Stigmatized or Less Urgent: Where Do STDs fall?

I'm in the process of gaining approval for the next step in my interviews, in which I'll be interviewing women who live in a shelter to see how resources and referrals compare to those provided to or identified by TC3 residents. I'm interested, in particular, to find out if there is a difference regarding what needs are expressed as unfulfilled. Women at TC3, when asked "How do you think female residents hear about health care services?" most often shared that it was simply through word of mouth. Many female residents share information with others, several longtime residents are considered the camp sages and several women stick entirely to themselves, leaving sans 'health care gossip.'

If, though, word of mouth is the means for awareness raising and resource referring, and no one has an idea about where to get a free pap smear or mammogram, then the chain of communication hits a road block. It would be incredibly interesting to see if a shelter- one which is also receiving funding from the city- has that same communication method and consequential breakdown as well. Or, perhaps, a shelter has a case worker onsite or management employees who keep resource handouts stocked and up-to-date. It should be pretty interesting to find out.

But what I really wanted to write this post about is sexually transmitted infections. No, not about challenges finding free testing and treatment- they're there, you just have to dig a bit. What I really want to talk about is a continuation of a conversation I had with my friend Lauren who works with a policy organization that specifically advocates for homeless people with HIV/AIDS and HIV/AIDS people who become homeless. The question: Are sexually transmitted infections still of such a stigmatized nature that we cannot or do not talk about them in the same way as other diseases, illnesses or health-related needs?

The gut reaction might likely me an resolute 'yes.' No one seems too willing to publicly share their recent bout of herpes or gonorrhea. But then, I had thought that menopause, yeast infections, abortion and mental illness often faced similar stigmas in our society as well. Commercials never actually call a yeast infection by its name, women are shamed for choosing to terminate a pregnancy, we speak of menopause in hushed tones, and mental illness is still looked upon with grave negativity in many circles.

What struck me throughout the interviews with TC3 women is that these otherwise stigmatized actions/changes/illnesses/infections were mentioned repeatedly, openly, honestly, and without any shame (not that there should be any shame attached to any of them). There were a few euphemistic references to having some changes "going on down there," but it was mentioned as part of a litany of health related needs and concerns. They were mentioned without being specifically asked but rather with a probing, "Are your reproductive health care needs met?" or "Are your mental health care needs met?" I never asked any interviewee specifically if she had chosen to have an abortion, if she had any particular mental health needs, if she was undergoing menopause but these bodily changes and challenges were all mentioned and discussed repeatedly.

Just one of the numerous pro-protection advertisments from the past
that places blame squarely on the woman. I'm actually headed to a movie
showing tonight showcasing old sex-ed videos.
 I'll be eager to share, I'm sure.

However, not a single interviewee mentioned any sexually transmitted infection in her listing of current or recent health needs or challenges. I can offer a few hypotheses for why this might be the case, per recent conversations with friends in the reproductive health world: 1) None of the women have an STI/STD; 2) STI/STDs are so common that they don't seem worth mentioning, placing them at the level of a common cold (which was in fact mentioned several times); 3) There are more pressing health care needs that put an STI/STD at the bottom of the list; or 4) STI/STDs still retain such a stigma and are linked with such blame and fault that they just aren't mentioned. (In fact, a quick google search returned the Facebook group, I can proudly say I've never had an STD).

There could surely be additional reasons, or thoughts about why one woman didn't share something compared to another. And my data set isn't nearly large enough to run any kind of quantitative, causal analysis but it's surely something to think about. And in a positive light, to be glad that those health care changes or challenges that were mentioned aren't facing a stigma that keeps someone from talking about them to a grad school interviewer without any medical training.