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

Control of Sexually Transmitted Diseases (STD) is important considerin g the high incidence of acute infections, complications and sequelae, their social and economic impact and their role in increasing transmis sion of the Human Immunodeficiency Virus. Unfortunately, a common resp onse to illness is to ''wait and see'' if symptoms persist, worsen or subside. This study was conducted to identify determinants of delay-be havior in a sample of individuals with STD-related symptoms (N = 585). In total 27% of the sample waited more than four weeks before they so ught medical treatment. Women, village inhabitants and heterosexual in dividuals more often delayed than men, persons with a homosexual prefe rence and persons living in small, medium sized and big cities. The de lay-behavior shown by respondents with high-risk sexual behavior was e qual to that of respondents with low-risk sexual behavior. Recurrent a ttenders did not try to obtain medical treatment any sooner than those who sought medical treatment for the first time. The Health Belief Mo del was used to predict delay-behavior. The four delay-behavior groups differed from each other with regard to anticipated infertility and a nticipated skin-injury, the lack of need for a consultation, the attri bution of STD-related symptoms to specific sexual behavior, partner pr essure, 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. Fur thermore, personal characteristics, such as: habits, shame/embarrassme nt and searching for the right physician were also related to delay-be havior. However, discriminant analysis among two extreme delay-behavio r groups (one week versus more than four weeks delay-behavior) reveale d that their predictive power was rather small. From these findings we may conclude that the utility of the Health Belief Model is limited i n explaining delay-behavior in individuals with STD related symptoms.