Patterns of general health care and STD services use among high-risk youth in Denver participating in community-based urine chlamydia screening.

To guide the development of innovative programs to increase the access of US adolescents and young adults to sexually transmitted disease (STD) prevention and treatment services data should be obtained at the local level from nonclinic-based samples comprised of those at greatest risk. Such a survey was conducted in Denver Colorado in 1996-97 by Youth in Action--a community-level chlamydia urine screening program. Questionnaires were completed by 221 of the 277 predominantly Black and Hispanic inner-city youth 13-25 years of age who underwent urine analysis during the study period. 25 (11%) reported a history of an STD. On urine screening 10.7% of males and 12.9% of females tested positive for chlamydia. 72% had accessed general health services in the past year primarily for routine checkups and 39% reported an STD evaluation at any time in the past. Community and school clinics were identified by 50% as a source for general health care and by 62% as a source for STD services. Only 14% of respondents attended STD clinics. In multivariate analysis the following factors were associated with an STD evaluation: recruitment in field settings female gender age above 16 years non-Hispanic ethnicity vaginal sex in the past 30 days presence of chlamydia on urine screening and a general health visit in the past year. Of concern was the finding that only 34% of youth who went for a general checkup reported an STD evaluation. These findings indicate needs for interventions to increase the provision of STD prevention services in general health care settings and community-based screening programs for those unable or unwilling to seek clinic-based services.