Shoveller J, Johnson J, Rosenberg M, Greaves L, Patrick D M, Oliffe J L, Knight R
School of Population and Public Health, University of British Columbia, Vancouver, Canada.
Sex Transm Infect. 2009 Sep;85(5):397-401. doi: 10.1136/sti.2008.035568. Epub 2009 Jun 8.
To analyse the experiences of youths accessing sexually transmitted infection (STI) services and to examine the perspectives of service providers in four British Columbia communities.
In-depth qualitative interviews were completed with 70 young men and women (15-24 years). In total, 22 service providers (for example, clinicians, staff) were interviewed about their experiences providing STI testing services as well as the policies and practice guidelines that inform their work with youths. In addition, naturalistic observation was conducted at 11 clinic sites, including: youth clinics, doctors' offices, public health units and a large clinic specialising in STI testing.
"Youth-friendly" STI testing services were rare despite being strongly desired by youth and service providers. Participants identified five barriers to accessing and/or providing youth-friendly STI testing: geography isolates many youths from testing service times or services, and presents privacy concerns, especially for rural youths. Clinic décor was perceived to be tailored for women and most service providers were female. Disclosing risky sexual behaviour to clinicians may be difficult for youths, especially for lesbian, gay, bisexual and transgender youths-particularly in contexts that are perceived to be homophobic. Many young women mistakenly believe that Pap smears include STI testing procedures, while many young men avoid testing because they fear the urethral swab and are unaware of alternative methods of specimen collection.
This research reveals how structural and socio-cultural forces (for example, gender, place, physical space, culture) interact to shape the experiences of youths accessing STI testing services.
分析青少年获得性传播感染（STI）服务的经历，并考察不列颠哥伦比亚省四个社区服务提供者的观点。
对70名年轻男女（15 - 24岁）进行了深入的定性访谈。总共采访了22名服务提供者（如临床医生、工作人员），了解他们提供性传播感染检测服务的经历以及指导他们与青少年工作的政策和实践指南。此外，在11个诊所地点进行了自然观察，包括：青少年诊所、医生办公室、公共卫生单位以及一家专门从事性传播感染检测的大型诊所。
尽管青少年和服务提供者都强烈希望获得“对青少年友好的”性传播感染检测服务，但此类服务却很少见。参与者确定了获得和/或提供对青少年友好的性传播感染检测的五个障碍：地理位置使许多青少年无法在检测服务时间获得检测服务，并且存在隐私问题，尤其是对农村青少年而言。诊所的装饰被认为是为女性量身定制的，而且大多数服务提供者是女性。青少年可能难以向临床医生透露危险的性行为，尤其是女同性恋、男同性恋、双性恋和跨性别青少年——特别是在被认为存在恐同现象的环境中。许多年轻女性错误地认为巴氏涂片检查包括性传播感染检测程序，而许多年轻男性则因为害怕尿道拭子检查且不知道其他样本采集方法而避免检测。
本研究揭示了结构和社会文化力量（如性别、地点、物理空间、文化）如何相互作用，塑造青少年获得性传播感染检测服务的经历。
