Delay in Seeking Healthcare Services Following Onset of Urethritis Symptoms in Men.

BACKGROUND: Symptom awareness, behavioral factors, and other barriers associated with timely STI healthcare provision in men is not well-studied.

METHODS: Men attending an STI clinic answered a questionnaire regarding their symptoms, sexual behavior, and socio-demographic and behavioral characteristics. Characteristics of symptomatic men were compared between those who did and did not delay seeking healthcare services. Delayed care-seeking was defined as clinic attendance >7 days after symptoms while early care-seeking was defined as clinic attendance ≤7 days.

RESULTS: Over one quarter [n=43] (27.7%) of men with urethritis symptoms (urethral discharge and/or dysuria) delayed seeking care for more than 7 days. Compared with men that sought treatment within 7 days, those that delayed care worried for longer periods that their symptoms were STI-related, were more likely to attempt self-treatment of STI symptoms, were more likely to continue engaging in sexual activity, and were less likely to use a condom during their last sexual encounter. Conversely, men that delayed care-seeking were less likely to have urethral discharge on physical exam, to have ≥5 polymorphonuclear leukocytes, and to test positive for Neisseria gonorrhoeae. When compared to men that sought care earlier, men that delayed care-seeking had fewer overall and new partners in the past 30 days.

CONCLUSIONS: Our data suggest that over a quarter of men aware of STI symptoms delay seeking health services. Interventions that promote better patient understanding of the importance of symptom recognition and that facilitate timely access to care may provide new opportunities to reduce STI transmission.