An exploratory community assessment in an underserved North Dallas community found wide lack of awareness of sexual health services as the primary barrier (57%), low knowledge of prevention options like PrEP and doxycycline PEP, and that ethnic and sexual minorities disproportionately affected by HIV/STI epidemics lack access to sexual health services in their communities.
Lack of awareness of sexual health services was cited as the primary barrier to access by the majority of participants.
Most participants expressed comfort accessing sexual health services across multiple venue types, with medical buildings being most preferred.
Participants showed strong interest in STI and HIV testing/treatment but very low interest in preventive pharmacological options.
Participants overwhelmingly preferred sexual health services located closer to their community.
Black individuals felt more comfortable than Latinx individuals when discussing sexual health across multiple social and clinical contexts.
The study population was drawn from communities disproportionately burdened by HIV and STI epidemics.
Local community assessments are proposed as a model for expanding sexual health services to address growing HIV and STI syndemics.
This research assessed what residents of an underserved North Dallas community know about, and want from, local sexual health services. One hundred people from groups at higher risk for HIV and sexually transmitted infections — including Black individuals, Latino/a individuals, and men who have sex with men — were surveyed about barriers they face, where they'd be comfortable getting services, and what services they want. The biggest barrier identified was simply not knowing that sexual health services exist in their area, reported by more than half of participants. Most people were open to getting tested and treated for STIs and HIV at a variety of locations including medical buildings, mobile clinics, and pharmacies, and most preferred services close to home. A striking finding was the very low interest in newer HIV prevention tools like PrEP (pre-exposure prophylaxis), nPEP (post-exposure prophylaxis), and doxycycline PEP — medications that can dramatically reduce HIV and STI transmission — with interest ranging from just 3% to 24%. The researchers interpret this as reflecting low knowledge about these options rather than lack of interest in prevention. The study also found that Black participants were more comfortable talking about sexual health with friends, partners, and healthcare providers compared to Latino/a participants, suggesting that culturally tailored outreach may be needed for different communities. This research suggests that simply making sexual health services available is not enough — communities need to know those services exist and understand the full range of prevention and treatment options available to them. The authors propose that this kind of local community needs assessment could serve as a practical model for other areas looking to improve sexual health services for underserved populations, particularly as HIV and STI rates continue to rise nationally.
Beckman D, Gonzalez E, Coleman B, Chow J. (2025). Low Knowledge, Awareness, and Availability of Sexual Health Services: An Assessment of a Diverse North Dallas Community.. Sexually transmitted diseases. https://doi.org/10.1097/OLQ.0000000000002149