Delay in Symptom Presentation among a Sample of Older GUM Clinic Attenders

Abstract

Prior research undertaken with predominantly youthful populations has established that delay between symptom recognition and health-care presentation is a common feature of sexually transmitted infection (STI) related illness behaviour1-4. However, it is not known whether similar behaviours are exhibited by older populations with genitourinary symptoms. The present analyses therefore aim to clarify this issue by focusing upon (1) extent of delay behaviour, (2) reasons for delay behaviour and (3) variables predicting delay behaviour among a sample of genitourinary medicine (GUM) clinic attenders aged over 50 years. A self-administered questionnaire study linked to patient note data was undertaken within 3 GUM clinics in the Trent region between January 1997 and March 1998 (Sheffield, Nottingham and Leicester). Of 121 symptomatic older attenders with suspected STI, 43.8% (n=53) waited over 2 weeks between symptom recognition and clinic attendance. Reasons given for delay included wanting to ‘wait and see’ if symptoms improved and being embarrassed or afraid to attend clinic. A logistic regression analysis identified that delay behaviour was predicted by history of HIV testing. Comparisons with previous research undertaken in this field indicate that levels of delay behaviour reported by this older sample are higher than those exhibited by youthful populations with genitourinary symptoms. This finding has significant implications for health-care professionals working both within a GUM setting, and with older people, especially when viewed in the context of an ageing population.