BMC Public Health 2009, 9:311 http://www.biomedcentral.com/1471-2458/9/311 sexually transmitted infections. As noted in the next sec- tion, several respondents were particularly concerned about being tested for specific sexually transmitted infec- tions such as Chlamydia (the young gay men who took part in the study (n = 3) were the only respondents to be concerned about Syphilis, and were the most concerned about contracting HIV); however these respondents, too, wanted 'full screens'. Respondents themselves (prior to completing testing) were often unsure about all of the STIs that they could be tested for. Analysis of interview tran- scripts reveals that most respondents were tested for HIV/ AIDS, Gonorrhea, Genital Warts, Herpes, Non-Specific Urethritis (NSU), Chlamydia, Syphilis, Hepatitis and Tri- chomonas. Respondents who tested positive for STIs were all diagnosed with Herpes, Chlamydia or NSU. Factors encouraging testing Several factors encouraged respondents' decision to seek STI testing. One was seeing STI testing as a responsible practice that adults should engage in. I'm nearly 28. I think it's just kind of the mature thing to do. (F/STI/late 20 s/-). I'm a grown up. It wasn't something I would have even thought of when I was younger. (F/FP/late 20 s/+). Another was having a protective orientation towards part- ners and other young adults. All respondents' indicated that they would experience significant guilt and distress if they transmitted an STI to another individual. STI trans- mission was viewed as a fundamentally unjust activity, a violation of moral norms. I'd feel like shit, absolutely [if I passed on a STI]. And that's why I wanted to get screened as well. I didn't want to do that cos I've had sexual partners in the past and she hadn't. I suppose it's like a domino effect, it's like passing it onto somebody and they in turn pass it on to somebody else. It's kind of unfair. (M/SH/early 20 s/-). Respondents (male and female) expressed particular con- cerns about the damage that STIs could do to their future fertility, indicating awareness of important complications in this at-risk group. STI testing was seen a crucial means of protecting this fertility. I just wanted to make sure I didn't have anything. I got a full testing like. Just for peace of mind. I could end up not being able to have children or like, I don't know, getting someone else not able to have to chil- dren (F/FP/late teens/-). The perceived risk status of respondents' sexual partners was also a factor that influenced care-seeking. Respond- ents judged partner's risk based on a number of character- istics, including appearance and geographical origin. As such they sometimes tended to rely on visual cues when judging partners' risk status. 'Dirty' partners or those from perceived risky regions (especially Africa and South Amer- ica) were most likely to increase respondents' concerns about the need to seek STI testing. Partner's past sexual history also influenced their care-seeking behavior; how- ever in many cases respondents had only a vague notion of their partner's actual sexual history other than that it had been 'colourful'. If they had AIDS or herpes I presume I would have noticed something. But this one was so random and drunken and stupid. And I don't know the guy, he was from Africa. I know that's an awful preconception but if he didn't want to use a condom with me I presume he didn't use one with anyone else. (F/GP/early 20 s/- ). I possibly didn't know as much about his partners or how many there might have been. (F/GP/mid 20 s/-). Many respondents who did not have symptoms when they attended health services testing expressed anxieties about the risk that asymptomatic STIs (especially Chlamy- dia) could affect them without their knowledge. I've heard that there's no symptoms with Chlamydia and I've no symptoms so I thought that maybe if I do have one, this could be it (M/SH/early 20 s/-). Chlamydia is such a scary, scary thing now, cos it's you know asymptomatic (F/GP/late 20 s/-). Respondents' anxieties about symptomless STIs stemmed from two sources. The first of these was consciousness- raising health promotion materials. I remember at the time they were doing a thing on Hollyoaks [British soap opera for young adults]. They were doing the whole STI thing on the TV. It was basi- cally what I got from there. (F/GP/late 20 s/+). You are aware, you see the signs around and advertis- ing on TV and you are aware that unprotected sex is not entirely beneficial for you! And the risk of catching an STI is quite a real risk nowadays (F/GP early 20 s/-). The second was proximity to individuals who had been diagnosed with STIs. Page 5 of 10 (page number not for citation purposes)