Community attitudes about discussing sexual health: assessing public opinion of local STD prevention campaigns.

OBJECTIVES: We assessed public views about the acceptability of and need for sexually transmitted disease (STD) and sexual health-related educational messaging in local campaigns. METHODS: A 28-item state-added module was included in the 2008 New York Behavioral Risk Factor Surveillance System survey (n=3,751). Respondents rated acceptability of venues/dissemination channels and messaging and agreement with attitudinal/need statements. Additional data were analyzed from a separate state survey with individual county samples (n=36,257). We conducted univariate, bivariate, and multivariable modeling analyses. RESULTS: Each venue was acceptable to more than three-quarters of respondents (range: 79% for billboards to 95% for teaching STD prevention in high school). All message areas were acceptable to at least 85% of respondents (acceptability rating range: 85% to 97%). More than 70% agreed that there is a need for more open discussion about STDs. Bivariate analyses identified areas where messaging tailored to specific subgroups may be helpful (e.g., 26% of white people, 44% of African Americans, and 45% of Hispanic people agreed with the statement, "I need ideas about how to talk to my partner about protection from STDs"). Little geographic variation was seen. Results of multivariable modeling on opposition showed limited interaction effects. CONCLUSION: These data provide key information about current community norms and reflect the public's approval for hearing and seeing more about sexual health and STDs in a range of public forums.

Comparability on knowledge, attitudes, and behaviors between STD clinic clients and high-risk individuals in community.

OBJECTIVES: To assess the feasibility and generalizability of STD clinic samples for studying STD-related knowledge, attitudes, and behaviors (KAB), and healthcare preferences among individuals at high risk for STDs in the same community. STUDY DESIGN: An STD clinic and a community sample were selected from each of two urban areas in New York State. At each STD clinic, 100 individuals were interviewed. In each community, about 400 individuals were selected by random-digit-dialing telephone survey during the same period. Community sample participants were defined as having high-risk profiles on the basis of five items related to their sexual behaviors. RESULTS: The STD clinic samples were younger and had a larger proportion of men and nonwhite people compared with the high-risk community samples. Although the majority of STD clinic clients would seek healthcare at the STD clinics, high-risk community participants were more likely to prefer private doctors for STDs care (P < .0001 for both areas). Overall STD-related KAB were similar between STD clinic and high-risk community samples; however, STD clinic clients may be more knowledgeable about specific STDs and more likely to feel embarrassment about getting an STD. The findings comparing KAB between high-risk community subjects and STD clinic attendees also varied by geographic location. CONCLUSIONS: STD clinic samples may not be sufficiently representative of community STD-related KAB collected by telephone surveys, even for that subset of community respondents with high-risk behaviors associated with STDs.