Barriers to asymptomatic screening and other STD services for adolescents and young adults: focus group discussions

Abstract

BackgroundSexually transmitted diseases (STDs) are a major public health problem among young people and can lead to the spread of HIV. Previous studies have primarily addressed barriers to STD care for symptomatic patients. The purpose of our study was to identify perceptions about existing barriers to and ideal services for STDs, especially asymptomatic screening, among young people in a southeastern community.MethodsEight focus group discussions including 53 White, African American, and Latino youth (age 14–24) were conducted.ResultsPerceived barriers to care included lack of knowledge of STDs and available services, cost, shame associated with seeking services, long clinic waiting times, discrimination, and urethral specimen collection methods. Perceived features of ideal STD services included locations close to familiar places, extended hours, and urine-based screening. Television was perceived as the most effective route of disseminating STD information.ConclusionsFurther research is warranted to evaluate improving convenience, efficiency, and privacy of existing services; adding urine-based screening and new services closer to neighborhoods; and using mass media to disseminate STD information as strategies to increase STD screening.

Where do young Irish women want Chlamydia-screening services to be set up? A qualitative study employing Goffman's impression management framework

“…It is a 'silent infection'-70% of women and 50% of men with Chlamydia are asymptomatic (Peipert, 2003). If left untreated, Chlamydia can cause severe reproductive complications in women, such as infertility and ectopic pregnancy (Tilson et al, 2004). Chlamydia is easy to detect using a urine test and easy to treat with a single dose of antibiotics (Peipert, 2003).…”

“…Identifying user-friendly settings is therefore a first step in setting up any kind of screening programme (Tilson et al, 2004). Overall, however, there has been little formative research that would provide empirical findings to underpin the selection of appropriate screening settings.…”

“…Internationally, most previous research on young people's STI setting preferences has been based on interviews with urban youth recruited from STI clinics or family planning clinics, thereby reaching the minority of target group individuals who are already attending reproductive and STI services (Goldenberg et al, 2008;Pavlin et al, 2006). Health service planners need better information about the setting preferences of asymptomatic individuals who have not sought out sexual health care (Tilson et al, 2004).…”

Meatal Swabs Contain Less Cellular Material and Are Associated with a Decrease in Gram Stain Smear Quality Compared to Urethral Swabs in Men

“…Another study attempted to quantify, using a visual analogue pain scale, the discomfort associated with urethral swab collection and found that collection with a urethral swab using the standard technique (inserting a swab 2 cm into the distal urethra) elicited a median pain score of 52 mm (on a 100-mm pain scale), which correlated with moderate (Ͼ30 mm) to severe (Ͼ54 mm) pain (10). Furthermore, multiple studies have identified discomfort from urethral swabbing as a major factor that causes men to delay seeking health care (11)(12)(13), and participants in adolescent focus groups expressed strong negative emotions when asked about the urethral swab testing process (12,13). In addition, the ease of obtaining a meatal swab facilitates self-collection for NAAT, allowing patients to self-collect specimens at home or in a clinical setting where regular interval screening of asymptomatic high-risk men is performed.…”

Low HIV testing rate and its correlates among men who inject drugs in Iran

“…While barriers to HIV testing among youth in Iran is poorly understood, decreased uptake of HIV testing among youth has been strongly associated with structural-and individual-level HIV-related stigma in numerous settings (Cunningham, Tschann, Gurvey, Fortenberry, & Ellen, 2002;Shoveller, et al, 2009;Tilson, et al, 2004).…”