Health seeking behaviour in men presenting with sexually transmitted infections at Prince Mshiyeni Gateway Clinic and KwaMashu Community Health Centre in 2015.

Abstract

Background: South Africa’s burden of disease due to sexually transmitted infections (STIs) is currently one of the largest in the world, with an estimated 11 million cases detected per year. There is evidence suggesting that early recognition of symptoms, and early presentation to health facilities with effective treatment would reduce the spread of treatable STIs. Aim: The aim of the study was to assess the factors associated with the health seeking and sexual behaviour of men presenting with STIs at Prince Mshiyeni Gateway Clinic and KwaMashu Community Health Centre, eThekwini. Method: This was an observational, descriptive and analytical cross-sectional study. Participants were systematically selected from patients who presented at the clinic with confirmed signs or symptoms of an STI, aged between 18 and 49 years, who agreed to participate. In total 134 questionnaires were collected. Results: Most of the participants were between ages of 26-35 (41%), the majority single (78.4%). Participants were knowledgeable about STIs, knew that they can get STIs by unprotected sex (88.1%) and through multiple partners (85.1%), and that to be protected a condom should be used at every sexual encounter (86.6%). The majority (68.7%), however, did not use a condom the last time they had sex, and 67.1% had more than ten lifetime partners. Over half of participants (53%) delayed presenting themselves to the clinic after noticing signs and symptoms of an STI, despite knowing about STIs. There was a significant association between delayed health seeking behaviour at the clinic and an initial visit rather to a traditional healer (p = 0.004). Participants at PMG clinic were less likely to delay seeking medical help than those from KCHC (OR 0.30; 95%CI: 0.15-0.62; p=0.001). Participants who visited traditional healers more than seven times a year were more likely to delay seeking medical help (OR 1.75; 95%CI: 1.07-2.89). When participants were asked “what would prevent them from coming to the clinic”, over half of participants (56.7%) reported fear of staff stigmatization and bad attitude. Importantly, most men stopped using condoms once they experienced erectile dysfunction. Conclusion: This study indicates the need to deal with men’s attitudes, because despite knowing about STIs and their prevention, men still engage in risky sexual behaviour. The health system needs to improve the standard of services provided, and to deal with health workers’ negative attitudes. Key words: Health seeking behaviour, delay health seeking behaviour, men, sexually transmitted diseases, HIV prevention, men’s roles, sexual health