Change Starts with Us: How to Reduce the Stigma of Sexually Transmitted Diseases

As society develops, its progress inevitably increases, but, paradoxically, the number of sexually transmitted diseases also increases.

According to official data from the Ministries of Health of different countries, syphilis infection, for example, is growing every year. And these are only officially identified cases. The real number of STI diseases in general will be clearly higher than statistical. And this applies not only to the countries of the post-Soviet space, but also to Europe. This is directly related to the stigmatization and specifics of these diseases. 

Sexually transmitted infections also include:

• gonorrhea,
• trichomoniasis,
• chlamydia, microplasma, herpetic, papillomavirus infections,
• HIV infection,
• syphilis,
• rare infections, such as: chancre, lymphogranuloma venereum, which are most common in southern countries, but due to globalization, they should not be overlooked, as well as well-known diseases
• viral hepatitis B and C
• scabies,
• molluscum contagiosum
• pubic lice (with close bodily contact)

Fears and Stigma around HIV/AIDS

It would seem that diseases of this type have been known for a long time, the name itself says so. It is surprising that in our time there is still stigmatization of people who have undergone this type of disease. A lot can be said and written about HIV stigma. Moreover, there is a special term "Serophobia", which means prejudice, rejection and stigmatization of people living with HIV/AIDS. 

Discrimination against people living with HIV/AIDS takes many forms: mandatory testing without their consent, violation of confidentiality in medical and other institutions, as well as targeted violence against people living with HIV/AIDS. Despite the fact that in many countries there is a ban on discrimination against people living with HIV/AIDS, in real life there are many cases of such discrimination. In general, around the world, discrimination/stigmatization of infected persons leads to their low attendance at health facilities, identity crisis, loneliness, suicidal thoughts and actions, social isolation, low self-esteem and lack of interest in containing the disease.

People living with HIV are systematically ostracized in society, as well as at work, in medical institutions, and so on. Combined with internal stress, this greatly prevents them from living and feeling comfortable anywhere. And everyone knows about the effect of stress on the immune system. 

In the Crosshairs of Society

There is also stigmatization in society in relation to persons who have been exposed to other sexually transmitted diseases. First of all, a person feels it at an appointment with a specialist. Even just coming with a request to do the appropriate analysis (smear), you see this specific smile that speaks of how "dirty" you are. 

Such an attitude is not the best way to combat STIs and detect them, and at least it is unethical. We need to talk about this. So often that it is not perceived as something unnatural.  

After all, no one would think of stigmatizing/blaming a person who has contracted tetanus just because this person worked in the garden without protective equipment. The infectious causative agent of tetanus is tetanus bacillus, which lives in soils and can get in case of skin damage. I took the knowledge about this infection from school and learned it well. The teacher paid great attention to telling about this, for which I thank her. But, unfortunately, no one told us about STIs. Perhaps because the teachers themselves considered this topic taboo and shameful!?

The tetanus bacillus, by the way, was also known in ancient civilizations. And now tetanus vaccination is included in the list of mandatory vaccinations. That is why this disease is very rare. 

In any case, it is customary to sympathize with people who have contracted one or another virus/infection, rare or not. But in the case of sexually transmitted infections, people most often meet with misunderstanding, ridicule and schadenfreude, they say, it is their own fault. 

A little-known fact, but you can get infected with gonorrhea, for example, by accident: by opening the toilet door, the handle of which was held by an infected person who does not observe personal hygiene (does not wash his hands after the toilet). This will cause an infection on your hands, and if you, in turn, do not wash your hands, this infection can easily infect you. 

Moreover, prejudice against people who have contracted any sexually transmitted infection/virus is found even in queer culture, where, logically, it should not belong at all. 

Maybe the problem is that we have been taught since childhood that sex is something dirty? Something not worth talking about. Moreover, to talk about diseases related to sex. This is still an unspoken taboo in most families. Unfortunately, this is the reality. 

School, as an educational institution, could inform high school students about STIs, albeit gently and unobtrusively, encouraging students to google information about it themselves.

And the family will become the place where the teenager would not be afraid to talk about his problem, fearing judgment and misunderstanding. 

In the meantime, WHO informs that:

1. every day, about 1 million people are infected with STIs, including asymptomatic ones. 
2. Every year, 374,000,000 new mutations of 4 main infections are formed: chlamydia, syphilis, gonorrhea and trichomoniasis. 
3. More than 500,000,000 people between the ages of 19 and 49 are infected with genital herpes. 
4. 311,000 thousand deaths from cervical cancer occur annually from infection with the human papillomavirus. 
5. In 2016, more than 1,000,000 women were infected with syphilis, resulting in 350,000 miscarriages.
6. STIs directly affect sexual and reproductive life through stigma, infertility, cancer, pregnancy problems and increased risk of HIV infection. 
7. tolerance to antibiotics is the main danger associated with the risk of increasing STIs worldwide. 

But instead of looking the problem in the face directly, we are embarrassed and afraid to get tested; we are afraid to tell our parents/friends that we have been diagnosed with a sexually transmitted infection; we are afraid to tell our former and current sexual partners about it; We are afraid to admit the problem even to ourselves and blame ourselves for the fact that it affected us. 

To start the path to destigmatization (no matter how terrible this word sounds), you need to start with yourself first of all. 

At least, follow the rules of personal and sexual hygiene, regularly take the necessary tests and do not reproach yourself if an unwanted infection occurs. 

A as a maximum: change your attitude to this type of disease, support your moral relatives who have faced STIs and spread information about the prevention of STIs in any possible way.  

^Sources:
1 who.int