Help and Care Seeking for Sexually Transmitted Infections Among Youth in Low-and Middle-Income Countries

• Published in: Sexually transmitted diseases 2017-06, Vol.44 (6), p.319-328
• Main Authors: Newton-Levinson, Anna, Leichliter, Jami S., Chandra-Mouli, Venkatraman
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescent Health Services - statistics & numerical data; Child; Developing Countries - statistics & numerical data; Health Knowledge, Attitudes, Practice; Health Services Accessibility - statistics & numerical data; Help-Seeking Behavior; Humans; Patient Acceptance of Health Care - statistics & numerical data; Qualitative Research; Review; Sexual Behavior - statistics & numerical data; Sexually Transmitted Diseases - epidemiology; Sexually Transmitted Diseases - prevention & control; Sexually Transmitted Diseases - transmission
• ISSN: 0148-5717; 1537-4521
• DOI: 10.1097/OLQ.0000000000000607

BACKGROUNDThe ability to seek help or medical care for sexually transmitted infections (STIs) is vital for sexually active youth; yet, their needs are often unmet. METHODSWe conducted a qualitative systematic review of studies to assess youth and provider views about the behaviors of young people in help seeking and care seeking for STI services in low- and middle-income countries. We searched peer-reviewed literature for studies published between 2001 and 2014 with a study population of youth (age, 10–24 years) and/or health service providers. Eighteen studies were identified for inclusion from 18 countries. Thematic analyses identified key themes across the studies. RESULTSThe majority of studies included discussion of youth not seeking treatment, resorting to self-treatment, or waiting to access care, suggesting that many youth still do not seek timely care for STIs. Youth desired more information on sexual health and cited barriers related to fear or taboos in obtaining help or information, especially from providers or parents. Many did not recognize symptoms or waited until symptoms worsened. However, many youth were able to identify a number of sources for STI related care including public and private clinics, pharmacies, alternative healers, and nongovernmental organizations. Youthʼs help seeking and care seeking preferences were frequently influenced by desires for confidentiality, friendliness, and cost. CONCLUSIONSYouth in low- and middle-income countries experience significant barriers in help seeking for STIs and often do not seek or postpone medical care. Improving uptake may require efforts to address clinic systems, provider attitudes, confidentiality, and cultural norms related to youth sexuality.