title: Relationships between perceived STD-related stigma, STD-related shame and STD screening among a household sample of adolescents.
abstract: BACKGROUND
  Important barriers to STD testing may include individuals' perceptions of STD-related stigma (negative societal attitudes toward STD infection) and expectations of STD-related shame (negative personal feelings) that would result from a positive STD test. Obtaining a clear understanding of the relationship between STD-related stigma, STD-related shame and STD testing may help inform programs and policies aimed at reducing STD transmission.
  
  
  METHODS
  Measures derived from previously published scales were used to assess perceived STD-related stigma, anticipated STD-related shame and receipt of an STD test in the past year in an urban, household sample of 594 sexually active 15-24-year-olds interviewed in 2004-2007. Logistic regression was used to examine associations between recent STD testing and perceived stigma, shame and other participant characteristics.
  
  
  RESULTS
  Thirty-seven percent of males and 70% of females reporting having had an STD test in the past year; the largest proportions of tests (42% among males and 59% among females) had occurred in the context of a routine health care visit, not because adolescents had had disease symptoms or were concerned about exposure to infection. For both males and females, the level of STD-related stigma was negatively associated with the odds of having been tested (odds ratio, 0.5 for each). STD-related shame was not related to STD testing.
  
  
  CONCLUSIONS
  Adolescents who view STDs as stigmatizing have a reduced likelihood of being screened, but it is unclear whether this relationship reflects their care seeking or providers' practice of offering STD screening at a routine health visit.
authors.affiliation: Sociometrics Corp., Los Altos, CA, USA. shayna.cunningham@gmail.com
authors.forename: Shayna D
authors.initials: SD
authors.lastname: Cunningham
authors.forename: Deanna L
authors.initials: DL
authors.lastname: Kerrigan
authors.forename: Jacky M
authors.initials: JM
authors.lastname: Jennings
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Ellen
mesh_terms: D000293:Adolescent; D015142:Baltimore; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000523:psychology*; D012752:Shame; D013240:Stereotyping; D055815:Young Adult
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