Patterns of general health care and STD services use among high-risk youth in denver participating in community-based urine Chlamydia screening

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 ser,ices. 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 inner-city Denver. Study Design: An interview-based survey conducted as part of a community program for urine chlamydia screening targeting black and Hispanic youth 13 gears to 25 Sears. 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 could 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.