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Perceived Monogamy and Type of Clinic as Barriers to Seeking Care for Suspected STD or HIV Infection: Results From a Brief Survey of Low-Income Women Attending Women, Infants, and Children (WIC) Clinics in Missouri

Crosby, Richard A. PhD*; Yarber, William L. HSD; Meyerson, Beth M.Div

Original Articles

Background and Objectives: Barriers to seeking care for sexually transmitted diseases (STDs) have not been assessed for low-income women. We sought to determine barriers to seeking care for STDs among women receiving Women, Infants, and Children (WIC) benefits in 21 Missouri counties.

Goal of This Study: Provide information for promoting care-seeking behavior among low-income women suspecting STD infection.

Study Design: A survey of 2,256 women was conducted; 491 reported a history of at least one STD. These women indicated possible barriers to seeing a doctor about a suspected STD and preference for type of clinic providing STD services.

Results: More than one fifth (21.3%) of those reporting an STD also reported at least one barrier to seeing a doctor about suspected STD or human immunodeficiency virus infection. Among those reporting barriers, the most common barrier was “I only have sex with my steady” (36.2%) followed by being asymptomatic (33.3%), embarrassment (22.8%), and cost (25.7%). Most (63.8%) preferred seeing their own doctor, with others reporting preference for community health centers (14.8%), family planning clinics (16.8%), and STD clinics (4.6%).

Conclusions: Low-income women experience multiple barriers to seeking care including perceptions about a protective value of monogamy. Also, STD services in locations providing other health services for women were preferred.

*From the Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia; †The Rural Center for AIDS/STD Prevention, Indiana University and Purdue University, Bloomington, Indiana; and ‡Public Policy Consulting

This study was supported, in part, by the Rural Center for AIDS/STD Prevention, a joint project of Indiana University and Purdue University.

At the time of study Beth Meyerson was the Chief of the Bureau of STD/HIV Prevention, Missouri Department of Health.

Reprint requests: Richard A. Crosby, Behavioral Interventions and Research Branch, Division of STD Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS-E44, Atlanta, GA 30333.

Received for publication January 7, 1999, revised March 4, 1999, and accepted March 30, 1999.

© Copyright 1999 American Sexually Transmitted Diseases Association