Between Idea and Act Falls the Shadow: Discrepancies Between STD Testing Attitudes and Behavior in a Survey of Young African American and Latina Women

Background:
African American and Latina women under age 26 have disproportionately high chlamydia and gonorrhea rates in Los Angeles County, CA. Higher levels of routine testing by at-risk women could dramatically reduce the STD burden in these populations.

Objective:
To describe results of a survey of African American and Latina women under age 26 regarding STD testing attitudes and practices.

Method:
To evaluate a social marketing campaign, a baseline survey of 150 African American women and 150 Latina women ages 18-25 was conducted in areas of L.A. County with high chlamydia and gonorrhea morbidity. Forty-eight Latinas were Spanish speakers. The survey utilized street-intercept interviews at selected venues and asked questions about demography, behavior and beliefs.

Result:
Overall awareness of chlamydia and gonorrhea was high, at 80% and 87% respectively. Of those who had heard of chlamydia and gonorrhea, 78% and 65%, respectively, believed they are curable; 83% and 71% believed a person could not always tell if she had them; and 85% and 86% believed they should be tested annually. Yet at least 72% did not perceive themselves at risk for chlamydia or gonorrhea, and only 55% reported being tested for chlamydia and 48% for gonorrhea in the past year. Testing was significantly higher among women who were older, had multiple partners, had health insurance, or were African American.

Conclusion:
Despite substantial knowledge that should encourage testing (e.g., regarding curability), and perceived desirability of annual testing, the majority of respondents did not perceive themselves at risk for these STDs, and nearly half or more did not report annual testing.

Implications:
Efforts to promote chlamydia and gonorrhea testing among young women of color should address discrepancies between desired and actual testing behavior, and the lack of perceived risk among many at-risk women. Increased testing with health insurance also suggests benefits from promoting the availability of free services.