Where do people go for treatment of sexually transmitted diseases?

Context: Major public health resources are devoted to the prevention of sex ually transmitted diseases (STDs) through public STD clinics. However, litt le is known about where people actually receive treatment for STDs. Methods: As part of the National Health and Social Life Survey household in terviews were performed from February to September 1992 with 3,432 persons aged 13-59. Weighted population estimates and multinomial response methods were used to describe the prevalence of self-reported STDs and patterns of treatment utilization by persons who ever had a bacterial or viral STD. Results: An estimated two million STDs were self-reported in the previous y ear, and 22 million 13-59;year-olds self-reported lifetime STDs. Bacterial STDs (gonorrhea, chlamydia, nongonococcal urethritis, pelvic inflammatory d isease and syphilis) were more common than viral STDs (genital herpes, geni tal warts, hepatitis and HIV). Genital warts were the most commonly reporte d STD in the past year, while gonorrhea was the most common ever-reported S TD. Almost half of all respondents who had ever had an STD had gone to a pr ivate practice for treatment (49%); in comparison, only 5% of respondents h ad sought treatment at an STD clinic. Respondents with a bacterial STD were seven times more likely to report going to an STD clinic than were respond ents with a viral STD-except for chlamydia, which was more likely to be tre ated at family planning clinics. Men were significantly more likely than wo men to go to an STD clinic. Young. poor or black respondents were all more likely to use a family planning clinic for STD treatment than older, relati vely wealthy or white respondents. Age, sexual history and geographic locat ion did not predict particular types of treatment-seeking. Conclusions: The health care utilization patterns for STD treatment in the United States are complex. Specific disease diagnosis, gender, race and inc ome status all affect where people will seek treatment. These factors need to be taken into account when STD prevention strategies are being developed .