SEXUAL HEALTH SERVICES Differences in demographics and risk factors among men attending public v non-public STD clinics in Baltimore, Maryland

Objective: To compare the demographics and risk factors of men who utilise the services of a municipal public sexually transmitted disease (STD) clinic with those who utilise the services provided by a non-public men’s STD clinic operated by a not for profit primary care clinic. Methods: A record based review of the characteristics and STD prevalence of men who visited a nonpublic STD clinic in Baltimore, Maryland, compared with those of a random sample of male attendees of a public STD clinic. Data abstracted from the records included information on age, race/ethnicity, self reported risk behaviours, and STD tests and results. We used x analysis as well as bivariate and multivariate modelling to compare differences in categorical factors between clinics groups. Results: Men who utilised the services at the non-public STD clinic were more often white (71% v 3%, p,0.001), MSM (65% v 2%, p,0.001), and presented for general screening (52% v 15%, p,0.001) compared to those at the public clinic. In addition, they more frequently reported>3 partners (22% v 11%, p = 0.005), and having an HIV positive partner (10% v 3%, p = 0.005). Factors independently associated with attendance at non-public clinic in multivariate analysis were general screening as reason for visit (OR=11.0, p,0.001), having 3+ partners in past month (OR=10.5, p =0.002), and ‘‘sometimes’’ using condoms (OR=3.6, p = 0.033). Conclusions: Non-public STD clinics can reach a distinct segment of the male population with high risk sexual behaviours that might not attend public STD clinics.