Open Access Research article

Barriers to asymptomatic screening and other STD services for adolescents and young adults: focus group discussions

Elizabeth C Tilson1*, Victoria Sanchez1, Chandra L Ford1, Marlene Smurzynski1, Peter A Leone23, Kimberley K Fox45, Kathleen Irwin and William C Miller12

Author Affiliations

1 University of North Carolina School of Public Health, Rosenau Hall, Chapel Hill, NC, 27599, USA

2 University of North Carolina School of Medicine, Manning Dr, Chapel Hill, NC, 27599, USA

3 Wake County Human Services-Public Health Center, 10 Sunnybrook Rd, Raleigh, NC, 27620-4049, USA

4 North Carolina Department of Health and Human Services, Division of Public Health, Raleigh, NC 27699-1915, USA

5 Centers for Disease Control and Prevention, Division of STD Prevention, 1600 Clifton Rd., Atlanta, GA 30333, USA

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BMC Public Health 2004, 4:21  doi:10.1186/1471-2458-4-21

Published: 9 June 2004



Sexually transmitted diseases (STDs) are a major public health problem among young people and can lead to the spread of HIV. Previous studies have primarily addressed barriers to STD care for symptomatic patients. The purpose of our study was to identify perceptions about existing barriers to and ideal services for STDs, especially asymptomatic screening, among young people in a southeastern community.


Eight focus group discussions including 53 White, African American, and Latino youth (age 14–24) were conducted.


Perceived barriers to care included lack of knowledge of STDs and available services, cost, shame associated with seeking services, long clinic waiting times, discrimination, and urethral specimen collection methods. Perceived features of ideal STD services included locations close to familiar places, extended hours, and urine-based screening. Television was perceived as the most effective route of disseminating STD information.


Further research is warranted to evaluate improving convenience, efficiency, and privacy of existing services; adding urine-based screening and new services closer to neighborhoods; and using mass media to disseminate STD information as strategies to increase STD screening.