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Abstract

Objective To determine reasons given by high school students for refusing to participate in a school-based noninvasive chlamydia and gonorrhea screening that was offered at no cost to students, using the health belief model as theoretical framework.

Design Cross-sectional survey.

Setting Public high schools in a southern urban United States school district.

Methods Every year since the school year 1995–1996, students in the school district have been offered free and confidential chlamydia and gonorrhea screening using nucleic acid amplification tests in urine specimens. All youth in the participating schools are eligible for screening if they have parental consent or are aged 18 years or older and provide consent. In 2004–2005, 50 males and 106 females who had consent but chose not to participate were asked to fill out a self-administered confidential survey about their reasons for refusing participation.

Results The most frequent single reason males gave for refusing to participate in the screening was that they just did not want to take the test (n = 24); females most frequently refused because they have never had sex (n = 32) or they just did not want to take the test (n = 26). Respectively, 22 males (44.0 per cent) and 63 females (59.4 per cent) perceived themselves not being susceptible to chlamydia or gonorrhea, 2 males (4.0 per cent) and 2 females (1.9 per cent) felt chlamydia and gonorrhea were not serious diseases, 11 males (22.0 per cent) and 37 females (34.9 per cent) perceived barriers and 4 males (8.0 per cent) and 1 female (0.9 per cent) saw no benefi t to chlamydia or gonorrhea screening.

Conclusion Respondents most frequently refused to participate because they simply did not want to take the test. Most females refused because they had never had sex. Many perceived themselves as not being susceptible to chlamydia and gonorrhea solely on the basis of misconceptions that are amenable to correction through health education.

Keywords

adolescents chlamydia gonorrhea health behaviour health belief model health education

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Reasons given by high school students for refusing sexually transmitted disease screening

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