“If I ask her to get tested, I am worried that it may offend her and affect our relationship negatively."
“While I was concerned about his STD status at first, with time, I trusted him and no longer felt he would be affected by such things.”
Have you ever had similar thoughts when it comes to talking about STDs (sexually transmitted diseases) and STD testing with your partner(s)?
You are not alone!
In this blog post, we'll share HeHealth's findings from the poll of 81 young adults regarding this topic, explore some of the reasons why people find it difficult to talk about STDs with their partner(s), and offer a few tips on how to make having such conversations easier.
So, whether you're single or in a relationship, read on for some helpful advice.
A gap between thinking and doing
HeHealth polled a global sample of 81 young adults on their perceptions and attitudes towards STDs and having STD conversations with their partner(s), and the results were eye-opening.
Over half of the respondents (50.6%) believe they are highly aware of STDs.
2 in 3 think they are not necessarily at risk of acquiring an STD.
Almost all (98.7%) said that they are open to discussing STDs with their partner(s).
About half (49.4%) said that they have discussed about STDs with their partner(s).
Majority (85.1%) expressed that they would request their partner(s) to get tested.
About 4 in 5 had never actually requested their partner(s) to get tested.
Overall, a few interesting insights have been observed:
Being highly aware of STDs doesn't necessarily mean they believe that they are personally at risk for contracting an STD.
There is a big difference between thinking and doing. A lot of people want to have discussions on STDs with their partner(s), but not many will actually take action! And even fewer attempted requests for testing.
In an effort to better understand the reasons behind these observations, our team has analyzed the poll results and conducted interviews and desktop research. We have talked to both STD experts and regular people, and we have compiled our findings below.
Why people might not think they are at risk of contracting an STD? (even when they think they are highly aware)
While it may be possible that some people are not at any real risk of getting an STD due to sexual inactivity, it has been found that many individuals, especially youths, are underestimating the risk of them contracting STDs, hence don’t think that it is necessary for them to get tested (Strome et al., 2022). This can be resulted from multiple reasons, such as having limited or inaccurate information about STD risk and transmission. Across our conversations and research, we have identified a few common misconceptions:
I’m in a faithful (monogamous) relationship, so I’m protected from STDs:
Many people don’t feel STDs are a risk for themselves because they feel monogamy is an invincible shield against STDs.
In reality, sometimes these infections can be transmitted non-sexually, such as through blood transfusions or shared needles. It is also possible that they have contracted an STD from a previous partner and never been treated because they might not even know! Some people can be infected for months or years and not show any symptoms until a much later time (mostly for virus infections, check out this video by Dr. Ina Park for more information). Some might have an incurable STD that's not being well managed (most incurable STDs can be managed with treatment and medication).
So while being in a monogamous relationship does decrease your risk for contracting an STD, it's not a guarantee that you will not get one.
STDs = HIV/AIDS:
We have heard that many young adults associate STDs mainly with HIV/AIDS, (Mansor et al., 2020), which they perceive as a disease that only affects certain groups of people. However, this is a misconception.
While HIV/AIDS is a serious and potentially life-threatening STD, it is not the only one. There are many other STDs that can be just as dangerous, including chlamydia, gonorrhea, and syphilis. But the truth is, many might not even know these diseases exist (Voyiatzak et al., 2021).
There are many other misunderstandings about STDs that are not mentioned by our respondents. You probably have also heard a few somewhere at some point of your life. But all in all, they all lead to many people into thinking that the risk of them contracting STDs is not that high!
Why do people find it hard to actually talk about STDs with their partner(s)?
“Our conversation went horribly. She said she felt judged and started cursing at me. I told her I wasn’t judging her, I was just concerned about my health. I was very careful about my language too. She didn’t care and continued to berate me saying I was “naive” and that I should be “willing to accept the consequences.” a poll respondent shared.
Some of you might be able to relate to this story. It revealed why having such conversations could be extremely difficult for many. But it is a complex issue that have multiple driving factors, here are a few that we have found through our research:
1. STD-related stigma and shame:
Fear of stigma and a sense of shame limit people's ability to make informed and accurate health decisions (Brannon, 2021). Our discussion with Dr. Rayner, socio-behavioral scientist and HeHealth’s Behavior Lead, revealed a few reasons behind this:
Being falsely labeled as promiscuous: Adultery and promiscuity deposit lots of shame and are perceived often associated with STDs (Young et al., 2007). Most people do not desire to have these labels attached to them.
Faulty attribution: The faulty attribution of thinking that being infected with an STD is his/her mistake, and they tend to feel responsible for their inaction of protecting themselves from STDs.
Fear of negative reactions from the partner(s): The stigma induced by social-culture factors leads to various concerns, such as violent reaction/rejection from the partner(s), and being judged for past sexual history (Kalichman et al., 2017; Wood et al., 2018). Some people shared that they only see themselves having such conversations at a later point when they actually start having "sex" with their partner(s), as they would prefer to maintain a positive impression at an early stage (Scheinfeld E., 2021). Some reported waiting for the other person to start the conversation, assuming that the other would bring it up if necessary (Hotton et al., 2015).
2. Some people might be afraid of what they'll find out if their partner(s) tests positive for an STD.
Our observations from multiple social platforms and research papers have given us some insights into why that is the case. Here are a few reasons to why people may be afraid of:
Their own reaction to their partner’s STD positive results and if things between them will be different
An STD positive result might signify a cheating affair that their partner had or is having (which is not necessarily true)
Realising that they could also be STD positive (Blake et al., 2003) or may in fact be the one who passed it on to their partner(s) due to their self-denial and not being honest about their sexual health from the beginning
With all that said, most of these factors are seen to be associated with the ongoing stigma that lurks around the topic of STD. Thus, even though this stigma is not an issue that can be resolved in a short period of time, it can slowly be eased by starting with a courageous step towards broaching the STD topic and having a conversation with your partner(s)!
How should I approach these conversations with my partner(s)?
These conversations are necessary as they can help keep both of you safe from infections in the long run! Of course, it is understood that approaching these conversations is not easy and may cause discomfort and stress for some. Hence, here are some tips to help encourage and assist you with your situation.
Know the facts Learning more about STDs could make talking about it with your partner(s) a little easier, as it's more likely that you think of it as a medical problem. With all the stigma and misconceptions around STDs, it's important that you know the facts and clarify any question before starting the conversation.
Prepare for the conversation (a) Knowing what you want to get out of the conversation and plan for what you want to say accordingly. It's normal to feel embarrassed, but taking a step to plan for it would help. (b) If you decide to meet face to face to have the conversation, choose a place where both of you can feel safe and comfortable to talk.
Start by talking about your most recent STD status A good way to start the conversation is by telling your partner(s) your most recent STD status. By talking about yourself first makes it a little less like you're trying to interrogate or you have trust issues. Do not open the conversation with blame!
Show that you care It's critical to approach the topic with mutual respect and show that you truly care for your partner's health.
Be open and establish a safe space “Establishing a safe space within which you can delineate boundaries, negotiate with your partner(s) and speak about these issues honestly is paramount to ensuring good sexual health,” said Dr. Rayner. Show empathy and holding a non-judgmental space can allow for better conversations.
These are just some of the general tips to encourage people to talk to their partner(s) about STDs and get tested for it.
However, we know there are so many different situations to think about. Hence, with the various scenarios that can take place, a more in-depth guide with details will be shared in our “Guides and tips on how to approach your partner(s)” blog soon. So stay tuned!
Strome, A., Moore-Petinak, N., Waselewski, M., & Chang, T. (2022). Youth's Knowledge and Perceptions of Health Risks Associated with Unprotected Oral Sex. Retrieved from https://www.annfammed.org/content/20/1/72
Brannon, G. E., & Ray, M. A. (2021). Participant-Reported Experiences of Conversations about Sexually Transmitted Infections with Romantic Partners: Perceptions of Ownership and Privacy. Health Communication, 1-10.
Hotton, A. L., French, A. L., Hosek, S. G., Kendrick, S. R., Lemos, D., Brothers, J., ... & Mehta, S. D. (2015). Relationship dynamics and sexual risk reduction strategies among heterosexual young adults: A qualitative study of sexually transmitted infection clinic attendees at an urban Chicago health center. AIDS patient care and STDs, 29(12), 668-674.
Kalichman, S. C., Mathews, C., Kalichman, M., Lurie, M. N., & Dewing, S. (2017). Perceived barriers to partner notification among sexually transmitted infection clinic patients, Cape Town, South Africa. Journal of Public Health, 39(2), 407-414.
Mansor, N., Ahmad, N., & Rahman, H. A. (2020). Determinants of knowledge on sexually transmitted infections among students in public higher education institutions in Melaka state, Malaysia. Plos one, 15(10), e0240842.
Voyiatzaki, C., Venetikou, M. S., Papageorgiou, E., Anthouli-Anagnostopoulou, F., Simitzis, P., Chaniotis, D. I., & Adamopoulou, M. (2021). Awareness, Knowledge and Risky Behaviors of Sexually Transmitted Diseases among Young People in Greece. International Journal of Environmental Research and Public Health, 18(19), 10022.
Wood, J. M., Harries, J., Kalichman, M., Kalichman, S., Nkoko, K., & Mathews, C. (2018). Exploring motivation to notify and barriers to partner notification of sexually transmitted infections in South Africa: a qualitative study. BMC Public Health, 18(1), 1-7.
World Health Organization. (2021, November 22). “Sexually transmitted infections (STIs): Retrieved from https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)
Centers for Disease Control and Prevention (2021). Diseases & Related Conditions: Retrieved from https://www.cdc.gov/std/general/default.htm
Scheinfeld E. (2021). Shame and STIs: An Exploration of Emerging Adult Students' Felt Shame and Stigma towards Getting Tested for and Disclosing Sexually Transmitted Infections. International journal of environmental research and public health, 18(13), 7179. https://doi.org/10.3390/ijerph18137179
Young, S. D., Nussbaum, A. D., & Monin, B. (2007). Potential moral stigma and reactions to sexually transmitted diseases: Evidence for a disjunction fallacy. Personality and Social Psychology Bulletin, 33(6), 789-799.
Blake DR, Kearney MH, Oakes JM, Druker SK, Bibace R. (2003) Improving Participation in Chlamydia Screening Programs: Perspectives of High-Risk Youth. Arch Pediatr Adolesc Med. 2003;157(6):523–529. doi:10.1001/archpedi.157.6.523