title: Patterns of general health care and STD services use among high-risk youth in Denver participating in community-based urine chlamydia screening.
abstract: 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 services. 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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  An interview-based survey conducted as part of a community program for urine chlamydia screening targeting black and Hispanic youth 13 years to 25 years.
  
  
  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 would 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.
authors.affiliation: Department of Public Health, Denver Health Medical Center, Colorado, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Rietmeijer
authors.forename: S S
authors.initials: SS
authors.lastname: Bull
authors.forename: C G
authors.initials: CG
authors.lastname: Ortiz
authors.forename: T
authors.initials: T
authors.lastname: Leroux
authors.forename: J M
authors.initials: JM
authors.lastname: Douglas
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D002690:Chlamydia Infections / Q000175:diagnosis / Q000517:prevention & control* / Q000652:urine; D003120:Colorado; D005260:Female; D006297:Health Services Accessibility; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D012309:Risk-Taking; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000517:prevention & control* / Q000652:urine; D014504:Urban Health