Background: Asymptomatic screening and timely presentation to care for symptoms are fundamental to reducing the prevalence of sexually transmitted diseases (STDs) in adolescents. The objective of this study was to clarify provider and clinic characteristics that adolescents consider important to their decisions to seek care for STDs.

Methods: We conducted a telephone survey with a random sample of 12-17 year old African American adolescents (N=301) residing in neighborhoods with high rates of STDs. Approximately 77% of contacted adolescents completed the interview. Subjects were asked how important various issues would be in their decision to seek care for an STD. A factor analysis of responses was performed; 3 factors emerged as significant. We developed scales from items loading on each of the factors. The “clinic privacy” scale consisted of 3 items, e.g., “How important is it that the clinic is located where no one could see you go in?”(α=.72). The “provider style” scale consisted of 6 items, e.g., “How important is it that doctors and nurses tell teenagers exactly what is wrong?” (α=.60). The “scheduling” scale consisted of 3 items, e.g., “How important is it that teenagers don't have to wait too long in the waiting room?” (α=.60). We performed bivariate analyses on results from all subjects. Since only sexually experienced adolescents were questioned regarding their history of seeking care, multivariate analysis was restricted to these subjects (n=118). This was performed to assess the independent relationships of age, gender,and history of STD care seeking with each factor.

Results: The mean age of subjects was 14.7 years; 55% were female. A history of sexual intercourse was reported by 39%. Of these, 42% had sought STD care in the past year. Overall, adolescents ranked all 3 factors as very or extremely important in their decisions to seek care. On both bivariate(p<.001) and multivariate (p=.015) analyses females were significantly more concerned with “clinic privacy”. On bivariate analysis higher importance was placed on “provider style” by older (p<.001), female (p=.003), sexually experienced (p=.006) and STD care seeking teens(p=.041). After multivariate analysis only gender remained significant.“Scheduling” concerns did not vary by any of the variables tested.

Conclusions: Adolescents consider provider style, privacy and clinic scheduling issues important in their decisions to seek care for STDs. Health care providers and organizations need to be aware of these concerns to better promote screening and treatment of STDs in this population.