Sexually transmitted diseases in Zimbabwe: a qualitative analysis of factors associated with choice of a health care facility.

BACKGROUND The control of sexually transmitted diseases (STDs) through rapid and effective treatment is critical in reducing the transmission of HIV infection. This is only possible when STD patients access appropriate STD care services. OBJECTIVES To examine factors associated with choice of STD health care facility in Zimbabwe. METHODS Focus Group Discussions (FGDs) were used to collect data from the following settings: Antenatal clinics, well baby clinics, long distance bus stops/market places, bars, areas (compounds) behind bars, factory sites and youth clubs. Data from 26 FGDs attended by 281 antenatal clinic attendees, 34 FGDs of 350 women attending well baby clinics, 8 FGDs of 82 women recruited at long distance bus stops/market places, 9 FGDs of 115 sex workers, 11 FGDs of 124 male factory workers, and 5 FGDs of 44 female adolescents belonging to youth clubs were analysed. RESULTS In total 93 FGDs were held of which 76 (81.7%) took place in urban areas and 17 in rural areas. Asked which health facility they would attend if they had an STD, all the different groups of the population mentioned a local clinic except for sex workers who preferred a hospital or a traditional practitioner, and male factory workers who preferred a factory clinic. Among the factors that would be considered in choosing a health facility were accessibility and affordability (stated by all groups), and privacy/ confidentiality, health care providers' attitudes, caring or professionalism (stated by all groups except male factory workers). CONCLUSION Although accessibility and affordability were the common factors mentioned by all the groups, it is important to consider group specific factors in the choice of health care facilities.