Perceived monogamy and type of clinic as barriers to seeking care for suspected STD or HIV infection: Results from a brief survey of low-income women attending Women, Infants, and Children (WIC) clinics in Missouri

Background and Objectives: Barriers to seeking care for sexually transmitted diseases (STDs) have not been assessed for low-income women. We sought to determine barriers to seeking care for STDs among women receiving Women, Infants, and Children (WIC) benefits in 21 Missouri counties. Goal of This Study: Provide information for promoting care-seeking behavior among low-income women suspecting STD infection. Study Design: A survey of 2,256 women was conducted; 491 reported a history of at least one STD. These women indicated possible barriers to seeing a doctor about a suspected STD and preference for type of clinic providing STD services. Results: More than one fifth (21.3%) of those reporting an STD also reported at least one barrier to seeing a doctor about suspected STD or human immunodeficiency virus infection. Among those reporting barriers, the most common barrier was 'I only have sex with my steady' (36.2%) followed by being asymptomatic (33.3%), embarrassment (22.8%), and cost (25.7%). Most (63.8%) preferred seeing their own doctor, with others reporting preference for community health centers (14.8%), family planning clinics (16.8%), and STD clinics (4.6%). Conclusions: Low-income women experience multiple barriers to seeking care including perceptions about a protective value of monogamy. Also, STD services in locations providing other health services for women were preferred.