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Sex Transm Dis. 1998 Oct;25(9):457-63.

Patterns of general health care and STD services use among high-risk youth in Denver participating in community-based urine chlamydia screening.

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1
Department of Public Health, Denver Health Medical Center, Colorado, USA.

Abstract

BACKGROUND:

In the United States, youth are at highest risk for STDs, and innovative programs have been called for to increase their access to essential STD-related services. To guide the development of such programs, locally relevant information is needed on current use of general health care and STD services in this population.

GOAL:

To study access to and use of general health care and STD services in a purposive sample of high-risk youth in inner-city Denver.

STUDY DESIGN:

An interview-based survey conducted as part of a community program for urine chlamydia screening targeting black and Hispanic youth 13 years to 25 years.

RESULTS:

Of 221 sexually experienced youth in the survey, 72% had accessed general health services in the past year and 39% reported an STD evaluation at any time in the past. Community and school clinics were reported by 50% as a source for general health care and by 62% as a source for STD services. STD clinics were reported by only 14% as a source for STD services. Routine checkups were the most important reasons to seek general health care, yet of those who went for a routine checkup, only 34% reported an STD evaluation. Although few barriers appeared to exist in accessing general health care, anticipated anxiety about procedures and results formed the major barrier to accessing STD services.

CONCLUSIONS:

Use of general health services was common in this population of high-risk adolescents; however, the provision of STD services as part of general health care visits appeared to be low. On the basis of these findings, a comprehensive STD prevention strategy may be envisioned, which would include provider interventions to increase the provision of STD prevention services in general health care settings; community interventions to enhance access to general health care and STD services; and community-based screening programs for those not able or willing to seek clinic-based services.

PIP:

To guide the development of innovative programs to increase the access of US adolescents and young adults to sexually transmitted disease (STD) prevention and treatment services, data should be obtained at the local level from nonclinic-based samples comprised of those at greatest risk. Such a survey was conducted in Denver, Colorado, in 1996-97 by Youth in Action--a community-level chlamydia urine screening program. Questionnaires were completed by 221 of the 277 predominantly Black and Hispanic inner-city youth 13-25 years of age who underwent urine analysis during the study period. 25 (11%) reported a history of an STD. On urine screening, 10.7% of males and 12.9% of females tested positive for chlamydia. 72% had accessed general health services in the past year, primarily for routine checkups, and 39% reported an STD evaluation at any time in the past. Community and school clinics were identified by 50% as a source for general health care and by 62% as a source for STD services. Only 14% of respondents attended STD clinics. In multivariate analysis, the following factors were associated with an STD evaluation: recruitment in field settings, female gender, age above 16 years, non-Hispanic ethnicity, vaginal sex in the past 30 days, presence of chlamydia on urine screening, and a general health visit in the past year. Of concern was the finding that only 34% of youth who went for a general checkup reported an STD evaluation. These findings indicate needs for interventions to increase the provision of STD prevention services in general health care settings and community-based screening programs for those unable or unwilling to seek clinic-based services.

PMID:
9800256
[Indexed for MEDLINE]
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