“That’s the whole thing-to get rid of it”:Stigma, Sexually Transmitted Infections and Attendance at the GUM Clinic
Ellen Mulholland, Clinical Nurse Specialist/Health Adviser
Hartlepool General Hospital
Tel: 01429 522577
If the research work is complete, when was it completed?
Summary of research topic
Previous research has identified many barriers that inhibit the uptake of sexual health screening which include fears of embarrassment, perceptions of stigma and perceived invulnerability as a function of stereotypical beliefs surrounding the risks of contracting sexually transmitted infections STI’s (Holgate & Longman 1998, Meyer -Weitz et al 2000). However little is known about the health seeking behaviours of those at risk as psychological research in this area is lacking.
Employing a theoretical sampling technique, this qualitative study utilised a phenomenological interpretative approach to interview ten patients (5 female/5 male) with an age range of 18-28 years (mean age: 22 years) attending a Genito-Urinary Medicine clinic. The aim being to explore their perceptions of sexual health screening, to ascertain whether these perceptions are endorsed by the Theory of Planned Behaviour (TPB) (Ajzen 1985, 1991), and to identify any gender differences.
Burnard’s (1991) stage method of thematic analysis identified seven salient themes which were all dominated by perceptions of stigma:
- Stigma surrounding STI’s
- Fear of exposure
- Reluctance to attend
- Relationship issues
- Perceived invulnerability
The findings suggest that perceptions of contamination seemed to underlie motivation to attend despite the perceived barriers. Significant gender differences were also identified. The TPB cannot account for these findings.
In support of previous research this study has demonstrated that sexual health screening does take place against a prevailing sexual (patriarchal) ideology that plays a major role in the social construction of barriers to sexual health care especially for women. Although the medical profession and the government are recommending destigmatisation of STI’s and GUM clinics (Foley & Patel 2001, DOH 2001) which ironically they have played a role in creating, it is possible that this stigma is motivating individuals to attend.
The participants of this study all voiced a real reluctance to attend the GUM clinic and described the psychological discomfort that they experienced as a result of stereotypical notions surrounding STI’s and the GUM clinic. However, although destigmatisation of GUM clinics would be a positive action to lessen this discomfort which might make it easier for individuals to attend, it could be argued that the active voices of the participants in this study demonstrated that the desire to “get rid” of the perceived contamination associated with the stigma of STI’s, may have paradoxically facilitated their attendance over and above the personal and organisational obstacles.
Should STI’s therefore be destigmatised ? Further psychological research is essential in order to address this question as there are huge implications for health promotion/massmedia campaigns, governmental policies, aswell as professional practice.