STI Stigma

Sexually transmitted infections (STIs) are once again on the rise in the United States. According to the Center for Disease Control, in 2017…

 

Gonorrhea, syphilis, and chlamydia are some of the most common STIs. Each are a different kind of bacterial infection that is curable with antibiotics, yet the majority of cases go undiagnosed and untreated. Why? The answer is complicated, but stigma plays a big part.

If you’re asking yourself what STI stigma is, consider this comparison.

A) Your friend calls to tell you that they have strep throat. You can conclude a few things: they have an illness contracted from another person, it’s a bacterial infection, it’s curable with antibiotics, and if left untreated—it could result in other serious health conditions (i.e. kidney inflammation or rheumatic fever).

B) Your friend calls and tells you they have chlamydia. Very similarly, your friend has an illness contracted from another person, it’s a bacterial infection, it’s curable with antibiotics, and if left untreated—it could result in other serious health conditions (i.e. pelvic inflammatory disease or infertility).

The contexts of these situations are not worlds apart, but your reaction to each is likely different. That’s stigma.

STI stigma is often fueled by misinformation and attitudes about morality. Misinformation is rooted in both an individual’s fear of illness/death, and inaccurate information about how STIs are transmitted. Others stigmatize STIs because of their personal belief that acquisition of such infections comes from irresponsibility or immoral behavior. This mentality usually stems from negative cultural beliefs surrounding sex, and a false categorization of people who contract STIs as the dirty and slutty.

But the reality is, the majority of people will contract at least one STI within their lifetime. STIs are an infection, no dirtier than the common cold or the flu. Understanding what stigma is and how it develops can actually reduce new cases of infection. Stigma not only plays into systemic governmental and healthcare barriers, but also causes barriers on an individual level.

A study conducted in 2009 found that increased STI-related stigma was associated with a lower chance of an individual having been recently tested for STIs. Even without empirical evidence, this can be understood on an intuitive level: the more stigma attached to STIs, the more likely an individual is to refuse STI testing, refuse to report/ lie about their status to partners, and/or delay seeking care—all because they fear how they may be judged by others.

Stigma often goes hand-in-hand with denial; the more an individual demonizes an STI, the more they mentally distance themselves from it. Some people struggle to believe that they can even personally contract STIs, because in their minds, they don’t exemplify the behavior they stereotypically associate with infection—leading them to forego protection altogether.

The most dangerous part about stigma is that it perpetuates a cycle. More stigma means less measures taken to prevent and treat STIs, which creates new cases of STIs… which ultimately ends in more stigma. To end this cycle, we must work to reduce stigma. Doing this is difficult and there is no clear cut path. It’s takes an active role that requires self-realization and acceptance of the fact that stigma has likely negatively affected your own attitudes toward STIs.

But a good way to start is..

  • Use condoms.
  • Educate yourself with accurate information about STIs, and in turn, educate your partners/peers.
  • Get tested regularly.
  • If you or a peer does contract an STI, notify past and current partners.
  • Remember: bacteria, a parasite, or a virus gave you a STI, not a person. Don’t attempt to identify “patient zero” because such behavior demonizes individuals.
  • Avoid using language such as “clean.” It perpetuates negative perceptions of STI contraction.
  • Speak up when you hear someone stigmatizing people with STIs.

 

Information leads to understanding, and will increase comfortability with STIs and sex-related topics. It might sound daunting, but normalizing these topics is a direct way to reduce stigma. It won’t go away overnight, but admitting it’s there and that we all contribute to it will decrease its power.