Shame and STIs: An Exploration of Emerging Adult Students’ Felt Shame and Stigma towards Getting Tested for and Disclosing Sexually Transmitted Infections

Abstract

Emerging adulthood is identified as a time of identity exploration, during which emerging adults (EAs) may engage in sexual exploration and risky behaviors, potentially resulting in the contraction of a sexually transmitted infection (STI). Many EAs, do not disclose their status to partners or those who can provide social support, like parents. Nor do they often get tested. This may be due to the changing status of stigma surrounding STIs. This study examines traditional measures of the stigma/shame of STI diagnoses, treatment, and testing, and their relevance alongside both increased opportunities for casual sex and not only heightened education surrounding STIs, but also heightened prevalence of STIs in the U.S. Results show EAs perceived that if their community found out they got tested, they would likely be treated differently. They also felt they would be uncomfortable disclosing an STI to parents as well as to sexual partners. However, disclosing to a monogamous partner yielded less felt shame and stigma by EAs. Lastly, stigma/shame was associated with STI communication, as well as with overall perception of STI knowledge, and getting tested. Further explanation of the results and possible implications of this study are discussed.

Consumer-Based STI Screening among Young Adult Women: The Negative Influence of the Social System

“…Studies have shown a positive correlation between increasing knowledge of how STI infections are transmitted and a decrease in levels of stigma. 9,21 However, it remains unclear if consumer-based methods of STI screening, even if including an educational component, will influence testing behavior and overcome the associated stigmas. Although consumer-based methods may address privacy and reduce judgment concerns from healthcare providers, it may not address the multilayered stigmas influencing screening.…”

“…This is particularly true related to STIs, where a complex web of individual, social, and systemic factors are known barriers to STI screening among women, especially among adolescent and young adult populations 6,8 . Individual-level perceptions, such as STI-related shame, are a commonly reported self-stigma experienced by people diagnosed with an STI 6,9,10 . Sexually transmitted infection diagnoses are associated with feelings of shame, which may cause adverse psychosocial distress, including embarrassment, fear of judgment, guilt, and isolation 6,10,11 .…”

“…6,8 Individual-level perceptions, such as STI-related shame, are a commonly reported self-stigma experienced by people diagnosed with an STI. 6,9,10 Sexually transmitted infection diagnoses are associated with feelings of shame, which may cause adverse psychosocial distress, including embarrassment, fear of judgment, guilt, and isolation. 6,10,11 Consequently, self-stigma contributes to delays in screening for STIs.…”

“…The problematic cycle of social stigma, such as concerns about gossip, partner mistrust, or use of the term "dirty," are barriers to women seeking STI screening. 9,10 Social stigmas, such as the perceived stigma associated with STI screening, have been noted as a fear among adolescent girls. 11 The social stigmas around STI screening may vary by the geographical context-adolescents and young adults living in the Southern United States report that it was unacceptable to openly discuss sexual behavior and STIs.…”

“…Consequently, self-stigma contributes to delays in screening for STIs. The problematic cycle of social stigma, such as concerns about gossip, partner mistrust, or use of the term “dirty,” are barriers to women seeking STI screening 9,10 . Social stigmas, such as the perceived stigma associated with STI screening, have been noted as a fear among adolescent girls 11 .…”