Treatment Delay and Reliance on Private Physicians among Patients with Sexually Transmitted Diseases in China

Abstract

We examined health-care seeking practices among patients with sexually transmitted diseases (STDs) in south China. In 1995, we recruited a consecutive sample of 939 STD patients attending the STD clinics of the Municipal STD Control Centers of Guangzhou and Shenzhen, 'special economic zones' near Hong Kong. Attending physicians interviewed patients face-to-face using a standard survey questionnaire. Twenty-seven per cent of all subjects had sought treatment elsewhere for their presenting complaints, before visiting a study clinic. The main sources of prior treatment were private physicians followed by public clinics and drugstores. Women were more likely than men to delay in presenting their current symptoms to a study clinic (32% vs 25%, P=0.046). Factors associated with treatment delay differed by gender. Among men, seeking prior treatment from private physicians (OR=3.31; 95% CI=1.70, 6.43), having no urethral discharge (OR=4.00; 95% CI=2.33, 6.85), having engaged in sex trade (OR=1.64; 95% CI=1.03, 2.63), or being a resident in Shenzhen (OR=1.80; 95% CI=1.12, 2.89) were more likely to delay seeking treatment. Among women, only living in Shenzhen (OR=2.86; 95% CI=1.56, 5.25) was associated with treatment delay. Promotion of appropriate health-seeking behaviours and better management of STDs must be a top priority to slow a rapid spread of STD/HIV in China. Health education, improvement of STD care in the public and private sectors, and regulations of unauthorized private physicians, may help with STD control and HIV prevention.

Socioeconomic Disparity in Healthcare-Seeking Behavior among Chinese Women with Genitourinary Symptoms

“…2 Although STIs can cause significant morbidity, treatments for STIs in China often were inadequate. 3 Chinese STI patients often relied on private unlicensed physicians rather than formally trained doctors in public hospitals because of stigma associated with public venues. 4 At the same time, education was found to be inversely related to STI prevalence in both men and women in China.…”

Sexually transmitted infections and private physicians in Peru, 2003

“…Patients may choose to see private physicians rather than a public practitioner for reasons of confidentiality, convenience, shorter waiting times, or better service (perceived or actual), among other reasons (26,27). Although patients may believe that better care is provided in private settings, the opposite may be true in the case of STIs, given that private physicians for the most part do not receive regular training, whereas in the public sector there are multiple efforts to train health personnel.…”

Self-Reported Sexually Transmitted Disease Symptoms and Treatment-Seeking Behaviors in China

“…However, little effort has been focused on promoting appropriate health-seeking behaviors or assessing the availability and use of existing STD services. 9 Misconceptions regarding appropriate STD treatments are common. 10 The stigma of being identified as an STD patient and the prejudicial attitude among health providers inhibits use of public clinics.…”

“…8,9 According to Choi et al, 9 the main sources of STD treatments among their study participants were private physicians followed by public clinics and drugstores and factors associated with treatment-seeking behaviors differed by gender. Zhao et al 8 identified pharmacies as the most common source of treatment.…”