SEEKING MEDICAL-CARE FOR A SEXUALLY-TRANSMITTED DISEASE - DETERMINANTS OF DELAY-BEHAVIOR

Control of Sexually Transmitted Diseases (STD) is important considering the high incidence of acute infections, complications and sequelae, their social and economic impact and their role in increasing transmission of the Human Immunodeficiency Virus. Unfortunately, a common response to illness is to ''wait and see'' if symptoms persist, worsen or subside. This study was conducted to identify determinants of delay-behavior in a sample of individuals with STD-related symptoms (N = 585). In total 27% of the sample waited more than four weeks before they sought medical treatment. Women, village inhabitants and heterosexual individuals more often delayed than men, persons with a homosexual preference and persons living in small, medium sized and big cities. The delay-behavior shown by respondents with high-risk sexual behavior was equal to that of respondents with low-risk sexual behavior. Recurrent attenders did not try to obtain medical treatment any sooner than those who sought medical treatment for the first time. The Health Belief Model was used to predict delay-behavior. The four delay-behavior groups differed from each other with regard to anticipated infertility and anticipated skin-injury, the lack of need for a consultation, the attribution of STD-related symptoms to specific sexual behavior, partner pressure, acquiring information from mass media, and expectations about the existence of the following service attributes: (1) quick cure; (2) being prescribed proper medication; (3) walk-in consulting hours. Furthermore, personal characteristics, such as: habits, shame/embarrassment and searching for the right physician were also related to delay-behavior. However, discriminant analysis among two extreme delay-behavior groups (one week versus more than four weeks delay-behavior) revealed that their predictive power was rather small. From these findings we may conclude that the utility of the Health Belief Model is limited in explaining delay-behavior in individuals with STD related symptoms.