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March 2002, Vol 92, No. 3 | American Journal of Public Health 378-381
© 2002 American Public Health Association


RESEARCH AND PRACTICE

Relationships of Stigma and Shame to Gonorrhea and HIV Screening

J. Dennis Fortenberry, MD, MS, Mary McFarlane, PhD, Amy Bleakley, MPH, Sheana Bull, PhD, Martin Fishbein, PhD, Diane M. Grimley, PhD, C. Kevin Malotte, DrPH and Bradley P. Stoner, MD, PhD

J. Dennis Fortenberry is with the Section of Adolescent Medicine, Indiana University School of Medicine, Indianapolis. Mary McFarlane is with the Behavioral Interventions Research Branch, Centers for Disease Control and Prevention, Atlanta, Ga. Amy Bleakley is with the Mailman School of Public Health, Columbia University, New York, NY. Sheana Bull is with the AMC Cancer Research Center, Denver, Colo. Martin Fishbein is with the Annenberg School of Communications, University of Pennsylvania, Philadelphia. Diane M. Grimley is with the Department of Health Behavior, School of Public Health, University of Alabama at Birmingham. C. Kevin Malotte is with the Health Science Department, California State University, Long Beach. Bradley P. Stoner is with the Department of Anthropology, Washington University School of Medicine, St. Louis, Mo.

Correspondence: Requests for reprints should be sent to J. Dennis Fortenberry, MD, MS, Riley Outpatient Garage, Room 070, 575 North West Dr, Indianapolis, IN 46202 (e-mail: jfortenb{at}iupui.edu).

Objectives. The purpose of this study was to assess the relationships between stigma and shame associated with seeking treatment for sexually transmitted diseases (STDs) and undergoing testing for gonorrhea and HIV.

Methods. Participants were 847 males and 1126 females (mean age: 24.9 years) in 7 cities. Two scales assessed STD-related stigma and STD-related shame.

Results. Rates of stigma and shame were higher among participants without a gonorrhea test in the past year and among those without an HIV test. Sex, age, health service use, previous suspicion of gonorrhea, and low levels of stigma were independently associated with gonorrhea testing. Age, enrollment site, use of health services, gonorrhea testing, and low levels of stigma were independently associated with HIV testing.

Conclusions. Shame is part of the experience of seeking STD-related care, but stigma may be a more powerful barrier to obtaining such care. (Am J Public Health. 2002;92:378–381)




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