Why do people delay obtaining treatment for an STD? Perspectives from a developing country

Abstract

A bstract Eighty-four consecutive clients at an urban clinic in Zimbabwe, who were seeking treatment for suspected STD s, were interviewed to ascertain the barriers and triggers which guided their behaviour. M ost respondents regarded having an STD as a serious problem, and were aw are of the ef® cacy of condom s in protecting them from ST Ds; nevertheless, very few reported using condom s regularly. K now ledge of ST Ds was patchy, with very few showing an understanding that they may be asym ptomatic. The m ain trigger for attendance was the presence of debilitating sym ptoms. M en were signi® cantly more likely than women to have visited the clinic for STD treatment on a previous occasion. M ost had tried som e form of self-treatment before attending; relatively few reported consulting a traditional healer. T he cost of treatment was a clear barrier to attendance for a num ber of respondents. Introdu ctionThe area of sexually transm itted diseases is one which has largely been neglected by psycho logists, with the exception of work on HIV/AIDS. Recently there has been a greater aw areness that, despite the availability of effective m edical treatm ent for m any of these diseases, ST D s continue to spread in the com m unity. O ne aspect of concern is the delay in seeking treatm ent for a sexually transm itted disease. Delays between th e onset of the disease and its effective treatm ent have tw o effects. The ® rst is to increase the risk of long-te rm dam age to the individual concerned; infertility am ongst wom en is one such problem . The other issue is th e continued spread of the disease in th e com m unity; untreated individuals put them selves and others at risk.The reasons for seeking m edical consultation and treatm ent are com plex. It is well know n that individuals will consult oth ers often before seeking general m edical advice (Scam bler & Scam bler, 1984). O ther factors which can in¯uence the decision to seek m edical opinion are the nature and severity of any sym ptom s and the construction of th ose sym ptom s in a cultural context. M acLachlan (1997) has written extensively concerning the cultural variations in illness representations, and other researchers have becom e particularly aw are of the in¯uence of lay representations on reactions to sym ptom s and illnesses (Petrie & W einman, 1997).