Feelings About STD Screenings for Adolescents

Summary
Sexually transmitted disease (STD)-related shame and stigma are thought to be an important barrier for STD testing. Because of non-testing or late testing, adolescents not only suffer from complications of the disease, but also spread the disease to other people. A study conducted in California examined the relationship between this shame and acknowledging that he/she had undergone an STD test in the past one year. “Our findings support the notion that adolescents who perceive STDs as stigmatizing are not as likely as others to undergo regular screening.”

Introduction
Gonorrhea and chlamydia are among the top 10 reported infections in the US. Infection rates of these diseases are very high among adolescents aged between 15 and 25 years. These infections do not produce any symptoms for a considerable period. Hence, this infection can be identified only through screening. However, many adolescents don’t want to be screened, as they are afraid of the shame associated with these diseases. According to current medical guidelines, all sexually active adolescents must be screened for chlamydia. This study was designed to obtain a clear picture about the relationship between STD testing and STD-related shame and stigma.

Methodology
* The study was conducted from April 2004 to April 2007. A total of 486 census block groups with a high prevalence of STDs were chosen for the study. Researchers contacted 27,194 families, of which 12 percent had adolescent children. Finally, 594 participants were included in the study.
* All the participants were asked about any testing for STD in the past one year. Information was collected regarding their education, number of sex partners during their lifetime, and their sexual orientation.
* Shame and stigma with respect to STD were measured using a questionnaire. The feelings of participants associated with acquiring of STD were noted.

Results
* Out of the 594 participants, 334 had been tested for STD in the previous year. Most of them had been tested when they visited their physician for routine health checkups. About 10 percent had been tested for STD because they had symptoms of STDs.
* STD-related shame was higher in males compared to females.
* Participants with higher stigma scores were less likely to be tested for STD. There was no association of STD-related shame with testing in either females or males.
* STD testing was positively associated with having had more than 10 sex partners among males and with having had more than two sex partners for females.

Shortcomings/Next steps
In this study, the information regarding STD testing was self-reported. There is a chance that some participants may not recall and some may not reveal that they had been tested for social reasons. Moreover, people may not be aware of the actual tests for STDs. This study was conducted only in a small part of Baltimore; hence, the results cannot be generalized.

Conclusion
This study has once again proved that STD-associated stigma is an important barrier for STD screening. It has also highlighted the inadequate screening of adolescents even in an area where there is high prevalence of STDs. These factors have to be considered in future campaigns that promote STD screening. A negative view about those who are infected must be avoided as far as possible. Physicians must be educated regarding screening for STDs in adolescents who are at risk. They must educate adolescents about STDs in a supportive way, so that the latter are not ashamed of being tested for STDs.

For More Information:
Relationships Between Perceived STD-Related Stigma,STD-Related Shame and STD Screening Among a Household Sample of Adolescents
Publication Journal: Perspectives on Sexual and Reproductive Health, December 2009
By Shayna D. Cunningham; Deanna L. Kerrigan; Sociometrics Corp., Los Altos, California and Bloomberg School of Public Health, Baltimore

*FYI Living Lab Reports Are Summaries of the Original Research

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