The Stigma of Sexually Transmitted Infections and How It Affects Oklahoma

There is an epidemic in Oklahoma that does not receive much media attention:
sexually transmitted infections (STIs).

“Don’t you mean STDs?” readers may ask. The use of the word “disease” has actually contributed to misinformation surrounding STIs. The Merriam Webster definition of the word disease includes the phrase “is typically manifested by distinguishing signs and symptoms.” Whereas, the definition of infection does not state there will be signs and symptoms. This makes infection a more appropriate term since STIs do not always show up as visible signs on or in the body. In fact, STIs can cause serious damage before there is any potential sign of an infection. 

If an STI does show up on the body, the physical signs might be different from person to person, and they might not be prevalent or continuous. Some examples include:

1. Chlamydia, which can take from one to three weeks for symptoms to show up from initial contact.
2. Herpes, which flares up in episodes, meaning symptoms will come and go.
3. Syphilis, which can damage internal organs over a number of years, undetected.
4. HIV, which may appear as simple as the flu, but more severe symptoms and irreversible damage may not occur for ten years or more.

The common lack of signs and symptoms, combined with stigma, increases the risk of spreading STIs, especially when people use denial as a strategy for managing their sexual health. Reducing infections relies heavily on sexually active people getting tested – even when they ‘feel fine’.

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The American Public Health Association has reported that STD-related stigma was associated with a decreased likelihood of being tested for gonorrhea or HIV. When people fear getting tested there is a potential for fewer infected people to get diagnosed. If people who are infected are not aware of their infection, it directly affects the lives of Oklahomans. In 2020, Oklahoma had the eleventh highest rate of chlamydia infections, fifth highest rate of gonorrhea infections, and fifth highest rate of congenital syphilis infections. 

Misguided phrases about who can get STIs and how people contract infections contribute to the stigma since they are incorrect and harmful to those individuals who are labeled. “Only certain people can get AIDS,” is an example of a phrase so misinformed that it is detrimental to our communities’ understanding of STIs. No one “gets” AIDS from another person. Acquired Immune Deficiency Syndrome, or AIDS, requires that someone already has HIV and their CD4 cell count has dropped below a certain level. Only HIV can be shared and only HIV can progress to AIDS, but not everyone who contracts HIV will acquire AIDS. 

The stigma behind STIs in Oklahoma stems from the lack of accurate communication on the subject and the lack of sexual health education in schools. Conversations about STI testing, resources, infection status, and barrier methods all reduce the risk of infection. But these conversations aren’t happening when people aren’t aware of the risks. When there is not quality sexual health education, we miss an important opportunity to provide STI prevention knowledge. 

Sexually transmitted infections are preventable. To destigmatize STIs and lower the rate of STIs in our state, we need high quality, medically accurate sexual health education available for all young people. We need to open up conversations in and out of school and disrupt the taboo nature of this subject. The well-being of thousands of Oklahomans depends on it.

Written in conjunction with Katia Harms.