“Something We'd Rather Not Talk About”: Findings from CDC Exploratory Research on Sexually Transmitted Disease Communication with Girls and Women

Abstract

Background: Chlamydia is a leading cause of pelvic inflammatory disease (PID), which can lead to ectopic pregnancy, chronic pelvic pain, and infertility. Annual Chlamydia screening is recommended for all sexually active women aged 25 years, yet only about 40% of eligible women are screened each year in the United States. To promote Chlamydia screening for the prevention of infertility, the Centers for Disease Control and Prevention (CDC) is developing direct-to-consumer efforts for sexually active young women and key influencers. To inform this effort, CDC sought to explore girls'=women's understandings of sexually transmitted disease (STD) and Chlamydia testing and STD communications and information sources. Methods: Two waves of one-on-one interviews (n ¼ 125) were conducted in 10 metropolitan areas with African American, Caucasian, and Latina females, aged 15-25 years. Results: Most participants were not knowledgeable about Chlamydia or its screening; their discussions about it suggested low levels of perceived susceptibility or relevance to Chlamydia and screening. STDs are rarely discussed in home or social settings or with partners or close friends; yet young women may turn to interpersonal sources if concerned about an STD. Providers are the primary and preferred source of STD information for girls and women, although missed opportunities for engaging young women in STD=sexual health discussions were identified in clinical and other settings. Conclusions: Providers, family members, friends, and partners may serve as important intermediaries for reaching young women and encouraging STD=Chlamydia screening. Resources are identified that could be leveraged and=or developed to facilitate such interactions.

Exploring access and attitudes to regular sexually transmitted infection screening: the views of young, multi‐ethnic, inner‐city, female students

“…The desire of young women to maintain a ‘good girl’ public image reflects both Goffman's theory of stigma and other reports . Our findings on barriers to testing are in line with reports from in North America, suggesting international relevance . Problems identified with postal screening may help to explain the poor uptake of systematic postal screening for chlamydia in England …”

A Missed Opportunity for U.S. Perinatal Human Immunodeficiency Virus Elimination

“…These demographic factors—and by extension risk factors for HIV acquisition—can be used to target subpopulations with HIV prevention messages. Pregnant women are more likely to believe their main sexual partner is monogamous compared with nonpregnant women 23,24 and may not be aware of their male partner’s HIV status or risk behaviors such as injection drug use and having sex with men, yet less than 30% of pregnant women use condoms during sexual intercourse 25 and safe sex practices may be even further limited for pregnant women who experience intimate partner violence. 26 …”

Sexually Transmitted Disease Testing Misconceptions Threaten the Validity of Self‐Reported Testing History

“…Women's knowledge of the STD testing process must be improved through open dialogue between patients and provider. Health care providers are preferred source of STD testing information for young women (Friedman & Bloodgood, ), yet the stigma associated with sexuality and STDs often interferes with sexual health communication (Hood & Friedman, ). In fact, in this sample, while young women reported embarrassment and anxiety about STD testing, many reported that they would be more at ease with the testing process if providers would explain the steps of the process.…”