STI Awareness Month: Talk the Talk and Pee in a Cup

Some time ago I wrote a short letter that cheekily called on more people to “pee in a cup” (primarily to test for chlamydia). I pointed out that – along with lack of health insurance – social barriers like stigma and lack of awareness keep many individuals from seeking the sexual healthcare they need.

I’ve been asked a number of times just what I meant by “social barriers” to healthcare, and how in the world does stigma really keep someone from entering a clinic?

To be sure, there are plenty of reasons we might put off seeking any sort of clinic visit; images of cold instruments and sharp needles are hardly inviting. Think of how often we avoid going to the dentist or getting a flu shot…

With care related to sexual health, you have all that plus the fact you’re dealing with issues “down there.” It can be difficult to even talk about such things, and the worry that we might get unwanted news or perhaps even be judged as “dirty” can no doubt keep us out of the clinic. It’s not just patients who get caught up in this, either; healthcare providers are not immune from being uncomfortable when it comes to S-E-X. Also, we (and our providers) may simply think STIs happen only to other people, and we aren’t at risk.

That mix of detriments at least partly explains why screening rates for infections like chlamydia, gonorrhea, and HIV remain less than optimal. We can do better.

The impact of STIs is no small matter. There are an estimated 19 million new cases each year, most of which don’t involve tell-tale signs. Testing is crucial: For example, HIV treatment regimens work better when started early, and untreated chlamydia and gonorrhea can lead to chronic pelvic pain and infertility in women (and sometimes does a number on males, too).

But how do we “normalize” sexual health and related care?

• A start is to support and encourage providers to follow guidelines that bring STI testing and prevention into routine care. This involves annual chlamydia testing for all sexually active females under age 26 and giving HPV and hepatitis B vaccines to all adolescents and young adults. Making this all “routine” also changes the mindset about sexual healthcare.
• Patients also have responsibilities to know what they need and to insist on it. Your clinician has never brought up STI and HIV testing? You do it. Are you (or your child) in the age group for which HPV vaccines are approved? Ask for them.
• Parents who might understandably cringe at the thought of their teens becoming sexually active should be gently reminded that, yes, your kids have hormones and the correct body parts to do the deed…and they will. Talk to them about how to resist pressure to have sex before they’re ready, but also teach them how to protect themselves.

I want to hear your thoughts, too. What do you think we can do to get past the awkwardness that often tags along with any discussion of sex and reproductive health? How do we talk to parents, teens, health professionals, and patients? What would YOU like to learn about? Contact us!

Stay healthy!

–Lynn Barclay
ASHA President and CEO

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