Barriers to asymptomatic screening and other STD services for adolescents and young adults: focus group discussions

TLDR

STDs pose a major public health threat to young people, including HIV transmission, yet prior research has focused mainly on barriers for symptomatic patients. The study aims to identify young adults’ perceptions of barriers to and ideal features of STD services, particularly asymptomatic screening, and to propose strategies—such as urine‑based testing, neighborhood‑based services, and mass media outreach—to enhance convenience, privacy, and uptake. The authors conducted eight focus group discussions with 53 diverse youth aged 14–24. Participants reported barriers such as limited knowledge, cost, shame, long wait times, discrimination, and invasive specimen collection, while they favored services located near familiar places, offering extended hours, and urine‑based screening, with television identified as the most effective medium for disseminating information.

Abstract

Sexually transmitted diseases (STDs) are a major public health problem among young people and can lead to the spread of HIV. Previous studies have primarily addressed barriers to STD care for symptomatic patients. The purpose of our study was to identify perceptions about existing barriers to and ideal services for STDs, especially asymptomatic screening, among young people in a southeastern community. Eight focus group discussions including 53 White, African American, and Latino youth (age 14–24) were conducted. Perceived barriers to care included lack of knowledge of STDs and available services, cost, shame associated with seeking services, long clinic waiting times, discrimination, and urethral specimen collection methods. Perceived features of ideal STD services included locations close to familiar places, extended hours, and urine-based screening. Television was perceived as the most effective route of disseminating STD information. Further research is warranted to evaluate improving convenience, efficiency, and privacy of existing services; adding urine-based screening and new services closer to neighborhoods; and using mass media to disseminate STD information as strategies to increase STD screening.