Determinants of delay in the health care seeking behaviour of STD patients

Background: Prevention of STDs is a strategic common element in the control of HIV, prevention of infertility and improving maternal and child health. Health care seeking behaviour is a central issue in the prevention and control of STDs. Timely and appropriate treatment is secondary prevention for the patient and primary prevention for the community. Knowledge about the proportion of patients, who delay in seeking appropriate treatment, and the factors affecting the delay can contribute in implementing preventive strategies. Methods: The study design was a hospital-based cross sectional study for a period of 6 months in a tertiary care centre in South Kerala. After informed consent, 93 symptomatic STD patients were studied. The data were collected using a structured questionnaire. The outcome variable was delay. The independent variables were socio-demographic characteristics, clinical characteristics, behavioural characteristics, cognitive factors, and geographical access to health care. Data were analysed using appropriate soft ware. For univariate analysis chi-square statistics was used. All the variables with a p value <0.25 in univariate analysis were entered into logistic regression model. Results: Out of the 93 patients, delay of 8 or more days in seeking appropriate treatment was observed in 54 (58.1%) patients. Among the 54 patients who had delay, 27 (52.9%) were males and 27 (64.3%) were females. After logistic regression modelling, the determinants of delay in males were lowered self efficacy (OR - 17.32, 95% CI - 1.48-207.3, p - 0.023), presence of growth in the genitalia (OR - 8.56, 95% CI - 0.619-118.3, p - 0.10) and symptoms other then urethral discharge (OR - 3.6, 95% CI - 0.59-22.4, p - 0.16). The determinants of delay in females were having non-ulcerative STDs (OR - 22.3, 95% CI - 3.4-152.9, p - 0.0012) and having a nuclear family (OR - 6.69, 95% CI - 1.08-44.02, p - 0.04). Conclusion: Both males and females delayed in seeking treatment if their disease was not associated with severe symptoms such as pain and ulcer. Many patients in spite of having adequate knowledge of STDs continued to have sexual contact while being symptomatic, and did not adopt preventive measures. Future preventive strategies should incorporate in the health education messages different aspects of STDs such as the modes of transmission, symptoms, importance of timely and appropriate treatment and the importance of preventive measures. Periodic training should be given to primary health care providers regarding adequate management of STDs. (C) 2015 INDIACLEN. Published by Elsevier, a division of Reed Elsevier India, Pvt. Ltd. All rights reserved.