The status of clinic-based STD patient education: the need for a commitment to innovation in health communication

Although knowledge of safer sex practices is increasing in high-risk populations, such as STD clinic patients, this knowledge does not often translate into behavior change. As a result, STD reinfection rates among clinic patients remain high, resulting in large numbers of return patient visits. As part of a study to evaluate strategies for improving clinic-based education for patients with STDs, we conducted formative research interviews with inner-city clinic managers or other key staff to identify opportunities for and barriers to enhancing STD patient education. These interviews revealed that most of the inner-city clinics had not introduced any new or innovative health communication strategies in the last several years. A primary barrier to innovation appeared to be the belief that patient needs were sufficiently addressed through one-on-one counseling, an assumption that does not take into account the limitations of this form of provider-patient communication. Another barrier was the emphasis placed on maintaining clinic flow, with little consideration given to how it might be altered to accommodate new educational approaches. We offer recommendations to encourage STD clinics to experiment with new and potentially more powerful health communication methods and to encourage the CDC and other funders to alter their STD service priorities toward improvements in health communication and education. We also offer steps that health communication specialists can take in helping clinics and funders move toward these goals.