Perceived Barriers to Care for Urinary Tract Infections in Emerging Adulthood

Urinary tract infections (UTIs) are common in emerging adulthood, yet barriers to care are not well understood.

To examine perceived barriers to UTI care among emerging adults, analyzing differences by social determinants of health.

Supplementary study to a cluster randomized controlled trial in 29 community colleges in California and Texas. Online surveys were administered May to October 2024. Multivariable mixed-effects logistic and linear regression were used to predict the most common barriers to UTI care and number of barriers by participant characteristics.

A total of 667 individuals aged 19-29, assigned female at birth, and sexually experienced with male partners.

Outcomes included 14 items assessing perceived barriers to UTI care, developed using the Levesque model of healthcare access as a framework, and a composite score of the total number of barriers.

The average age of participants was 22.6 years; 56% identified as Hispanic and 30% reported a prior UTI. The most common perceived barriers to UTI care were concerns about hearing bad news (59%), appointment delays (46%), cost (45%), fear of parents learning about symptoms (42%), time constraints (40%), and concerns that they might have a sexually transmitted infection (37%). On average, participants reported 4.18 barriers; in multivariable regression, participants reported significantly more barriers if they were younger (β =  - 0.19, SE = 0.06), Asian/Pacific Islander (β = 0.71, SE = 0.35), non-English language speakers at home (β = 0.57, SE = 0.25), food insecure (β = 1.32, SE = 0.24), uninsured (β = 0.65, SE = 0.28), or without a usual source of care (β = 0.97, SE = 0.23).

Findings showed substantial challenges to UTI care among emerging adults, especially among socially disadvantaged participants. Youth-focused interventions, including education and expanded telehealth services, are needed to promote health equity for UTIs.