Attitudes and the STI Epidemic
■ SEX IN REAL LIFE High-Risk Sexual Behaviors
Sexually Transmitted Infections
Ectoparasitic Infections: Pubic Lice and Scabies Bacterial Infections: Gonorrhea, Syphilis, Chlamydia, and More
■ SEX IN REAL LIFE The Lost Children of Rockdale County
■ SEX IN REAL LIFE Vaccines for Sexually Transmitted Infections?
■ PERSONAL VOICES What Would You Do If Your Partner Told You He or She Had an STI?
Viral Infections: Herpes, Human Papillomavirus, and Hepatitis
Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS)
Knowledge and Attitudes About AIDS
■ SEX IN REAL LIFE Microbicides: New Barriers Against HIV Families and AIDS Global Aspects of AIDS
Asia and the Pacific Europe and Central Asia Sub-Saharan Africa Latin America and the Caribbean The Middle East and North Africa Other Issues
Preventing STIs and AIDS
Early Detection Talking About STIs
Sexuality Now Go to www. thomsonedu. com to link to SexualityNow, your online study tool.
Ш t is estimated that roughly 22% of the U. S. population (or just over 65 million M people) are living with an incurable sexually transmitted infection (STI). The f Centers for Disease Control and Prevention estimate that there are approximately 19 million STI infections each year and half of these are among men and women between the ages of 15 and 24 years old (Weinstock et al., 2004). Although there are more than 25 infections spread primarily through sexual activity, in this chapter we will limit our discussion to pubic lice, scabies, gonorrhea, syphilis, chlamydia, vaginal infections, herpes, human papillomavirus, viral hepatitis, and the human immunodeficiency virus. We will explore attitudes, incidence, diagnosis, symptoms, treatment, and the prevention of STIs.
^ATTITUDES AND THE STI EPIDEMIC
The sudden appearance of a new disease has always elicited fear about the nature of its contagion. Cultural fears about disease and sexuality in the early 20th century gave way to many different theories about casual transmission (Brandt, 1985). At the turn of the 20th century, physicians believed that STIs could be transmitted on pens, pencils, toothbrushes, towels, and bedding. In fact, during World War I, the United States Navy removed doorknobs from its battleships, claiming that they were responsible for spreading sexual infections.
Sexually transmitted infections have historically been viewed as symbols of corrupt sexuality (P. A. Allen, 2000). When compared with other illnesses, such as cancer or diabetes, attitudes about STIs have been considerably more negative, and many people believe that people so afflicted “got what they deserved.” This has been referred to as the punishment concept of disease. In order to acquire an STI, it was generally believed, one must break the silent moral code of sexual responsibility. Those who become ill therefore have done something bad, for which they are being punished.
Kopelman (1988) suggests that this conceptualization has endured because it serves as a defense mechanism. By believing that a person’s behavior is responsible for acquiring an STI, we believe ourselves to be safe by not engaging in whatever that behavior is. For example, if we believe that herpes happens only to people who have more than 10 sexual partners, we may limit our partners to 2 or 3 to feel safe. Whether we are safe, of course, depends on whether our beliefs about the causes of transmission are true or not. Negative beliefs and stigma about STIs persist today. One study found that many people who are diagnosed with STIs experience “self-stigmatization,” which is an acceptance of the negative aspects of stigma (feeling inadequate and ashamed; Fortenberry et al., 2002). These negative feelings can also interfere with the act of getting tested at all.
College students are often apprehensive about getting tested for STIs, especially when they think they might be positive. One study found that social stigma and negative consequences of testing often cause college students to delay or avoid getting tested for STIs (Barth et al., 2002). Students report that they would feel “embarrassed” and worried that other people perceive them as “dirty.” This is probably why in one study, many students said they would “rather not know” if they had an STI (Barth et al., 2002).
College students often act as though they are invincible; they may believe that although others may get STIs, it will not happen to them. In fact, the majority of young people believe that they are not at risk for contracting an STI (Ku et al., 2002). Yet, we know that college students are a part of the population that is most at risk for contracting an STI. This is because college students engage in many high-risk sexual be-
SEX in Real Life