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Table 2: Treatment sought elsewhere and referral status among women and men attending the STD clinic.
Men Women
Had Sought Treatment Had Been Referred Had Sought Treatment Had been Referred
Before (n=150)
(n=61)
Before (n=187)
(n=104)
Type of facility
n (%)
n (%)
n (%)
n (%)
Nairobi City Council 36 (24) 45 (74) 79 (42) 80 (77)
Government 14 (9) 2 (3) 18 (10) 12 (12)
Private 71 (47) 7 (1) 65 (35) 8 (8)
Chemist 13 (9) 0 (0) 5 (3) 0 (0)
Mission 11 (7) 3 (5) 19 (10) 3 (3)
Traditional healer 5 (3) 0 (0) 1 (1) 0 (0)
Other 0 (0) 4 (7) 0 (0) 1 (1)
Of the men, 181 (77%) were found to have urethritis, 12 (8%) genital ulcer disease, 6 (3%)
other infections, and 19 (8%) no STD. Of the women, 83 (35%) were found to have vaginitis,
95 (40%) cervicitis, 30 (13%) pelvic inflammatory disease, 12 (8%) genital ulcer disease, 5
(2%) other infections, and 15 (6%) no STD.
Table 3 shows the delay between the appearance of symptoms and the seeking of medical
care by gender and by medical problem. The participants were symptomatic for an average
of 1 week before seeking treatment, but the range of delay was wider for the women.
Moreover, the participants, particularly the women, postponed their visit to the STD clinic for
approximately 1 month, except in case of genital ulcer disease. Referred patients had a
significant shorter delay before attending a health facility than the non-referred patients (12.7
days versus 40.6 days, P = 0.01).
Table 3: Delay in days (median and percentiles [25-75]) between appearance of symptoms and medical contact, by gender.
Days Before Seeking Treatment
Days Between First Treatment and Visit to
STD clinic
Syndromes Man Women Man Women
Any complaint 7 (3-14) 7 (3-21) 23 (5-60) 29 (7-90)
Urethritis/PID/cervicitis 7 (3-14) 7 (3-30) 28 (5-60) 27 (7-90)
GUD 7 (3-14) 7 (3-14) 14 (7-30) 16 (7-30)
Vaginitis 7 (3-21) 46 (7-90)
Non-STD 7 (2-21) 14 (3-30) 16 (7-60) 29 (3-150)
Table 4 shows the participants' sexual behavior characteristics. Approximately half of the
patients, significantly more women than men engaged in sex while symptomatic. Most of the
women had sex with only one partner, who in most cases was their spouse or a regular
partner. About one third of the men who engaged in sex while symptomatic had sex with two
or more partners, and 22% had casual sex partners or sex in exchange for money. Only 19%
of those who engaged in sex during illness used condoms, the men more often than the
HEALTHCARE-SEEKING BEHAVIOR AND SEXUAL BEHAVIOR IN NAIROBI 41