Advancing Sexual and Reproductive Health and Rights
Perspectives on Sexual and Reproductive Health
Volume 41, Number 4, December 2009

Relationships Between Perceived STD-Related Stigma, STD-Related Shame and STD Screening Among a Household Sample of Adolescents

By Shayna D. Cunningham, Deanna L. Kerrigan, Jacky M. Jennings and Jonathan M. Ellen

CONTEXT: Important barriers to STD testing may include individuals' perceptions of STD-related stigma (negative societal attitudes toward STD infection) and expectations of STD-related shame (negative personal feelings) that would result from a positive STD test. Obtaining a clear understanding of the relationship between STD-related stigma, STD-related shame and STD testing may help inform programs and policies aimed at reducing STD transmission.

METHODS: Measures derived from previously published scales were used to assess perceived STD-related stigma, anticipated STD-related shame and receipt of an STD test in the past year in an urban, household sample of 594 exually active 15–24-year-olds interviewed in 2004–2007. Logistic regression was used to examine associations between recent STD testing and perceived stigma, shame and other participant characteristics.

RESULTS: Thirty-seven percent of males and 70% of females reporting having had an STD test in the past year; the largest proportions of tests (42% among males and 59% among females) had occurred in the context of a routine health care visit, not because adolescents had had disease symptoms or were concerned about exposure to infection. For both males and females, the level of STD-related stigma was negatively associated with the odds of having been tested (odds ratio, 0.5 for each). STD-related shame was not related to STD testing.

CONCLUSIONS: Adolescents who view STDs as stigmatizing have a reduced likelihood of being screened, but it is unclear whether this relationship reflects their care seeking or providers' practice of off ering STD screening at a routine health visit.

Perspectives on Sexual and Reproductive Health, 2009, 41(4):225-230




Shayna D. Cunningham is senior research associate, Sociometrics Corp., Los Altos, CA. Deanna L. Kerrigan is program officer, Sexuality and Reproductive Health, Ford Foundation, Rio de Janeiro, and assistant professor, Department of International Health, Bloomberg School of Public Health, Baltimore. Jacky M. Jennings is assistant professor, Division of Pediatrics and Adolescent Medicine, Johns Hopkins University School of Medicine, and Department of Epidemiology, Bloomberg School of Public Health. Jonathan M. Ellen is professor, Division of Pediatrics and Adolescent Medicine, Johns Hopkins University School of Medicine.