Addressing misconceptions about sexually transmitted infections
In my school district, sex education was mandatory for one year at each school level. At first, it was a simple enough class, mostly full of anatomic drawings and technical terms, without any mention of what sex was.
High school was when the conversation became serious. My teacher, a man in his late thirties who was, by my assessment, not a healthcare professional, would give an in-depth lecture on something once previously only glossed over. I’ll never forget the amount of time he spent reminding us of sexually transmitted infections, that they were something inherently wrong and disgusting and that the only way to avoid them was to abstain from sex altogether.
It’s not the teacher’s fault he started the conversation in this manner. Although I was lucky enough to receive a sex education expansive enough to include a conversation on the prevention of pregnancy and sexually transmitted infections, it was also a heavily “abstinence only” education. There was no mention of how one might go about getting tested and treated for an STI. And no one told us that, according to the Center for Disease Control, 87 percent of people with herpes haven’t been clinically diagnosed, and condoms don’t entirely prevent contraction of the virus. Our education didn’t acknowledge that accidents happen, or someone could contract an STI during sexual assault. Even this fairly comprehensive sex education wasn’t completely accurate, as it didn’t teach us about safety in a way that would diminish discomfort or stigma.
This stigma, often started in the classroom, may prevent people from having a conversation about STIs and changing the attitude surrounding them. It not only keeps people from seeking testing and treatment, but it also keeps them from starting a conversation with their partners and revealing their status, even when doing so means preventing transmission. A college student, who asked to remain anonymous for reasons of privacy, spoke about her experience with a non-monogamous sexual partner who ignored her before revealing his potential STI status. Her partner neglected to inform her that he believed he contracted an STI, and then neglected to inform her again when his test results came back negative.
“When my partner informed me that he thought he had contracted an STD, he blamed me immediately,” she said. “And the stigma of our ‘non-exclusive’ relationship and my willingness to see other people more than he did immediately blended with the stigma of having an STD.”
Although both she and her partner tested negative, her scare is not uncommon. These conversations are difficult and easily ignored in relationships.
Shirley Stephenson, an advanced practice nurse who specializes in infectious disease and global health at the University of Chicago Hospital, notes the emotional component is often one of the hardest parts of destigmatization.
“There’s sometimes a lot of anxiety and guilt over whether or not they should reveal it,” she explains, “because it’s not just about the STD, it’s about expectations in relationships.”
It’s these expectations that, to a degree, make these conversations difficult. Part of the stigma surrounding transmission is that the carrier is often thought to be participating in behaviors deemed “high-risk,” such as unprotected sex with multiple partners.
This is obviously not always the case; not every situation is preventable. Condoms don’t completely prevent the spread of herpes or human papilloma virus, and, according to the American Sexual Health Association, 25 percent of Americans are living with an incurable STI.
Even with the knowledge of these common protective measures, it’s also important to consider sexual assault. A different college student, who wanted to be referred to in the article by their first name, Julie, because of privacy reasons discussed their recent STI scare and the way it impacted how they felt about sex.
“I thought I had an STI because the symptoms I had been producing were new to me and lined up with my sexual assault,” they said. It’s a common story; a survivor of sexual assault will notice symptoms and get tested, only to discover they are now STI positive. It’s a growing issue that isn’t often discussed.
Julie reveals that, in regards to their sexual assault and any impact it could have had on their STI status, there was “definitely a lot of trouble talking to [their] mom about it.” This again emphasizes the difficulty of these conversations, regardless of the level of consent or awareness one has about their STI status. It’s not something people talk about and, according to Stephenson, talking about it could be what promotes positive change.
“Of course, we tell everyone to have protected sex,” Stephenson acknowledges, “but we know people go out and don’t have protected sex.” And that’s always going to happen because, as she points out, “things happen.” To a degree, this is the responsibility of sexually active people.
“It’s a bit circular,” she says, “even if you trust someone, you have to acknowledge that things happen.” It’s this mutual conversation that can lead to testing and treatment, encouraging others to do so. “If we’re more open about getting treated, we’re not going to spread it. Destigmatizing improves treatment rates, which, in hand, reduces transmission.”
According to her, it’s not only the role of sexually active people to be aware of their sexual health, but also the responsibility of healthcare providers.
“You don’t scold people,” she says of her job, “you encourage people to be safe, but don’t shame them when things happen, so people get tested sooner.” By making health clinics and doctor’s offices a safe place to talk about sexual activity and sexually transmitted infections, people will be encouraged to ask questions of healthcare providers, to discuss options for STI prevention and treatment, and, most importantly, to get tested.
“We don’t have these conversations,” she says, “but I think education and acknowledgement are what’s important.”
It’s time to destigmatize STIs, from a social, educational and medical perspective. Talk about them with your friends. Ask your partner to get tested with you. Ask questions of your healthcare provider about the best method of prevention for you. Education is de-stigmatization, and de-stigmatization is prevention.
Audra Joiner is a first-year exploratory major who just wants you to get tested, and also just wants you to donate to Planned Parenthood by calling 1(800) 430-4907. You can reach them at [email protected].