Objective: To explore the essential elements of the lived experiences of urban adolescents diagnosed with recurrent chlamydia infection and to describe the meanings made of this phenomenon by the people experiencing it.

Design: A qualitative phenomenological research study design was used, opened-ended interview questions were developed based upon the reviewed literature and the conceptual framework of the Health Belief Model.

Setting: Outpatient urban health clinics in Detroit, Michigan.

Patients/Participants: Ten Urban Detroit adolescents, ages 15-19, who self-reported recurrent chlamydia infections within the previous twelve months.

Methods: Participants completed a demographic questionnaire and were interviewed using questions developed from the conceptual framework of the Health Belief Model.  Sessions were audio-taped. The tapes were transcribed and the transcripts reviewed to ensure accuracy. Hand-coding and a qualitative software package (Nvivo 8) were used to generate and classify codes. Themes were generated by the researcher who transcribed all interviews, read and reflected on transcripts, and reviewed field notes for overall meaning. To ensure the analysis process was systematic and verifiable, an expert with more than 25 years experience in women's urban health was asked to review the data.  Transcripts were discussed, as a means to increase rigor and to discern any additional impressions of the data and ideas for additional themes and patterns.  

Results: Participants expressed a heightened Perceived Susceptibility after recurrence of the disease. A knowlege deficit existed as of the seriousness of chlamydia, and its comparison to other Sexually transmitted infections (STI).  The benefit of consistent condom use (to prevent future recurrence) was supported by nine participants.  Many efficacious statements were expressed, suggesting a (new) self empowerment position.  Having a recurrent infection was a "wake up call", which encouraged them to change and practice less risky sexual behaviors. 

Conclusion/Implications for nursing practice: This study investigated some of the underlying reasons urban adolescents continue to practice risky sexual behavior.  The interviews offered an understanding of some psychosocial issues urban adolescents' experience upon which Nurse Practitioners can build better counseling and educational support.  After obtaining this information, an evaluation of the existing procedures related to STI follow up can be compared, contrasted, and improved.  Educating adolescents and offering support (which include condoms, education and counseling) are some of the necessary approaches suggested by participants in the study. The nursing community can develop new models of care to help eliminate this crisis based upon finding from this study.   

Keywords: chlamydia, reinfection, urban teens