title: Relationship of STD-related shame and stigma to female adolescents' condom-protected intercourse.
abstract: OBJECTIVE
  Shame and stigma associated with sexually transmitted diseases (STDs) are barriers to adolescents seeking prompt and appropriate diagnosis and treatment. However, little is known about how these constructs are related to STD-protective behaviors, such as condom-protected intercourse. Thus, we prospectively examined the relationship between shame and stigma and condom use in adolescent females.
  
  
  METHODS
  There were 192 African American females age 17.4 +/- 1.7 years (range 15-21 years) recruited for the study from local teen-oriented health clinics. At baseline, participants completed demographic and psychosocial measures (including STD-related shame and stigma), and chart- or laboratory-confirmed history of STDs was obtained. At 6 months follow-up, rate of condom-protected intercourse in past 14 days was assessed. Participants' baseline shame and stigma scores, prior history of STDs, and select demographic and theoretically important psychosocial variables were entered into a hierarchical linear regression model to predict condom-protected intercourse in the 14 days prior to the 6-month follow-up assessment.
  
  
  RESULTS
  After controlling for variables identified in bivariate correlations, STD-related shame was significantly predictive of condom-protected intercourse in the 14 days prior to follow-up, with higher shame predicting higher rates of condom-protected intercourse.
  
  
  CONCLUSIONS
  Future prevention efforts attempting to reduce adolescents' risks for STDs and HIV may benefit from addressing STD-related shame and stigma in addition to explicitly linking health-promoting behavior changes (condom use) to a decreased likelihood of future infection with STDs.
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA. jmcderm@emory.edu
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Sales
authors.forename: Ralph J
authors.initials: RJ
authors.lastname: DiClemente
authors.forename: Eve S
authors.initials: ES
authors.lastname: Rose
authors.forename: Gina M
authors.initials: GM
authors.lastname: Wingood
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Klein
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Woods
mesh_terms: D015492:AIDS Serodiagnosis; D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology* / Q000523:psychology; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000704:Analysis of Variance; D017280:Condoms / Q000706:statistics & numerical data*; D003268:Contraception Behavior / Q000208:ethnology* / Q000523:psychology; D005260:Female; D005845:Georgia / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D015995:Prevalence; D012044:Regression Analysis; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control* / Q000523:psychology; D012752:Shame; D012959:Socioeconomic Factors