We Can Do Better as Educators and Clinicians: Part II
We are not effectively reducing STD rates, because we are not effectively tackling one of the main issues: stigma.
Jenelle Marie Pierce, The STD Project
May 5, 2017
This is Part Two of a two part series by Jenelle on stigma and how we talk about sexual health. Check out Part One here!
How we talk about sex in STD awareness campaigns needs to change, but let’s not stop there. Throughout the testing and treatment process, we are also failing people. When the few who come in to get tested or reach out to ask questions about exposure, risk reduction, symptoms, and treatment, we infuse our already sterile environments with more sterile conversations by using language like: “always use a condom,” “get tested before and after every new partner,” “never engage in sexual activities with someone who’s status you don’t know.” I understand where this language is coming from, because we want to emphasize the importance of and strongly encourage the benefits of safer sex while instilling sexually healthy practices when we can, but what we don’t get is that we aren’t being heard.
When we talk to people from this authoritative, unrealistic platform, they stop listening immediately, because they think we don’t get it. Our advice is impractical, impersonal, and it’s not for them. Instead, I think we can be especially mindful to remove the absolutes should, always, and never from most discussions we have about STDs, prevention, and safer sex. It is not up to us, despite our vast array of knowledge and understanding about these things, to tell someone what they should be doing with their bodies. Instead, we can arm them with knowledge to help them make the decisions that are right for them and their partners.
That fact is that most people get an STD at some point, even when/if they use safer sex methods. Let’s empower our patients, our listeners, and the public.
Try, “If you’d like to reduce your risk as much as possible, here are the things you can incorporate into your sex life.” Then resist the urge to use the words always and never. You don’t have to compromise your thorough approach, just adapt your language to be more understanding and inclusive of different choices and risk assessments.
Instead of “always use a condom for all sexual activities” try “if you’d like to reduce your risk, using a condom for manual (hand jobs), oral (going down on), and penetrative sex (vaginal and anal) is a great way to reduce your exposure to things that can be transmitted through bodily fluids as well as helping a little bit to reduce your risk for things that can be transmitted through skin to skin contact.”
You could follow that with, “It’s up to you and your partner or partners to decide which risks you’re willing to consider and which safer sex practices are going to be right for you. STDs are very common, and most people contract one at some point in their lives, but because they can’t all be tested for and most people don’t know they have one because they don’t show signs or symptoms, it’s important to know all of the options available to you.”
This is lengthy, and it requires more work than simply telling people to always use barriers, to get tested all of the time, to never use substances when engaging in activities, to limit their partners and talk to all of them about sexual health, to always use lube…… But people aren’t following that advice. So, let’s meet them where they are instead. I would posit that it’s less important if they are choosing to use fewer safer sex practices than you might advise than if they don’t understand the likelihood of contracting an STD. That fact is that most people get an STD at some point, even when/if they use safer sex methods. Let’s empower our patients, our listeners, and the public. We can be accurate and practical, we can share facts without being fear mongers, and we can reduce the spread of STDs by reducing the public’s fear of them, but we have to address the stigma problem first.
Disclaimer: The views and opinions expressed in this blog are those of the author(s) and do necessarily reflect the position of the National Coalition of STD Directors (NCSD). Any medical advice contained herein should not be used to substitute for sound medical guidance. Please talk to your health care provider before making any medical decisions.