title: Healthcare-seeking preferences of patients with sexually transmitted infection attending a tertiary care center in South Kerala.
abstract: BACKGROUND
  Sexually transmitted infections (STIs) are a major public health problem in developing countries. These diseases are associated with increased risk of transmission of human immunodeficiency virus as well as adverse outcomes on pregnancy and reproductive health. Sexual behavior and healthcare-seeking behavior are identified as the true risk factors of STIs.
  
  
  METHODS
  Hospital-based cross-sectional study design was adopted. Eighty-five STI patients were studied regarding the inappropriate treatment-seeking behavior, the nature of the first point of contact with the health care, the appropriateness of treatment and the concerns of the patient regarding the services rendered by government health-care facilities.
  
  
  RESULTS
  Among the 85 patients studied, 55.3% were males and 44.7% were females. Inappropriate treatment-seeking behavior was seen in 29.8% of males and 36.8% of females. About 59.6% of males and 81.6% of females sought appropriate treatment from modern medicine practitioners before attending our institution. Only 7.1% of males and 3.2% of females received appropriate treatment. The government sector was the choice of treatment for 46.4% males and 93.5% females and this difference was statistically significant (P= 0.00081). Lack of free medicines, issues of confidentiality, and privacy were the major service-related issues in the public sector.
  
  
  CONCLUSIONS
  Appropriate treatment at the first point of contact with the health system is an important measure to prevent further transmission and development of complications. Health providers from both private and public sector should be given frequent periodic training regarding syndromic management of STIs and the training should stress on the need for risk reduction and condom promotion messages along with medical management. Program planners should take necessary steps to ensure adequate and continuous supply of free drugs and tackle issues of confidentiality and privacy.
authors.affiliation: Department of Dermatology and Venereology, Government Medical College, Thiruvananthapuram, Kerala, India.
authors.forename: Sabeena
authors.initials: S
authors.lastname: Jayapalan
keywords: Healthcare-seeking behavior; sexually transmitted infection; syndromic management