RESUMO
OBJECTIVE: To explore reasons for the high chlamydia recurrence rate among African American (AA) urban women. DESIGN: In this phenomenological qualitative study, young AA urban women with recurrent chlamydia were interviewed using open-ended questions guided by the conceptual framework of the health belief model (HBM). SETTING: The study was set in three urban health clinics in Michigan. PARTICIPANTS: Ten African American adolescents, age 15 to 19, participated. METHODS: In face-to-face recorded interviews, participants shared their personal experiences and viewpoints on what led to their recurrent chlamydia infections. The data were transcribed and analyzed through hand coding and NVivo 8 a qualitative software package. RESULTS: Overall, participants demonstrated significant knowledge deficits about the seriousness of chlamydia compared to other sexually transmitted infections (STIs). After reinfection, their perceived susceptibility changed: condom use was seen as beneficial and perceived barriers to condom use diminished as participants gained a new sense of empowerment. CONCLUSION: Chlamydia infection among African American urban adolescents is nearly 3 times that of the general population. Lack of education is still a barrier to STI prevention. Participants reported a desire to receive counseling and support from the health care staff. A STI care model that includes education, counseling, and regular screening of high-risk adolescents should be considered. Further research, using the HBM or similar theoretical models, are needed to gauge the success of any planned or implemented intervention.
