Debunking Stigmas Around STIs

SHOP addresses STI increase in UCSC community

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College campuses are places where people interact with new environments and ideas. They also provide a space to explore one’s sexuality.

“College permits a lot of space for exploration in fields of polyamory and hookups,” said third-year student Maria Vega in an email.

As stigmas around having multiple partners break down, students are confronted with a different stigma: sexually transmitted infections (STIs).

Increased testing by the UC Santa Cruz Student Health Center has revealed that UCSC is following the nationwide rise in STIs. The Center for Disease Control and Prevention (CDC) reported that positive test rates for gonorrhea rose 13 percent nationally between 2014-15. On campus, one in every 100 tests was positive for gonorrhea in 2015-16, while 2014-15 saw just one in 200 positive results. This is likely due to an increase in both on-campus testing and nationwide STI rates.

What is an STI?

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STIs are communicable infections that are transferred by bodily fluids, including blood, saliva and semen.

While still widely known as sexually transmitted diseases (STDs), the term STI is more encompassing, because while diseases always show symptoms, infections do not, said nurse practitioner and patient care coordinator at the UCSC Student Health Center Beth Hyde.

“If we wait for somebody to have symptoms, we are way far gone. Chlamydia, which is the most common STI in the country, almost never has symptoms for women, and only about a third of men get symptoms,” Hyde said. Although chlamydia is the most common STI in the country, rates are just rising in line with nationwide increases. Gonorrhea, on the other hand, is spiking on the UCSC campus.

Gonorrhea is also developing resistance to antibiotics, according to the CDC, making it more difficult to treat than chlamydia.

Because few people show symptoms for chlamydia, it is often not caught until later stages when treatment is less effective.

Culture of Connection

Rates of STIs among 15 to 24 year olds have always been higher in comparison to other age groups. The Office of Disease Prevention and Health Promotion attribute this to different accepted sexual practices among this age group. Satveer Kler, a third-year student and CARE intern who stressed their opinions don’t necessarily reflect those of CARE, said from their experience, college students tend to be more accepting of and willing to participate in nontraditional relationships, like polyamory and noncommittal relationships.

“College students are more aware of different types of relationships and intimacy and seek happiness with the forms that make the most sense given their unique contexts and experiences,” Kler said in an email. “[…] Social media plays a role in contributing to hookup culture on college campuses by allowing for easier communication about wants, needs and desires.”

Because social media provides a massive platform for people to meet, Hyde says these new connections may have contributed to the recent spike in STI rates.

“Social media has changed how people are actually sexual and how they find and participate in sexual activity,” said nurse practitioner Beth Hyde.

Hyde explained communities on- and off-campus, which traditionally did not come into contact as frequently, have broken down barriers through the use of social media. She said students are now likely to have more sexual partners who are both students and non-students.

Hyde thinks dating apps may give users the ability to meet more local potential partners. Having more partners in a shorter time frame may spread STIs faster if communication is lacking. This creates issues when tackling the rise of STIs in the student population at UCSC because it’s not an isolated pool of people.

Kler, who identifies as a queer person of color, said social media can also be beneficial for underrepresented groups when looking for partners. When combined with conscious decision making and thorough discussion about safe sex, it can be a way to find new relationships without fear of retaliation.

“[Social media] allows you to know those who hold similar attractions to yours without fear for approaching someone in person who may or may not hold those attractions,” they said.

Testing

Testing on campus nearly doubled over the last three years from 1,700 students in 2013 to 3,000 students in 2016. But even with this increase, only around 17 percent of the total student population was tested by the Student Health Center in 2016. This statistic does not include testing by off campus resources like Planned Parenthood and other medical groups.

“While testing for STIs has risen dramatically, we are still not reaching our goal of annual STI testing for all sexually active adults under the age of 25,” said nurse practitioner Beth Hyde. “[…] If you need to be tested we want you to be tested.”

Hyde also discussed the importance of testing the parts of the body used during sexual activity. A urine test will likely not show gonorrhea in the rectum or throat. Last academic year, the Student Health Center began prioritizing rectum and throat testing for gonorrhea.

Being able to openly discuss STI testing with your partner is just as important as getting tested, but because of stigmas, sometimes it can introduce tension, said third-year student Nekeisha Barnett Mcneil. She has found that asking people if they have been tested can be a source of contention.

“Men who I’ve hooked up with [are sometimes] outraged when I asked them if they’ve been tested lately,” Barnett Mcneil said in an email.

Normalizing STIs

“I think there are definitely stigmas around STIs. It somehow equals ‘you were unsafe, you weren’t being smart, you were being reckless,’” Barnett Mcneil said in an email. “ […] When [having an STI is] stigmatized, you don’t want to talk to your partner about it.”

One of the hardest parts about tackling this rise in STIs is dismantling the stigma, said senior health educator for Student Health Outreach and Promotion Program (SHOP) Ali Hayes.

Students say one of the most difficult parts about receiving a positive STI test is talking to their partner(s) about the results, said Chancellor’s Undergraduate Internship Program (CUIP) education coordinator for SHOP Maya Novak-Herzog. Stigmas surrounding STIs can pose a larger burden than the actual treatment of the infection because students worry how they will be perceived for having an STI.

“By normalizing STI testing as a regular part of our health care routine and by bringing it up with partners as easily as you would a cold, we can make this campus a more welcoming place for everyone,” Novak-Herzog said.

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This involves eliminating language that perpetuates stigmas such as the idea that someone without an STI is “clean,” which implies that someone with an STI is “dirty.” Novak-Herzog said changing the dialogue around getting tested can also help to normalize testing and integrate it into personal health care practices.

“The way in which people frame STIs is a lens of ‘clean’ or ‘dirty.’ Many [students with STIs] feel dirty. They feel like no one will love them,” Hayes said. “They feel a devastation about a communicable disease that you do not feel when you get the flu or chickenpox.”

Third-year student Maria Vega said she thinks having an honest discussion about STIs can even strengthen the bond between two people.

“[Talking about an STI] could even further the trust within the relationship of particular individuals, knowing that your partner is honest and open about something seen as so ‘dirty’ within our culture,” Vega said in an email. “It means that they would rather keep the other parties safe and let them know about it even though it is stigmatized.”