Relationship of STD-Related Shame and Stigma to Female Adolescents’ Condom-Protected Intercourse

• Type of Material: Article
• Authors: Jessica Sales, Emory University; Ralph Joseph Diclemente, Emory University; Eve Rose, Emory University; Gina M Wingood, Emory University; Jonathan D. Klein, University of Rochester; Elizabeth R. Woods, Harvard Medical School
• Language: English
• Date: 2007-06
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2007 Society for Adolescent Medicine. All rights reserved.
• License: Creative Commons Attribution-NonCommerical-NoDerivs 3.0 Unported
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jadohealth.2007.01.007
• Title of Journal or Parent Work: Journal of Adolescent Health
• ISSN: 1054-139X
• Volume: 40
• Issue: 6
• Start Page: 573.e1
• End Page: 573.e6
• Grant/Funding Information: This work was supported, in part, by National Institute of Mental Health Grants 1 RO3 MH65152-02 and 1 R01 MH61210-05, National Institutes of Health; and Project 5T71MC00009-14 and 5T71MC00012-14 from the Maternal and Child Health Bureau (Title 5, Social Security Act), Health Resources and Services Administration, Department of Health and Human Services.
• Keywords: condom-protected intercourse; Adolescents; shame and stigma; STDs
• Research Categories: Health Sciences, Public Health; Psychology, Social; Health Sciences, Epidemiology

Abstract

Purpose 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 192 African American females age 17.4 ± 1.7 years (range 15-21) were 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 six months follow-up, rate of condom-protected intercourse in past 14 days prior to follow-up 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.