So how did it get so bad? Considering the role young people play in this---half of the 19 million estimated STD transmissions occur in those 15 to 24---it’s tempting to say the abstinence-until-marriage programs that became ubiquitous in the past decade have something to do with this. And I’m going to give into the temptation and say it’s likely. Abstinence-only education---a legislative fetish that refuses to die---often teaches that condoms don’t work. Educators like to believe that scaring kids off condoms will keep them from having sex, but of course, the likelier result is that scaring kids off condoms will simply scare them off condoms. As Will noted, most of the STDs that we’re talking about can be prevented with regular condom use.
Another way that the prudery behind abstinence-only helps the spread of STDs is through inculcating shame about sexual activity and feelings that you’re “dirty” if you get an STD. I think a lot of people would like to believe that shaming people about STDs helps reduce their transmission, but actually, it has the opposite effect. Shame causes denial, specifically the denial that the symptoms you’re showing should be taken seriously. A lot of people who show symptoms take a “wait and see” attitude, hoping that it’s not the STD that it looks like, but something more minor that will clear up on its own. The problem with this is that avoiding treatment often results in the infection getting worse, which can cause scarring and infertility. And it often means you’re having sex while waiting and seeing, which means that you’re likely to spread the infection. And, as Will noted, having STDs like syphilis makes you more vulnerable to catching others, such as HIV.
Of course, another reason people take the “wait and see” attitude is they don’t have health care coverage, and they really can’t afford to pay for treatment out of pocket. For this reason alone, we can expect the STD transmission rate to improve if we manage to pass a workable universal health care bill.
But simply having more health care access will not be enough. As Will explains in his piece, public resources to combat STDs have been rolled back in recent years, due to lack of funding. Since these kinds of groups are the only people out there talking about how to treat and prevent STDs, this is no small issue.
This is a situation that can be fought on several fronts, and average people can really do a lot to fight our ridiculously high STD transmission rates. Yes, you can do more than insist on using condoms every single time you have sex outside of the context of a tested, monogamous relationship. After all, reducing the stigma attached to sexual activity and STDs will mostly require social change, and that’s best effected by opening your mouth (or your blog) and talking.
Dan Savage set an excellent example years ago when he wrote about his youth, when he contracted gonorrhea. (Reciting this from memory, since I can’t find a link to it.) Or more specifically, when he contracted gonorrhea and, out of shame, failed to tell his partner about it, who contracted gonorrhea from Dan as a result. Luckily, his partner rolled with it, which is exactly the attitude you want to have in order to reduce the shame and stigma around STDs. And Dan learned the lesson, and came out with this story so that the rest of can see that the world doesn’t end if we’re honest about STDs.
Sex educators have exposed me to the idea that getting people talking about their own experiences with STDs can have the counterintuitive effect of reducing STD transmission rates. Even herpes, which has the superpower of getting around latex barriers, can be reduced through honesty and lack of shame. After all, if you communicate openly and without shame about break outs with your partner, you can shift into sexual practices that reduce the potential for transmission during those times. It’s not foolproof, by any means, but it can help.
And while most people don’t have the courage to come out in a public forum like Dan Savage did, I’ve found that talking about your experiences with STDs with friends needn’t be as fraught as some people fear. I’ve certainly heard people talk about contracting chlamydia, gonorrhea or herpes in straightforward, humorous terms that normalized the experience….and made me realize that if I ever showed symptoms, it would be no big deal to go straight to doctor with my head held high.
Because of this, I’m grateful that the HPV vaccine, which targets strains of the virus that can cause cervical cancer, has started a national conversation about the prevalence of STDs. There are many strains of human pappilloma virus (HPV), and while most are relatively benign, a few have been shown to cause cervical cancer in some women. Because it is easy to transmit HPV, most people have one or another strain. Yet until recently, misinformation about HPV, as well as other sexually transmitted infections, left us with little recourse except to treat the symptoms. Even a few years ago, I would have found it hard to believe that so many people would easily accept that contracting HPV was more likely than not if they didn’t get vaccinated at a young age, and not feel weird or ashamed about that. And while there’s been a lot of hysterics who want to turn contracting HPV into some kind of moralistic theater, there’s been more people who happily take their daughters to get the now available vaccine to protect them against the most dangerous strains. If we can see more of that attitude, and expand it to other sexually transmitted infections, we’ll have taken a big step towards reducing the transmission rate.
