Jul 162013

This is a post by one of my Summer 2013 interns. Find more posts from her and other current and former interns under the Intern Corner section.Shanna

I was listening to a radio show a couple of years ago that dropped a statistic that essentially prompted my learning excursion into the psychology behind sexually transmitted infections (STIs), and the stigmatization that surrounds them. According to the radio show, research done through the University of Cincinnati found that a little over 40% of individuals that receive calls from a health clinic regarding their STI status did not call back or, in a more technical sense, were deemed “lost to follow-up.”

Despite the fact that, in the context of the radio show, the comment was used to make a bigger point about the efficacy of health services, I still could not get that statistic out of my head. I understand that a telephone call is probably not the most effective method of alerting someone to their medical condition, but surely that alone can’t account for over 40% of non-responders based on that technicality alone.  It led me to think about the attitudes and opinions that are associated with STIs, and I wondered if stigmatization could partially contribute to this lack of follow up.

Sociologist, public health officials and health researchers have conducted many studies of the institutional factors that impact STI follow-up. Indeed, the literature I’ve read talks in great length about the role socioeconomic status, neighborhood and resource availability play, but I have been hard pressed to find literature that analyzes how stigmatization affects follow-up. Given our brains work on cognitive blueprints for processing information, saying something in a particular fashion could possibly condition one to think a specific way as the structure of how something is said could be associated with other ideas that are negative. Therefore, I decided to take it upon myself to compile a short (and by no means complete) list of common ideas about STIs, and try to break them down and bring to light some of the misconceptions that could perpetuate stigmatization.

Belief #1: If you’re smart and educated, you will never get an STI.

Science Says: Just as no contraception can guarantee with 100% certainty that you will not get pregnant, no amount of barriers can guarantee with 100% certainty that you will not contract an STI. Infection spreads by the exchange of risky fluids* (or skin to skin in the case of herpes and HPV), and so even though by wearing a condom/female condom/dental dam you significantly decrease the likelihood of exchange, if fluids are still being produced by both partners, then there is still going to be a (albeit possible, but not probable) chance for STI transmission.

*Here is a quick list of risky fluids: (1) Blood (2) Semen (3) Vaginal discharge (4) Pre-cum (5) Breastmilk (6) Anal Fluid

*Here is a quick list of non-risky fluids: (1) Saliva (2) Mucos (3) Sweat (4) Tears

Ok, but what does this mean?: Besides the false advertising, teaching that “you will never contract an STI if you do x, y and z” leaves very little support for those who actually are proactive about doing x, y, and z and unfortunately still end up with an STI. Those in that position may wonder what they did wrong, or (perhaps more accurately) if they didn’t do everything right enough. Family, and health practitioners may assume they were careless or ignorant and may offer less support. This reinforces the feelings of shame they may have, which could increase the likelihood that they will withdraw.

Solutions?: Talk about it! Not only will it decrease the big, bad, stigmatization that seems to be associated with STIs, hopefully by participating in a dialogue, there will be greater clarity about STIs and answers to some of the questions people may have about STIs. When you open up a conversation, you quickly find that you are not alone with your concerns, and support will be more forthcoming.

Part II is on its way!


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