Patterns of General Health Care and STD Services Use Among High-Risk Youth in Denver Participating in Community-Based Urine Chlamydia Screening

• Published in: Sexually transmitted diseases 1998-10, Vol.25 (9), p.457-463
• Main Authors: RIETMEIJER, CORNELIS A., BULL, SHEANA S., ORTIZ, CHARLENE G., LEROUX, TOBY, DOUGLAS, JOHN M.
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescent Behavior; Adult; African Americans - statistics & numerical data; Biological and medical sciences; Children & youth; Chlamydia Infections - diagnosis; Chlamydia Infections - prevention & control; Chlamydia Infections - urine; Colorado; Female; General aspects; Health Services Accessibility; Hispanic Americans - statistics & numerical data; Human infectious diseases. Experimental studies and models; Humans; Infectious diseases; Male; Mass Screening - methods; Medical sciences; Medical screening; Population; Preventive Health Services - statistics & numerical data; Public health; Risk-Taking; Sexually transmitted diseases; Sexually Transmitted Diseases - diagnosis; Sexually Transmitted Diseases - prevention & control; Sexually Transmitted Diseases - urine; STD; Studies; Urban Health
• ISSN: 0148-5717; 1537-4521
• DOI: 10.1097/00007435-199810000-00003

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 innercity 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.