within the project “Salute Inclusiva”, funded by the Italian Ministry of Health(CCM 2024), a consortium of academic institutions, regional health authorities, national public health bodies and CBOs is conducting a cross-sectional mapping study across 6 Italian regions. The design combines a scoping-style review of regional documents(strategic plans, care pathways and agreements with CBOs) with qualitative in-depth interviews involving key informants at 4 levels: regional governance, local health authority management, territorial STI services, and CBOs. Standardised tools will enable systematic comparison across regions and governance tiers; reflexive thematic analysis and cross-source triangulation will identify organisational patterns, gaps between formal frameworks and practice, and integration mechanisms.
Results
This study will produce the first national, comparable description of STI governance and care pathways in Italy, outlining how responsibilities are distributed across institutional levels, the role of CBOs within the regional service networks, and which structures support or hinder equitable access and continuity of care.
Conclusions
Mapping how STI services are organised in practice provides evidence to strengthen governance and interoperability between health services and community actors. It will support the development of integrated and continuous care pathways for vulnerabilised populations, informing national and regional policy.