218780 When “feeling bad” and “not knowing” make a difference: The impact of stigma and blame on STI healthcare utilization

Tuesday, November 9, 2010 : 5:00 PM - 5:15 PM

Kimberly McBride, PhD, MA , Academic Edge, Inc., Bloomington, IN
Richard Goldsworthy, PhD, MSEd , Academic Edge, Inc., Bloomington, IN
J. Dennis Fortenberry, MD, MS , Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
BACKGROUND: Stigma associated with sexually transmitted infections (STIs) and the extent to which an individual blames, or is blamed by, his or her partner for introducing an STI into the relationship may affect use of healthcare services, especially those services that require partner interaction, including partner notification, testing, and treatment. This study investigated the role of stigma and blame on intentions to engage in these services. METHODS: Structured interviews were conducted among 40 male and 40 female Midwestern U.S. public health clinic patients aged 18-40. Participants were asked about their willingness to participate in various partner-oriented services and benefits, disadvantages, and other factors influencing that willingness. Open-ended thematic analysis led to a conceptual framework which was then re-applied to the data. RESULTS: STI stigma and partner blame emerged as salient themes among participants. Participants indicated that stigma was a major barrier to partner notification, partner testing, and partner treatment. Participants were more likely to engage in health care practices that offered opportunities to minimize stigma. Fear of being blamed for introducing the STI into the partnership was a significant barrier to partner notification. Blaming the notifying partner for introducing the STI influenced the uptake of specific testing and treatment options. DISCUSSION: Results indicate stigma and blame have important implications for partner-oriented healthcare services and suggest that both selection and counseling of patients for services may be better served by directly addressing these issues. Improved understanding of these influences will be important to effective STI prevention and treatment.

Learning Areas:
Public health or related education
Social and behavioral sciences

Learning Objectives:
Explain the role of stigma and blame in STI health care utilization. Identify stigma related barriers to partner notification, testing and treatment. Compare the differential affects of blame. Describe the implications of findings as related to partner-oriented STI health care services.

Keywords: Health Care Utilization, STD Prevention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Have PhD in Health Behavior. Have presented at APHA before. Serve as a reviewer for the HIV section yearly.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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