BMC Public Health 2009, 9:311 http://www.biomedcentral.com/1471-2458/9/311 had the advantage of enabling these respondents to test their partners' faithfulness, and whether they could con- tinue to trust them or not. Generally, re-testers found re-testing to be a more positive experience than the initial testing experience. Re-testers had experience of the most effective procedures to use to access particular healthcare settings (for example, know- ing to queue early to get into an STI clinic) and their con- cerns about stigma and being judged had often been positively addressed by healthcare professionals on the first visit. I just kind of knew what to expect. I had the feelings before so they weren't fresh. They didn't stick in my mind. It's not that it was fine, it was still. It was just a more comfortable experience because I knew what to expect. I knew what was happening. (F/GP/mid 20 s/- ). I would say that it's much easier since I've got it done. It's still, taking off your clothes and stuff like that, a very intimate procedure but the first one is definitely the hardest. (F/FP/late 20/+). One re-tester's identity concerns became more acute the more she attended health services for testing, however. She felt that regular re-testing signaled to healthcare work- ers that she was being continuously promiscuous, sleep- ing with many different risky men on an on-going basis. As such the act of re-testing risked stigmatizing and spoil- ing her identity more than the original act of testing did. You know if you change partners then it's like I'm being really bold. It's the whole slut factor again you know. Six months later you have another new partner and you go in for another screening and then it's again the whole what are they going to think of me. (F/GP/ late 20 s/-). Discussion As far as we are aware this is the first study to explore the reasons why young adults in the Republic of Ireland go for STI testing, and one of the few studies to explicitly focus on and explore this topic in the international literature [8]. Previous studies found that individuals attend health services for STI testing for a variety of reasons including: the desire to be free of contamination [8], health mainte- nance, the presence of symptoms (own and partner's) and partner's risk status [7]; and the individual's own per- ceived level of risk [16]. Some of the reasons for seeking a STI test that were revealed in our study have been identi- fied in previous studies, notably having had unprotected sex and anxieties around symptoms [7,8]. We believe that this is the first study to identify the importance of transi- tional moments in young adults' lives as prompts for their seeking STI testing. We also believe that we are the first to identify the ritualistic identity benefits that testing at tran- sitional moments can supply to young people, though similar benefits have been observed in relation to the re- testing process in a study by Hilary Piercy [14]. Piercy's study found that re-testing is often used as a practice to signal that the individual is at the end of a dirty stage in his or her life and about to begin a new, uninfected clean stage. A number of the factors encouraged respondents in this study to seek STI testing (including partner's perceived risk status, viewing testing as a positive practice). Several of these have previously been reported [17,18]. The spe- cific concerns expressed about Chlamydia (as a prompt to full STI screening), articulated by most of our respond- ents, may be particular to this study. These concerns may reflect growing awareness and concern amongst young adults in Ireland about Chlamydia, as an outcome of health promotion and awareness activities by the health services, voluntary agencies and the media in Ireland. The increased prevalence and reported incidence of Chlamy- dia may also mean that young people are encountering more other young people with the infection, an interac- tion that could disrupt the feelings of invulnerability that young people might otherwise experience in relation to STIs. Respondents indicated that a number of barriers (stigma, embarrassment, shame and cost) often deterred them from immediately following through on their decision to go for STI testing. These findings echo previous research [19-21]. Such delays are worrying because young people who are unknowingly positive for STIs may transmit the infection to others while they consider when and where they will attend health services for testing. Infection dura- tion is closely correlated with the likelihood of harmful consequences to self and others [22]. One of the more interesting findings from this study, however, is the reali- zation that some young people who delayed seeking test- ing for several weeks or even months not see this as delay. It might be useful for health promotion efforts (which appeared to have a significant effect on at least some of our respondents) to therefore include messages highlight- ing that STIs can have deleterious consequences on indi- viduals soon after transmission, and to communicate in straight forward terms that social and biological concepts of immediacy can be quite different. Limitations of the study include the size of the study sam- ple (drawn from several clinical settings, and from two regions of Ireland), and the limited number of men who took part in the study. Because of the small sample size the results must be considered to be tentative. 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