Factors Associated with Delay in Seeking Care for Sexually Transmitted Diseases in Male and Female Adolescents and Young Adults

Background: Delay in seeking health care for sexually transmitted diseases (STDs) has adverse consequences. We sought to identify factors associated with delay in seeking care for STDs and to assess whether these factors differed in males and females.

Methods: Subjects were 300 persons (aged 15-24 years old; 50% female) attending an STD clinic because of symptoms (63%) or because they were told to seek care (37%). Subjects completed a structured interview that evaluated care-seeking intervals and factors possibly associated with delays in seeking care.

Results: Thirty percent waited for more than 7 days to seek care. In multivariate analysis, significant predictors for delay included having symptoms as reason for visit, agreeing that “my partner would blame me if I had an STD” (OR=2.4, 95% CI 1.30, 7.4) and that “it is hard to find time to get checked for STDs” (4.3, 95% CI 2.40, 7.4). Factors associated with a decreased likelihood of delay included belief that they would be “more likely to get an STD test without a genital exam” (0.2, 95%CI 0.10, 0.6) and “would consider an STD test at home if one were available” (0.3, 95% CI 0.12, 0.7). Gender was not associated with any differences in delay, and predictors of delay did not differ significantly by gender.

Conclusions: Many symptomatic men and women delay seeking care for STDs, with both individual and clinic-based factors affecting delay. Strategies to improve STD care seeking may include increased clinic access, greater confidentiality assurances, and improved access to testing options.