A theoretical discussion of the impact of stigma on psychological adjustment to having a sexually transmissible infection

This paper provides a discussion of the utility of stigma theory as a conceptual framework for the interpretation and analysis of the psychological impact of contracting a sexually transmissible infection (STI). Most particularly, it focuses on those viral infections that cannot be medically cured, such as genital herpes and genital human papilloma virus. Recent research in the area of STIs suggests that the stigma associated with these conditions can hinder psychosocial and sexual adjustment post-diagnosis, and provides support for the use of stigma theory as a conceptual framework with which to analyse these experiences. This paper defines the concept of stigma and presents a theoretical overview of the process of stigmatisation. Three dimensions of stigma relevant to the experience of having a STI are then presented: the degree of concealability of the condition including the social consequences of concealing a condition; the origin of the condition; and the degree of peril presented by the condition. An overview of the way in which the presence of a stigmatising condition such as a STI may affect a person’s feelings of self and his/her intimate relationships is then presented. Finally, the implications of stigma theory as a conceptual framework for guiding future research in the area of personal and interpersonal reactions to STIs is discussed.

Sexually transmissible diseases, sexual factors and prostate cancer: A review of literature

A review of literature was carried out regarding sexually related factors, sexually transmissible diseases (STD's) and infections with prostate cancer (PC) development risk. The review of literature, in conjunction with the tabulation of studies, suggested that ejaculation and circumcision may play a protective role in the development of PC and that multiple sex partners and an active sex life may play a causal role in the development of PC which may negate and counteract the protective effects of ejaculation and circumcision. HIV infection may plausibly play a function in deteriorating and compromising immune controls on carcinogenesis. Because of the coexistence of a highly active sexual lifestyle and sexual promiscuity with the growing occurence of STD's, their maybe a correlation with the high incidence of prostate cancer in the United States. Potential multi-institutional studies are warranted to confirm the high incidence of this neoplasm with the increasing cases of STD's and if in fact there is a proportional association to further elucidate the factors responsible for its high incidence.^

Candidaemia or Candidasis: Controversy of Staphylococcus Sexually Transmitted Infection?

Herbal medications are becoming increasingly popular but a most-extraordinary claim by traditional/herbal medical practitioners relates to a Gram-positive bacterium, Staphylococcus , which has been depicted as a deadly sexually transmitted disease that manifest in the form of worms and other symptoms; with contributory roles including infertility, sexual dysfunction and impotency. They further boasted that they are the only ones that possessed the remedy (herbal) for the Staphylococcus sexually transmitted scourge. In the absence of distinguishing phenotypic taxonomic tools, Staphylococcus and Candida spp. may be confused for each other. However, Staphylococcus is a bacterium and not an infection; therefore, there must be more to the traditional medical practitioners’ boasts in ability to cure an infection that was not an infection in the first place. In conclusion, the common sense is that candiaemia or candidiasis is most likely the misdiagnosed sexually transmitted Staphylococcus disease, which is of significant human clinical health issue.

HtrA, RseP, and Tsp do not elicit a pathology related serum IgG response during sexually transmitted infection with Chlamydia trachomatis

Chlamydia trachomatis sexually transmitted infection can cause serious reproductive morbidities. This study determined the prevalence of serum IgG response to C. trachomatis putative stress response proteins in females to test for an association with genital tract pathology. There was no significant association of serum IgG to HtrA, Tsp, or RseP with infection or pathology. cHSP60 serum IgG prevalence was significantly associated with infection compared to negative (infertile) controls (p = 0.002), but not with upper genital tract pathology. Serum IgG1-4 antibody subclasses reactive with the antigens was not significantly different between cohorts, although different responses to each antigen were detected.

Predictors of sexually transmitted infection in Australian women : evidence from the Australian longitudinal study on women’s health

This longitudinal study examined characteristics of women diagnosed with sexually transmitted infections (STI) for the first time in their later 20s and early 30s. Participants were 6,840 women (born 1973–1978) from the Australian Longitudinal Study on Women’s Health. Women aged 18–23 years were surveyed in 1996 (S1), 2000 (S2), 2003 (S3), and 2006 (S4). There were 269 women reporting an STI for the first time at S3 or S4. Using two multivariable logistic regression analyses (examining 18 predictor variables), these 269 women were compared (1) with 306 women who reported an STI at S2 and (2) with 5,214 women who never reported an STI across the four surveys. Women who reported an STI for the first time at S3 or S4 were less likely to have been pregnant or had a recent Pap smear compared to women reporting an STI at S2.Women reporting a first STI at S3 or S4 were less likely to have been pregnant or had a recent Pap smear compared to women reporting an STI at S2. Women were more likely to report an STI for the first time at S3 or S4 compared to women not reporting an STI at any survey if they were younger, unpartnered, had a higher number of sexual partners, had never been pregnant, were recently divorced or separated, and reported poorer access to Women’s Health or Family Planning Centres at S2. These findings demonstrate the value of longitudinal studies of sexual health over the life course beyond adolescence.

Guided reflection: transcending a routine approach in the management of sexually transmissible infections

This paper describes a distinctive approach to the sexually transmissible infections (STI) clinical consultation: 'the guided reflection approach'. The authors coined this term and identified the guided reflection approach through analysis of 22 in-depth interviews with practitioners who provide care for people with STI, and 34 people who had attended a healthcare facility in Australia for screening or treatment of an STI. A grounded theory method was used to collect and analyse this information. The data revealed when the STI consultation is conducted using the principles characterized by the guided reflection approach creates contexts for sexual empowerment that have the potential to effectively assist people to gain autonomy for safe sex. Routinely, most of the practitioners in this study were shown to direct the STI consultation towards risk behaviours and practices and prevention of transmission, with minimal intervention. However, this study shows that if clinical interaction is to make a difference to the patient's autonomy for sexual behaviour, two changes will be required. First, practitioners need to adopt the goal of assisting patients to attain levels of autonomy, and second, practitioners require education to assist them to develop the interactive skills needed to engage patients in dialogue and reflection about sexual behaviour.

The impact of stigma on couples managing a sexually transmitted infection

Recent research has indicated that the stigma surrounding sexually transmitted infections (STIs) creates a psychological and emotional burden for individuals with these conditions. It would be expected that the stigma of having a STI would also alter the dynamics of an intimate relationship. This paper reviews the literature on the impact of STIs on intimate relationships, and considers the relevance of this research to both clinicians and researchers. In particular, the types of relationships in which the presence of a STI may have a varying degree of impact are examined. Since disclosure of a STI would also be expected to impact on a relationship, an overview of the factors involved in the disclosure of a STI to a partner is also considered. Finally, the implications of this research for both clinicians and researchers are discussed.

Effects of sexually transmitted infection status, relationship status, and disclosure status on sexual self-concept

Research has indicated that having a sexually transmitted infection (STI) such as genital herpes and genital human papilloma virus (HPV) can have a negative impact on an individual's sexuality. The current study was designed to evaluate the effect of STI status, relationship status, and disclosure status on various dimensions of sexual self-concept. A questionnaire that evaluated the above variables was completed by 117 individuals with genital herpes, 82 individuals with HPV, and 75 individuals with no STI. The results demonstrated that having herpes or HPV had a significant negative impact on aspects of sexual self-concept. It does not appear that an individual's relationship status is a factor associated with the impact of having an STI on the sexual self-concept. Respondents who had disclosed their STI to their partners, however, had significantly more positive feelings about aspects of their sexual self-concept than those who had not disclosed their STI to their partners. The implications of these research findings for health practitioners are discussed.

General practitioner and the control of sexually transmissible infections

Sexually transmissible infections (STIs), one of the major preventable health problems affecting the Australian population, are often asymptomatic and, if undetected, can cause sub-fertility, infertility and chronic morbidity. In addition to these significant and costly consequences, STIs increase the risk of transmission of HIV. Given that 80% of Australian patients attend their General Practitioner (GP) each year, GPs are well placed to have a significant impact on STI transmission by diagnosing and treating both asymptomatic and symptomatic disease. Good professional practice would suggest that all GPs will undertake certain actions when they are consulted by a patient who either has symptoms of an STI or who appears to be at risk of acquiring an STI. This expectation is based on the premise that all GPs share the same detailed knowledge of STI risk factors and symptoms. It assumes that they will have no difficulty in eliciting such information from the patient, that the patient will comply with STI testing and treatment and that the patient will return for follow-up, to ensure that they and their sexual partners have been adequately treated. Given the constraints of the real world in which general practice exists, the sensitive nature of sexual health, and the stigma associated with STIs, there are many barriers to achieving such an outcome. My own previous research has highlighted some of the difficulties experienced by GPs in the area of STI control. This study has used data from four different sources (policy and stakeholder documents, literature, key informant interviews and my own past research) to examine ideal practice and actual practice in the prevention and treatment of STIs. A number of discrepancies were identified, and from these arose a series of recommendations for ways of making STI control in general practice less complex. To ensure that the results of the study were firmly embedded in the reality of general practice, comments on the recommendations were sought from GPs employed in a variety of practice settings, including those with low STI caseloads. These comments were used to modify the recommendations to ensure they would offer a practical and effective contribution to STI control in Victoria.

Being diagnosed with a sexually transmitted infection (STI): sources of support for young women

BACKGROUND: Sexually transmitted infections (STIs) are prevalent throughout the world with the rate of these infections increasing on a daily basis. STI acquisition has the ability to cause personal adversity and elicit feelings of stigma and shame. AIM: The aim of this paper is to report on the sources of support young women who acquired STIs drew on to overcome their associated adversity.

METHODS: This study utilised a feminist qualitative methodology.

FINDINGS: Findings revealed that the women drew on both personal and anonymous sources of support.

CONCLUSION: Nurses and other health-care professionals need to be equipped with knowledge and strategies to promote personal wellbeing and minimise the adversity felt among people having acquired these infections.