Sexual Double Standards and Sexually Transmitted Illnesses: Social Rejection and Stigmatization of Women

Disclosure of Sexually Transmitted Infections to Sexual Partners: A Systematic Critical Literature Review

The purpose of this review was to systematically and critically evaluate the STI disclosure literature (excluding HIV disclosure literature), summarize limitations and omissions, and identify opportunities for future research. We used the Health Disclosure Decision-Making Model (DD-MM) as a guiding theoretical framework. Following PRISMA guidelines, database searches using key terms identified 387 possible articles, 32 of which ultimately met inclusion criteria for this review. Findings indicated that individuals with STIs experience a variety of negative feelings and emotions related to the prospect of disclosure. Reasons for disclosure included moral obligation, love for partner, and desire for support, whereas reasons to not disclose included fears about partner's reaction and response, fears of being rejected or broken up with, and beliefs about the lack of obligation. Disclosers used a variety of disclosure strategies, including priming messages, framing, and direct disclosure. Non-disclosers used strategies to pass as uninfected (i.e. passing), withdraw from relationships, and using outbreaks to time sexual activity. Among studies that examined disclosure timing, around half or fewer individuals disclosed or believed they should disclose prior to engaging in sexual activity. The findings indicated that relationship-related factors such as greater levels of commitment, relationship quality, length together, and feelings of closeness were important predictors of disclosure. Finally, some individuals experienced negative partner responses, whereas others experienced positive responses and relationship outcomes. Our review revealed that the experiences of receivers of STI disclosures are not well-represented in the literature. Implications for future research, education, and intervention are specified.

The Relationship between the Sexual Double Standard and Women's Sexual Health and Comfort

The current research explores the relationship between Sexual Double Standard (SDS) endorsement and women's sexual health and attitudes. Women (n = 705) completed an SDS endorsement scale, and then answered a variety of questions in three main categories of outcome variables: sexual comfort, sexual reputation, and sexual health. Results suggest that women's SDS endorsement was not related to women's sexual comfort. Further, SDS endorsement was slightly positively related to how concerned women were about their sexual reputation. Regarding sexual health, SDS endorsement was related to a shorter timespan since women's last OBGYN screening, and unrelated to women's discomfort discussing birth control with their OBGYN. Results suggest there is much more to explore in targeted studies on the relationship of SDS endorsement to women's perceptions of their sexual reputations and their interactions with OBGYNs with respect to the SDS. Previous and related research is discussed, along with implications of the current research.

Stigma Surrounding Sexually Transmitted Infections among Medical Students in Germany

Stigmatization by health care professionals leads to decreased help-seeking behaviors in those being stigmatized. Prejudicial attitudes are especially pronounced concerning sexually transmitted infections (STIs), which is crucial in light of rising prevalence rates of STIs in recent years. We aimed to examine stigmatization against patients with sexually versus non-sexually transmitted infections among medical students in Germany. We also assessed how a person's sexual orientation or gender might contribute to stigma. Medical students (N = 332) read about a fictious patient with symptoms of pharyngitis after having had a casual sex encounter. Gender (female/male) and sexual orientation (hetero-/bi-/homosexual) of the patient as well as the pathogen causing the infection (gonococcus/H1N1-virus) were randomly varied. Afterwards, stigma against the patient was assessed. Patients with a gonococcal pharyngitis were perceived as more prone to engage in risky behavior, dumber, and less responsible than patients with a H1N1-virus pharyngitis. Bisexual patients were perceived as more prone to engage in risky behavior than hetero- and homosexual individuals. The predictability of the consequences of the patient's actions was rated higher in bisexual patients. Stigmatizing attitudes toward patients with a STI were frequent, especially against bisexual patients. More education should be dedicated to sexual/LGB health during medical school to reduce existing stigma.

Thinking as the others do: persistence and conformity of sexual double standard among young Italians

The double standard represents a standard of good behaviour that, unfairly, some people are expected to follow or achieve, but others are not. Once neglected by social scientists, the double standard in sexual attitudes has become more and more studied. In this paper, we inquire about the existence of the double standard in opinions regarding peers’ sexual behaviours and study its determinants. What makes young people judge the sexual behaviour of women in a more conservative way than that of men? The paper uses data collected from Italian university students, who are asked to express their (dis)approval of a series of sexual behaviours, considering peers of either gender participating in those behaviours. The results show that the double standard exists and has been persistent amid Italian undergraduate students over the last 20 years, and that the cultural context matters more than the family in shaping students’ beliefs.

What do young women living in regional and rural Victoria say about chlamydia testing? A qualitative study

Background Chlamydia trachomatis is the most commonly notified sexually transmissible infection in Australia, with almost 100000 cases diagnosed in 2018. Chlamydia is easy to diagnose and treat, but infections are underdiagnosed. Eighty per cent of chlamydia cases are asymptomatic. Without testing, infections will remain undetected. Several barriers to testing have been identified in previous research, including cost, privacy concerns for young rural people, knowledge gaps, embarrassment and stigma. The aim of this study was to investigate young regional and rural women's understanding of chlamydia and factors that may prevent or delay testing.

METHODS

Semistructured interviews were conducted with 11 women aged between 18 and 30 years residing in north-east Victoria, Australia. Interviews were transcribed verbatim and analysed thematically.

RESULTS

Themes were grouped under four categories: (1) chlamydia and stigma; (2) the application of stigma to self and others; (3) factors affecting testing; and (4) knowledge. A chlamydia infection was associated with stigma. The young women in this study anticipated self-stigma in relation to a positive diagnosis, but resisted stigmatising others. Increased knowledge about chlamydia prevalence was associated with reduced self-stigma. The most consistent factor affecting testing decisions was personal risk assessment. Knowledge gaps about symptoms, testing and treatment were also identified, with participants not always accessing information from reputable sources.

CONCLUSION

Chlamydia testing was viewed as a positive activity among this cohort. However, there is considerable perceived stigma about being diagnosed with an infection. Interventions that communicate prevalence, reduce stigma and provide factual information about testing and risk are still needed. Clinicians have an opportunity to convey this information at consultation. Health promotion workers should continue to develop and run campaigns at a community level to encourage regular screening.

Male Stigma: Emotional and Behavioral Effects of a Negative Social Identity on a Group of Canadian Men

Although the concept of stigma has been used to examine the place of various minority populations and women in society, it has not been previously applied to men. This qualitative research explores the experience of 16 Canadian men who believe they were stigmatized due to their sex. The study concludes that the experiences of these participants are consistent with social stigma involving assumptions of male violence and inadequacy with respect to the care of children. Mechanisms whereby such stigmatic assumptions could be maintained are explored along with the need for further research. The results of this research will have immediate application to counsellors working in the area of men's wellness who wish to understand the experience from the perspective of their clients.

“We’re like the sex CPR dummies”: Young women’s understandings of (hetero)sexual pleasure in university accommodation

In this article, we explore the discourses that affect young women’s experiences of (hetero)sexual pleasure, drawing on data from focus groups with young women and young men who lived within a university residential setting in Aotearoa/New Zealand. Here we focus on the gendered understandings among the participants that prioritise men’s sexual pleasure and largely position women as the means of achieving that pleasure. The young women spoke of multiple barriers to gaining equality during (hetero)sexual experiences, with key issues being the coital imperative and women’s supposed sexual passivity. In challenging these barriers, the young women described various tactics used to resist their subordinate position. However, the women often placed the onus of responsibility for dismantling these barriers on themselves, thus bearing the burden of responsibility for not only young men’s sexual pleasure but also their own.

US Black college women's sexual health in hookup culture: intersections of race and gender

Approximately 60-80% of college students in the USA report a hookup experience in the form of a casual sexual encounter between individuals without the expectation of a dating or romantic relationship. Given the potential health risk posed by these sexual encounters, the need exists to critically examine this cultural phenomenon on college campuses. Yet, the existing hookup literature is overwhelming White and often exclusive of historically marginalised populations such as Black women. Accordingly, this paper examines the role of the intersecting identities of race and gender and other social factors that influence the sexual health and wellbeing of Black women on US college campuses. Specifically, we explore issues related to the gender ratio disparities present on college campuses, relationship power imbalances, inconsistent condom use and low sexual-risk perception. Moving forward, hookup research needs to utilise an intersectional approach; we offer specific suggestions for the important inclusion of Black women in the broader hookup discourse and future research.

Predictors of the Sexual Well-being of Individuals Diagnosed with Herpes and Human Papillomavirus

Research suggests that having a sexually transmitted infection (STI) such as genital herpes and human papillomavirus (HPV) can negatively affect sexual well-being. However, there is little research examining factors associated with poorer sexual well-being among individuals with a STI. This study investigated the extent to which stigma experiences, individual characteristics, and STI characteristics were associated with multiple aspects of sexual well-being among individuals diagnosed with herpes and/or HPV. Participants were an average of 36 years old (SD = 11.58) and included 188 individuals with herpes and/or HPV who completed measures of sexual activity, sexual problems, and sexual cognitive-affective factors. The results showed that experiences of stigmatization were the most important predictors of sexual well-being. Participants who perceived were stigmatized by others as well as those who internalized negative social attitudes to a greater extent reported poorer sexual well-being across all dimensions, over and above individual and STI characteristics. The implications of these findings for sexual health professionals are discussed.

Unveiling the hidden epidemic: a review of stigma associated with sexually transmissible infections

Stigma has long accompanied sexually transmissible infections (STI) and hindered prevention and control efforts. It not only acts as a formidable barrier to STI testing, treatment and disclosure, but has a multitude of consequences for the health and quality of life of infected individuals. This review summarises the literature related to STI stigma and offers practical approaches to counter STI-associated stigma through multi-level efforts. Specifically, it describes the key sources that breed and perpetuate stigma, outlines how STI-associated stigma has been conceptualised and measured in the literature, documents the impact of stigma on infected and uninfected individuals, and summarises the stigma reduction strategies recommended in the literature. Gaps in the literature are identified and areas for further research are suggested, along with practical strategies for moving forward.

Sex education during the school-aged years influences sexual attitudes and sexual health in college: a comparative study from Korea

Sex education is provided routinely to school-aged children in many countries without enough evidence that it will benefit them when they become adults. The purpose of this study was to examine the long-term influence of the sex education that was provided during the school-aged years on the attitudes, behaviors, and sexual health among male and female college students in Korea. For this descriptive, comparative study, the data were obtained from 3609 male and 2180 female college students by using the proportional quota sampling method. Overall, the female students had more opportunities for sex education. Receiving this education during the school-aged years lowered the sexual double standard score but was not related to sexual activity among the male and female students. Receiving sex education at different time points during the school-aged years had differential influences on the sexual attitudes and indicators of sexual health between the male and the female students. The results of this study suggest extending the role of school nurses to include redesigning the content of sex education programs, based on the sex and age of the students, and using midwives to provide sex education in community settings.