Association of sexually transmitted disease-related stigma with sexual health care among women attending a community clinic program

Sex Transm Dis. 2008 Jun;35(6):553-7. doi: 10.1097/OLQ.0b013e3181685855.


Objectives: The objective of this study was to assess the association of sexually transmitted disease (STD)-related stigma on sexual health care behaviors, including Papanicolaou smears and STD testing/treatment, among women from a high-risk community.

Methods: Descriptive statistics were used to assess the association of demographics, sexual and drug-related risk behaviors, and 3 measures of STD-stigma (internal, social, and tribal stigma, the latter referring to "tribes" of womanhood) with sexual health care in the past year. Pearson's chi-square test and Mann-Whitney test were used to assess significance. Multivariate logistic models were used to determine the association of STD-stigma with sexual health care after controlling for other factors.

Results: Lower internal stigma score was marginally associated with reporting an STD test in the past year [median score (interquartile range) for those reporting and not reporting an STD test were 0.79 (0.30-1.59) and 1.35 (0.67-1.93), respectively]. In an adjusted model, internal stigma retained a negative association with reporting of STD testing in the past year (adjusted odds ratio, 0.92; 95% confidence interval, 0.85-0.99).

Discussion: Most women had received a Papanicolaou smear in the past year, and none of the STD-stigma scales were associated with reporting this behavior. Internal stigma retained an association with not having any STD test or treatment. Although sexual stigma is a deeply rooted social construct, paying attention to how prevention messages and STD information are delivered may help remove one barrier to sexual health care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Ambulatory Care
  • Canada / epidemiology
  • Community Health Services / statistics & numerical data*
  • Female
  • Humans
  • Mass Screening / methods
  • Papanicolaou Test
  • Patient Acceptance of Health Care
  • Sexually Transmitted Diseases / diagnosis
  • Sexually Transmitted Diseases / epidemiology
  • Sexually Transmitted Diseases / prevention & control*
  • Sexually Transmitted Diseases / psychology*
  • Stereotyping*
  • Vaginal Smears