Determinants of delayed healthcare seeking among STI patients in Eastern Ethiopia: a case-control study

Abstract

Background: Delayed healthcare seeking is one of the major impediments to successfully preventing and controlling sexually transmitted infections. A delay in healthcare seeking prolongs the period of infectiousness and increases the incidence of sexually transmitted diseases. The majority of sexually transmitted infections are curable, but several social and behavioral factors hinder people from seeking early healthcare. Objective: To identify determinants of delay in healthcare seeking among patients with sexually transmitted infections at governmental hospitals in the Harari region, Ethiopia. Methods: In this study, a facility-based, unmatched case-control study was conducted. A total of 197 cases and 197 control study participants were selected by a systematic random sampling technique from patients with sexually transmitted infections. Data were collected through face-to-face interviews using a pre-tested structured questionnaire. Collected data were entered using Epi-Data version 4.6 and then exported to SPSS 26.0 for analysis. Bivariable analysis was done to select candidate variables for multivariable analysis at a p-value less than 0.25. Finally, multivariable logistic regression analysis was performed to identify determinants of delay in healthcare seeking based on AOR, with 95% CI and a p-value less than 0.05. Model fitness was checked by the Hosmer and Lemeshow test, and multicollinearity was checked with the variance inflation factor. Results: The current study identified that small family size (AOR = 0.2; 95% CI:0.14-0.73), unmarried marital status (AOR = 2.6; 95% CI: 1.02-18.24), poor knowledge (AOR = 3.26; 95% CI: 1.06-9.97), fear of social stigma (AOR = 4.75; 95% CI:1.4-9.97), having a single sexual partner (AOR = 0.31; 95%CI: 0.10-0.95), and non-enrolled in CBHI (AOR = 2.31; 95%CI:1.11-9.45) were found to be determinants of delay in healthcare seeking. Conclusion and recommendation: This study revealed that having a large family size, unmarried marital status, poor knowledge, fear of social stigma, number of sexual partners, and being non-enrolled in community-based health insurance were determinants of delay in healthcare seeking among patients with sexually transmitted infections. It was recommended that health education and awareness creation should be done for STI patients so that they become members of community-based health insurance.