Abstract

Objectives: To analyse the experiences of youth accessing STI services and to examine the perspectives of service providers in four BC communities.

Methods: In-depth qualitative interviews were completed with 70 young men and women (15-24 years). Twenty-two service providers (e.g., clinicians; staff) were interviewed about their experiences providing STI testing services as well as the policies and practice guidelines that inform their work with youth. In addition, naturalistic observation was conducted at 11 clinic sites, including: youth clinics, doctors’ offices, public health units, and a large clinic specializing in STI-testing.

Results: ‘Youth-friendly’ STI-testing services were rare, despite being strongly desired by youth and service providers. Participants identified five barriers to accessing and/or providing ‘youth-friendly’ STI testing: Geography isolates many youth from testing service times or services, and presents privacy concerns, especially for rural youth. Clinic décor was perceived to be tailored for women and most service providers were female. Disclosing risky sexual behaviour to clinicians may be difficult for youth, especially for lesbian, gay, bisexual, transgender and queer youth or those sexually active with same-sex partners – particularly in contexts that are perceived to be homophobic. Many young women mistakenly believe that Pap smears include STI testing procedures, while many young men avoid testing because they fear the urethral swab and are unaware of alternative methods of specimen collection.

Conclusion: This research reveals how structural and socio-cultural forces (e.g., gender, place, physical space, culture) interact to shape the experiences of youth accessing STI testing services.