Delay in Seeking Care for Sexually Transmitted Diseases in Young Men and Women Attending a Public STD Clinic

Angela M. Malek1, *, Chung-Chou H. Chang2, Duncan B. Clark3 , Robert L. Cook4
1 Department of Neurosciences, Medical University of South Carolina, Charleston, SC, USA
2 Departments of Medicine and Biostatistics, University of Pittsburgh, Pittsburgh, PA, USA
3 Departments of Psychiatry and Pharmaceutical Sciences, University of Pittsburgh, Pittsburgh, PA, USA
4 Departments of Epidemiology and Medicine, University of Florida, Gainesville, FL, USA

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© Malek et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Neurosciences, College of Medicine, Medical University of South Carolina, 19 Hagood Avenue, Suite 501, Charleston, SC 29425, USA; Tel: 843-792-9590; Fax: 843-792-2484; E-mail:



Delay in seeking care for sexually transmitted diseases (STDs) has adverse consequences for both the individual and population. We sought to identify factors associated with delay in seeking care for STDs.


Subjects included 300 young men and women (aged 15-24) attending an urban STD clinic for a new STD-related problem due to symptoms or referral for an STD screening. Subjects completed a structured interview that evaluated STD history, attitudes and beliefs about STDs, depression, substance use, and other factors possibly associated with delay. Delay was defined as waiting > 7 days to seek and obtain care for STDs.


Nearly one-third of participants delayed seeking care for > 7 days. Significant predictors for delay included self-referral for symptoms as the reason for visit (OR 5.3, 95% CI: 2.58 – 10.98), and the beliefs “my partner would blame me if I had an STD” (OR 2.44, 95% CI: 1.30 – 4.60) and “it’s hard to find time to get checked for STDs” (OR 3.62, 95% CI: 1.95 – 6.69), after adjusting for age, race, sex, and other factors. Agreeing with the statement “would use a STD test at home if one were available” was associated with a decrease in delay (OR 0.24, 95% CI: 0.09 – 0.60).


Many young persons delay seeking care for STDs for a number of reasons. Strategies to improve STD care-seeking include encouragement of symptomatic persons to seek medical care more rapidly, reduction of social stigmas, and improved access to testing options.

Keywords: : Delay, healthcare-seeking behavior, men, sexually transmitted diseases, symptoms, women..