We need to talk about sexually transmitted infections and diseases

Becoming more sex-positive doesn’t mean we’re only open to talking about the good parts of sex. If we want to foster a better understanding of sexual health, we need to change the conversation around sexually transmitted infections and diseases—because the current one is dangerous.

Sexually transmitted infections and diseases (STIs and STDs) are heavily stigmatized. We don’t want to talk about them, we don’t want to hear about them, and we definitely don’t want to contract them. Fair enough—STIs and STDs can have serious health implications. But if we’re not participating in and listening to conversations about them, we’re at a higher risk to be impacted by them.

It’s difficult to know what language to use when referring to sexually transmitted pathogens.

While ‘STI’ first cropped up in the 1980s, it wasn’t until recently that medical professionals and sexual health advocates started to push for its use over ‘STD.’ One of the reasons for this move is scientific: the pathogens that result in infections don’t always cause disease. Simply put, the virus or bacteria can linger in your body—causing an infection—without inspiring symptoms, which would qualify it as disease. It turns out that STI and STD aren’t perfect synonyms despite their similarities.

The shift from STD to STI also marks a surface-level effort to destigmatize these conditions. The idea is that, by labelling these as ‘infections’ rather than ‘diseases,’ it better motivates people to get tested or seek treatment. It is thought that ‘disease’ is a more stigmatized word—which is another problem in itself—and in shifting away from that language, people will feel less ashamed to speak about their experiences with them or less afraid to seek medical help. There’s no consensus among the medical or public health communities as to whether this shift in language actually accomplishes anything toward destigmatizing STIs and STDs, though.

For the sake of clarity, moving forward, I’m going to stick with the term STI. But whether or not we’re labelling them as diseases or infections, the stigma surrounding STIs is rooted far deeper than the terms we use to describe them.

Our discomfort around STIs undeniably has to do with how they’re transmitted. Hundreds upon hundreds of years of stigma around sex and sexuality has bled into our perceptions of these infections and diseases, and we—rather arbitrarily—view them as socially unacceptable. HIV/AIDS, for example, is still associated with stigma rooted heavily in homophobia.

At the end of the day, we just don’t hold the same repugnance for the common cold or strep throat that we do for STIs.

We’re watching a very similar social phenomenon unfold right in front of us with COVID-19. Contracting the virus is something that has been stigmatized, in part because of the health risks it presents to the carrier and others, and because we make assumptions about how a person has been infected. We’ve drawn a connection between contracting COVID-19 and flaunting necessary public health guidelines when that’s not always the case. This happens with STIs as well; assumptions are made about a person’s sexual health practices, like whether or not they are engaging in casual sex with multiple partners or using condoms.

The reality is that STIs are surprisingly prevalent, and even the most rigorous safe sex practices don’t always offer perfect protection. That’s not to say that those of us who are imperfect in our sexual health practices deserve to face stigma—we don’t shame people who accidentally contract the flu or Lyme disease, even if they weren’t doing everything they could to protect themselves.

While, ethically, we shouldn’t blame sick people for being sick, everyone has an obligation to do what they can to reduce the spread of bacteria and viruses. But the way to achieve this isn’t through shame—in fact, the stigmatization of STIs only contributes to their spread. If people feel afraid to get screened, they may unknowingly pass pathogens onto others. If they have symptoms but are too embarrassed to see a doctor, they could damage their health. If someone fears being shamed, they may not take the necessary step to inform their partner(s) of their potential to pass on an STI.

The most effective way we can go about preventing these situations from occurring is to normalize talking about STIs like we would any other infection. Yes, that’s easier said than done: sex is viewed as an inherently private thing, and it can feel awkward talking about it. But normalizing STIs doesn’t have to mean divulging details about your health and sex life. It could be as simple as adopting a more sex-positive stance in your interactions with other people or supporting your friends when they get a diagnosis.

Normalizing STIs doesn’t understate the importance of safe sex. If anything, it promotes it.

Without the shame and silence around STIs and proper sexual health education, people will be empowered to be proactive, get tested, and inform their partners. If we destigmatize STIs, people aren’t going to be rushing out to get them—and we’ll be keeping ourselves safer if we do contract them.

sexual health, STIs

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