title: Barriers and Facilitators of Screening for Sexually Transmitted Infections in Adolescent Girls and Young Women in Mombasa, Kenya: A Qualitative Study.
abstract: OBJECTIVE
  Young women bear the greatest burden of sexually transmitted infections (STIs), so it is important to identify and address barriers to STI screening in this population. We conducted a qualitative study to explore the feasibility of STI screening among adolescent girls and young women in Mombasa, Kenya.
  
  
  METHODS
  We conducted 17 in-depth interviews (IDIs) (8 with adolescent girls and 9 with young women) and 6 focus group discussions (FGDs) (4 with adolescent girls and 2 with young women, total 55 participants). The audio recordings for the IDIs and FGDs were translated and transcribed into English. Transcripts were independently reviewed by two researchers, and a set of codes was designed to help analyze the data using the content analysis approach. Data content was then analyzed manually and digitally using ATLAS.ti, and consensus was reached on central and specific emergent themes discussed by the research team.
  
  
  RESULTS
  Adolescent girls and young women in Mombasa, Kenya expressed willingness to participate in STI screening. A major incentive for screening was participants' desire to know their STI status, especially following perceived high-risk sexual behavior. Lack of symptoms and fear of positive test results were identified as barriers to STI screening at the individual level, while parental notification and stigmatization from parents, family members and the community were identified as barriers at the community level. Uncomfortable or embarrassing methods of specimen collection were an additional barrier. Thus, urine-based screening was felt to be the most acceptable.
  
  
  CONCLUSIONS
  Kenyan adolescent girls and young women seem willing to participate in screening for STIs using urine testing. Addressing stigmatization by parents, health care workers and the community could further facilitate STI screening in this population.
authors.affiliation: University of Nairobi Institute of Tropical & Infectious Diseases (UNITID), Nairobi, Kenya.
authors.forename: Ethel
authors.initials: E
authors.lastname: Avuvika
authors.affiliation: Department of Epidemiology, University of Washington, Seattle, Washington, United States of America.
authors.forename: Linnet N
authors.identifier: http://orcid.org/0000-0003-4704-9154
authors.initials: LN
authors.lastname: Masese
authors.affiliation: University of Nairobi Institute of Tropical & Infectious Diseases (UNITID), Nairobi, Kenya.
authors.forename: George
authors.initials: G
authors.lastname: Wanje
authors.affiliation: Student Services, Technical University of Mombasa, Mombasa, Kenya.
authors.forename: Juliet
authors.initials: J
authors.lastname: Wanyonyi
authors.affiliation: Mombasa County Department of Health, Mombasa, Kenya.
authors.forename: Benard
authors.initials: B
authors.lastname: Nyaribo
authors.affiliation: School of Nursing Sciences, University of Nairobi, Nairobi, Kenya.
authors.forename: Grace
authors.initials: G
authors.lastname: Omoni
authors.affiliation: Mombasa County Department of Health, Mombasa, Kenya.
authors.forename: Anisa
authors.initials: A
authors.lastname: Baghazal
authors.affiliation: University of Nairobi Institute of Tropical & Infectious Diseases (UNITID), Nairobi, Kenya.|Department of Epidemiology, University of Washington, Seattle, Washington, United States of America.|Department of Medicine, University of Washington, Seattle, Washington, United States of America.|Department of Global Health, University of Washington, Seattle, Washington, United States of America.
authors.forename: R Scott
authors.initials: RS
authors.lastname: McClelland
mesh_terms: D000293:Adolescent; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008403:Mass Screening; D010342:Patient Acceptance of Health Care; D036301:Qualitative Research; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D055815:Young Adult