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RESEARCH ARTICLE

Psychosocial factors influencing the disclosure of sexually transmissible infection diagnoses among female adolescents

Shayna D. Cunningham A D , Todd Meyers B , Deanna Kerrigan A and Jonathan M. Ellen C
+ Author Affiliations
- Author Affiliations

A Johns Hopkins University Bloomberg School of Public Health, Department of International Health, Baltimore, MD 21205, USA.

B Johns Hopkins University School of Arts and Sciences, Department of Anthropology, Baltimore, MD 21205, USA.

C Johns Hopkins University School of Medicine, Department of Pediatrics, Baltimore, MD 21205, USA.

D Corresponding author. Email: scunning@jhsph.edu

Sexual Health 4(1) 45-50 https://doi.org/10.1071/SH06032
Submitted: 19 May 2006  Accepted: 28 October 2006   Published: 26 February 2007

Abstract

Background: Individuals diagnosed with a sexually transmissible infection (STI) often face psychosocial concerns through which they must navigate to arrive at disclosure decisions. The objective of this study was to qualitatively explore the decision-making process for disclosure of STI diagnoses to sex partners among adolescent females in Baltimore City, MD. Methods: Semi-structured interviews were conducted with 21 African American adolescent females who tested positive for chlamydia and/or gonorrhoea in the previous 3 months. Three individuals also provided audio diaries in which they tape recorded a daily journal discussing their lives and experiences with STIs. Results: Female adolescents often do not notify all potentially infected sex partners or tell sex partners all of the STIs to which they may have been exposed. Although participants recognised the importance of informing their sex partner(s) of their STI diagnosis, there were other competing psychosocial factors that influenced their decisions to disclose, such as perceptions of the social consequences of having an STI including fear of stigmatisation and loss of relationship. Such concerns appear to vary by disease and partner type as well as previous STI experience. Conclusions: To increase disclosure of STI diagnoses, clinic counselling strategies to encourage partner notification should seek to engage patients in a dialogue regarding their fears related to their diagnoses, how this might affect their relationships with different types of partners and the individual and social meanings their specific STI diagnosis(es) might hold.


Acknowledgements

This research was funded by the National Institute of Allergy and Infectious Disease (NIAID grant #AI36986). We thank the young women who generously participated in our study. We also thank Kavita Pillay and Eva Moore for data collection.


References


[1] Eng TR , Butler WT . The hidden epidemic: confronting sexually transmitted diseases. Washington, DC: Institute of Medicine, National Academy Press; 1997.

[2] Hodgens JB,  Oh MK,  Reynolds J,  Wallace SL,  Berman S. Adolescent preference and beliefs regarding partner notification of sexually transmitted diseases. Sex Transm Dis 1994; 21 S201.
Crossref | GoogleScholarGoogle Scholar |

[3] Oh MK,  Boker JR,  Genuardi FJ,  Cloud GA,  Reynolds J,  Hodgens JB. Sexual contact tracing outcome in adolescent chlamydial and gonococcal cervicitis cases. J Adolesc Health 1996; 18 4–9.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[4] Fortenberry JD,  Brizendine EJ,  Katz BP,  Orr DP. The role of self-efficacy and relationship quality in partner notification by adolescents with sexually transmitted infections. Arch Pediatr Adolesc Med 2002; 156(11): 1133–7.
PubMed |

[5] Goffman E . Notes on the management of a spoiled identity. Englewood Cliffs, NJ: Prentice-Hall; 1963.

[6] Crocker J , Major B , Steele C . Social stigma. In: Gilbert DT, Fiske ST, editors. The handbook of social psychology. Boston, MA: McGraw-Hill; 1998. pp. 504–553.

[7] Fortenberry JD. Health care seeking behaviors related to sexually transmitted diseases among adolescents. Am J Public Health 1997; 87 417–20.
PubMed |

[8] Cunningham SD,  Tschann J,  Gurvey JE,  Fortenberry JD,  Ellen JM. Attitudes about sexual disclosure and perceptions of stigma and shame. Sex Transm Infect 2002; 78 334–8.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[9] Gorbach PM,  Aral SO,  Celum C,  Stoner BP,  Whittington WL,  Galea J, et al. To notify or not to notify: STD patients’ perspectives of partner notification in Seattle. Sex Transm Dis 2000; 27 193–200.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[10] Green J,  Ferrier S,  Kocsis A,  Shadrick J,  Ukoumunne OC,  Murphy S, et al. Determinants of disclosure of genital herpes to partners. Sex Transm Infect 2003; 79 42–4.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[11] Bartos M,  McDonald K. HIV as identity, experience or career. AIDS Care 2000; 12 299–306.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[12] Centers for Disease Control and Prevention. Sexually transmitted disease surveillance, 1999. Atlanta, GA: US Department of Health and Human Services; 2000.

[13] Centers for Disease Control and Prevention. Sexually transmitted disease surveillance, 2000. Atlanta, GA: US Department of Health and Human Services; 2001.

[14] Centers for Disease Control and Prevention. Sexually transmitted disease surveillance, 2001. Atlanta, GA: US Department of Health and Human Services; 2002.

[15] Centers for Disease Control and Prevention. Sexually transmitted disease surveillance, 2002. Atlanta, GA: US Department of Health and Human Services; 2003.

[16] Centers for Disease Control and Prevention. Sexually transmitted disease surveillance, 2003. Atlanta, GA, US Department of Health and Human Services; 2004.

[17] Baltimore City Health Department. Baltimore, MD: Bureau of Communicable Disease and Epidemiology; 2002.

[18] Glaser BG , Strauss AL . The discovery of grounded thoery: strategies for qualitative research. Chicago, IL: Aldine Publishing Company; 1967.

[19] van de Laar MJ,  Termorshuizen F,  van den Hoek A. Partner referral by patients with gonorrhea and chlamydial infection. Case-finding observations. Sex Transm Dis 1997; 24 334–42.
Crossref | GoogleScholarGoogle Scholar | PubMed |