Factors Associated with Health Care Seeking Behavior for Sexually Transmitted Infections among Adolescent Girls and Young Women Attending Post Natal Clinic at Marindi Sub-County Hospital Homa Bay, Kenya

Abstract

In Eastern Africa 50% of individuals delay seeking care for sexually transmitted infections (Agimas et al., 2024). Kenya reported the pooled prevalence of care-seeking behavior for Sexually Transmitted Infections to be low at 18% (Teshale et al., 2025). Furthermore, the use of Sexual and Reproductive Health Services among adolescent girls in Homa-bay County is low (Embleton et al., 2023). The study aimed to assess the factors associated with healthcare-seeking behavior for STIs (syphilis, gonorrhea, chlamydia and trichomoniasis) among young women and adolescent girls attending post-natal clinic at Marindi sub-County Hospital Homa bay County in Kenya. Specifically, to examine socio-demographic factors, perceived susceptibility, perceived barriers, and perceived severity associated with health care seeking behavior for STIs among adolescent girls and young women 15-24 years old. Analytical cross-sectional study design was applied with a sample size of 317 AGYW aged 15–24 years (Fischers et al) using consecutive sampling. Pretested questionnaires were used to collect data on factors associated with health care seeking behavior for Sexually Transmitted Infections among adolescents and young women attending post-natal clinic at Marindi sub-county hospital. Data was collected for a period of 30 days by the researcher and two trained Community health promoters. Two key informant interviews were purposively selected by the researcher. Descriptive statistics, bivariate analysis, and multivariate logistic regression were used to determine associations between independent variables and healthcare-seeking behavior. KII data were analyzed thematically. Findings showed that 43.8% of respondents demonstrated good health care seeking behavior while 56.2% exhibited poor healthcare seeking behavior. Age was the only significant socio-demographic predictor of healthcare-seeking, with older AGYW (20–24 years) more likely to seek STI treatment than younger adolescents (15-19 years). Perceived barriers especially stigma, lack of privacy, and negative provider attitudes significantly reduced healthcare-seeking behavior (AOR = 0.61, p = 0.006). Perceived susceptibility (AOR = 1.92, p = 0.005) and perceived severity (AOR = 1.73, p = 0.021) were strong positive predictors of seeking care. Thematic analysis revealed themes that supported these results, highlighting stigma, fear, unfriendly provider attitudes, and partner influence as key barriers. Healthcare-seeking behavior for STIs among AGYW is strongly influenced by personal perceptions and health-system barriers rather than socio-demographic characteristics such as education or marital status. While knowledge of STI risks is high, stigma, poor privacy, and provider attitudes hinder timely care-seeking. Strengthening youth-friendly services, improving confidentiality, and reducing stigma are essential for improving STI treatment-seeking among Adolescent Girls and Young Women.