Let’s talk about sex…ually transmitted infections
Author: Yaoying Lin | Vice President of Operations
Chlamydia. Gonorrhoea. Syphilis. Genital herpes. Pause here and take a moment to reflect on your initial reaction upon reading those words.
In 2017, Melbourne, Sydney and Adelaide ranked 17th, 47th and 58th respectively as the most sex-positive cities in the world. Two years later, a sexual health survey published by the University of New South Wales found that only 36.5% of respondents believed that their friends would support them getting tested for sexually transmitted infections (STIs). For a country that supposedly leads the world in our positive and judgement-free attitudes towards sex, that’s an extremely disconcerting figure. It reveals a persistent stigma surrounding the topic, which can isolate and paralyse the 4 million Australians that report having an STI at some point in their lifetime.
Source: https://www.google.com/url?cd=vfe&psig=AOvVaw21yX72HPguOMPI2jC-o8_T&sa=i&source=images&url=https%3A%2F%2Fwww.today.com%2Ftmrw%2Fsti-stigma-how-we-were-taught-be-ashamed-instead-educated-t191595&ust=1618838429832000&ved=0CA0QjhxqFwoTCKCE5bDxh_ACFQAAAAAdAAAAABAD
The Consequences of STI Stigma
If you were sick in bed with an awful throat infection, would you tell your friends and family? The answer is probably a yes. Now let’s change the situation and pretend that you had just been diagnosed with genital herpes – would your answer remain the same?
“Sexually transmitted infections should not be treated any differently from other infections.”
The topic of STIs is one that is often swept under the carpet and talked about only when it can no longer be avoided. Although many people get tested when they notice symptoms such as abdominal pain, sores or painful urination, the asymptomatic nature of many STIs mean people often go on to infect others before they find out themselves. In general, women are more likely to be asymptomatic than men; it is estimated that chlamydia symptoms are exhibited in only 25% of women compared to 50% of their male counterparts. Upon diagnosis, most STIs can be easily treated, but when they fly under the radar, they can cause a range of long-term health problems including:
Cervical cancer - associated with certain types of human papillomavirus infection
Pelvic inflammatory disease, which can lead to infertility, chronic pain and cause ectopic pregnancies - associated with gonorrhoea and chlamydia
Damage to major organs such as the brain, heart and liver - associated with syphilis
“Chlamydia is the leading cause of infertility in women in Australia which is depressing because it’s really preventable.”
Source: https://browngirlmagazine.com/2018/02/violated-hopes-my-struggle-to-report-on-female-genital-cutting-in-pakistan/sealed-lips-1/
In the hyperconnected world that we live in, the stigma surrounding STIs can be incredibly dangerous. According to the most recent national health data from the Kirby Institute, the rates of chlamydia, gonorrhoea and syphilis increased substantially in 2018. Whilst testing rates have risen, they fall behind the surge in diagnoses, providing evidence for increased transmission of these infections. In an attempt to explain why these rates are rapidly rising, one factor that experts are pointing the finger at are dating apps. Indeed, in a world where apps like Tinder, Hinge and Bumble have broadened our dating networks beyond local or even national boundaries, the stigma, shame and fear attached to STIs can prevent people from being honest with new sexual partners. This leaves them to get tested of their own volition to discover that they’ve contracted an STI - potentially after they’ve infected others.
Source: https://news.sky.com/story/dark-side-of-online-dating-crimes-rise-by-300-in-five-years-11073230
The Global Landscape
When we pan out from Australia, it’s clear to see that STIs are a persistent and endemic health threat globally. According to data released by the World Health Organisation, more than 1 million new cases of STIs are diagnosed every day, with 75-85% of annual new cases occurring in low-income countries.
In Australia, accurate STI testing is easily accessible. Patients can simply visit the doctor or a sexual health clinic to get tested, often free of charge. The process is straightforward, where the type of STI test that the individual receives depends on their personal situation. If they test positive, most infections can be cured with a simple antibiotic or antifungal treatment. If the infection is not curable, it can be managed with ongoing medical treatment.
Unfortunately, the same cannot be said for individuals in many low- and middle-income countries, where STI prevalence is traditionally the highest. Barriers such as long wait times, geographical inaccessibility and high healthcare costs prevent patients from accessing public health services. Instead, surveys conducted in these countries have shown that upon recognising STI symptoms, nearly half of the participants chose to seek treatment from street drug vendors, traditional healers and unqualified practitioners. In addition to being more accessible, convenient and cheaper, they also report that these private sector businesses are often less judgemental about this heavily stigmatised topic. What they may not consider, however, is that these businesses are often poorly trained in diagnosing and treating STIs, resulting in delayed and inadequate care which, in turn, can cause long-term health complications.
Source: https://www.borgenmagazine.com/prevention-of-sexually-transmitted-diseases-in-developing-countries/
Let’s do more, because we can
Source: https://www.teachhub.com/classroom-management/2019/05/classroom-management-for-an-effective-learning-environment/
We are extremely fortunate to live in a country with affordable, rapid and effective STI diagnostic and prevention tools. Indeed, a key success that was realised under the Third National STI Strategy was becoming the first country to document substantial declines in HPV infection, genital warts and cervical pre-cancer due to our human papillomavirus vaccination program. However, despite our undeniable progress in STI management as a nation, there is still more work to be done.
In particular, the social stigma of STIs poses a significant barrier to people accessing early testing and treatment that could potentially save their lives. As the government works to break down this stigma through the implementation of STI prevention education initiatives and relationship and sexuality education in schools, we too, can help. We have the responsibility to educate ourselves and promote honest and healthy conversations around this topic. We need to work towards a society where having an STI possesses exactly the same amount of stigma as having the flu – none.
Additional Resources
For Unimelb students, you can book a free STI test through the University of Melbourne’s website: https://services.unimelb.edu.au/health/our-services
For those outside of Unimelb, reach out to your GP, sexual health clinic, family planning clinic or women’s health centre to get tested.