Providers' Experiences with Young People's Cognitive Representations and Emotions Related to the Prevention and Treatment of Sexually Transmitted Infections

Sexual health behaviours and partner notification practices related to sexually transmitted infections in young adults in Ireland

BACKGROUND

Sexually transmitted infections (STIs) impose burdens on individuals and communities, while their prevalence in young people has risen continually in recent years. Partner notification is an effective public health strategy which can limit STI transmission.

AIMS

This study aimed to explore young adults' sexual health behaviours, attitudes toward STI testing, and feelings toward visiting a sexual health clinic. It also aimed to investigate preferences for partner notification and the role of self-efficacy in people's intentions to notify a partner for STIs including the human immunodeficiency virus (HIV).

METHODS

A quantitative, cross-sectional design was applied. Participants were 400 adults aged 18-34 years (M = 23 years; SD = 4.27), recruited from the Republic of Ireland.

RESULTS

Over half of the participants reported never being tested for STIs. These young people placed less importance on undergoing regular STI testing and testing after unprotected sex than their counterparts who had been tested for STIs. Self-efficacy was significantly associated with intentions to notify partner(s) for STIs including HIV.

CONCLUSIONS

As STIs are becoming increasingly prevalent in young adults, it is important to gain a deeper understanding of the interventions used to break the transmission chain and how different beliefs and attitudes may affect them. Self-efficacy was a key component in PN intentions, suggesting that the belief in someone's ability or skillset to perform a sexual health behaviour is positively related to their intention to perform the behaviour.

Participant-Reported Experiences of Conversations about Sexually Transmitted Infections with Romantic Partners: Perceptions of Ownership and Privacy

Sexually transmitted infections (STIs) affect millions of people annually, costing $16 billion in direct costs each year. Young adults often avoid communicating with their romantic partners about STIs for fear of stigma, thereby limiting their own and their partners' ability to make informed and accurate health decisions. Using Communication Privacy Management theory as the theoretical framework, this study investigates how young adults in romantic relationships communicate about STIs with their partner. Findings show that participants report having conversations about STIs, but do not engage in regular STI testing, thereby limiting their ability to provide accurate information. They also discuss STIs in general rather than the communicating about their own history with STIs, being tested for STIs, or discussing STI test results with their partners. Practical and theoretical implications are discussed.

Managing Face while Managing Privacy: Factors that Predict Young Adults' Communication about Sexually Transmitted Infections with Romantic Partners

Sexually transmitted infections (STIs) are among the most common infectious diseases in the United States with nearly 20 million new cases diagnosed each year in young adults (age 15-24). Communicating with romantic partners about STIs can positively influence health outcomes, as treatment can then be sought, yet the discussions themselves can pose several face risks to both the person requesting STI information from a partner and the receiver of that request. This study examines how young adults enact and manage facework strategies in STI-related conversations with romantic partners, using Politeness Theory and Communication Privacy Management Theory as theoretical frameworks. Specifically, this study seeks to understand how self-efficacy in conversations about STIs, intentions to talk about STIs and willingness to communicate about health in general predicts four face response strategies (avoid, communicate with partner/talk, defend self, consider other), and to investigate how boundary permeability moderates each of these relationships. We found that boundary permeability affected the relationships between intentions regarding STIs and the communicate with partner and consider other face management responses in conversations about STIs.

What's in a Name? Perceptions of the Terms Sexually Transmitted Disease and Sexually Transmitted Infection Among Late Adolescents

BACKGROUND

There has been a shift from using the term sexually transmitted disease (STD) to sexually transmitted infection (STI), primarily based on conjecture that STI is less stigmatizing. However, there is a dearth of evidence regarding how the public actually perceives these terms.

METHODS

Students at a Midwestern university participated in an online survey and were randomized to the open-ended question "What comes to mind when you think of the term sexually transmitted disease (STD)?" (n = 205) or "What comes to mind when you think of the term sexually transmitted infection (STI)?" (n = 208). Conventional content analysis was conducted to identify response themes. Cross tabulations with the χ statistic determined the number of participants that endorsed each theme and any differences between the STD and STI responses.

RESULTS

Almost all themes occurred in similar numbers across the STD and STI responses. Overarching themes for both terms were contracted through sex; specific STDs/STIs; severe; negative emotional affect; types of people who get STDs/STIs; physical symptoms; preventable; common; and treatable/curable. However, participants were more likely to mention that STDs were common (P = 0.030) and reported less negative emotional affect for STIs (P = 0.024). Two themes emerged only in the STI group: STDs (P = 0.001) and site of infection (P = 0.003).

CONCLUSIONS

With some exceptions, late adolescents have overlapping conceptualizations of the terms STD and STI. The most commonly reported themes revealed likely areas of misinformation. Although language is an important aspect of health communication, more than a terminology change is needed to reduce the stigma associated with STDs/STIs.

The emancipatory potential of nursing practice in relation to sexuality: a systematic literature review of nursing research 2009-2014

Nurses play a key role in the provision of services in relation to sexuality in both primary and sexual and reproductive health-care. Given the intersection of sexualities with a range of social injustices, this study reviews research on nursing practice concerning sexuality from an emancipatory/social justice perspective. A systematic review of English articles published in nursing journals appearing on the Web of Science database from 2009 to 2014 was conducted. Thirty-eight articles met the inclusion criteria. Analysis consisted of a descriptive phase (types and location of studies, aspects of sexualities focused on, target health users and aspects of nursing practice focused on) and a critical/emancipatory phase. In terms of practice, our analysis revealed that: barriers exist to the integration of issues relating to sexuality in nursing practice; the social location of nurses and their personal feelings regarding sexuality influence their practice; content that addresses gendered norms and media that assist in communication underpin some emancipatory practices. Few studies locate analyses of nursing practice within gendered, cultural and social norms; consider advocacy as part of the practice of nurses; or analyse the promotion of health user participation in health services and structures. The implications for emancipatory practice are drawn out.

Being diagnosed with a sexually transmitted infection (STI): sources of support for young women

BACKGROUND

Sexually transmitted infections (STIs) are prevalent throughout the world with the rate of these infections increasing on a daily basis. STI acquisition has the ability to cause personal adversity and elicit feelings of stigma and shame.

AIM

The aim of this paper is to report on the sources of support young women who acquired STIs drew on to overcome their associated adversity.

METHODS

This study utilised a feminist qualitative methodology.

FINDINGS

Findings revealed that the women drew on both personal and anonymous sources of support.

CONCLUSION

Nurses and other health-care professionals need to be equipped with knowledge and strategies to promote personal wellbeing and minimise the adversity felt among people having acquired these infections.

Formative research for the development of an interactive web-based sexually transmitted disease management intervention for young women

Sexually transmitted diseases are common among young women and effective self-management is foundational to improving health outcomes and preventing negative sequelae. Advances in technology create the opportunity for innovative delivery methods of self-management interventions. However, it is essential to conduct formative research with the target population to identify both the needs and the preferences for the content and delivery method of a sexually transmitted disease self-management intervention prior to intervention development. Eight focus groups were conducted with 35 young women between 18 and 24 years of age. We found that young women strongly support the use of a Web-based intervention to provide sexually transmitted disease self-management guidance. Women were interested in receiving comprehensive management information from the perspective of both clinicians and other women who have experienced a sexually transmitted disease. There was a clear interest in incorporating new media into the Web-based intervention to allow for communication with providers as well as to create opportunities for social networking between women. This formative research provides critical information about the content and delivery method of a self-management intervention and gives direction for intervention development that is inclusive of varying types of new media to allow for connectivity among users, their peers, and clinicians.

Young women's Representations of Sexually Transmitted Diseases (RoSTD): a psychometric study

Measurement of beliefs about sexually transmitted diseases (STDs) is important to understanding sexual health behaviors. The purpose of this study was to develop and test the psychometric properties of the Representations of STDs (RoSTD) Scale. The RoSTD was developed to measure young women's representations of STDs, and it is intended to be used to measure beliefs about any of the seven most common STDs. Confirmatory factor analysis indicated a four-factor structure for the 40-item RoSTD: Future Perspective, Cause, Psychosocial Consequence, and Identity. Internal consistency for the subscales (measured for each of seven different STDs) ranged from .67 to .93 and 2-week test-retest correlations ranged from .69 to .90. The RoSTD shows evidence of reliability and validity in young women.

Triggers of self-conscious emotions in the sexually transmitted infection testing process

Background

Self-conscious emotions (shame, guilt and embarrassment) are part of many individuals' experiences of seeking STI testing. These emotions can have negative impacts on individuals' interpretations of the STI testing process, their willingness to seek treatment and their willingness to inform sexual partners in light of positive STI diagnoses. Because of these impacts, researchers have called for more work to be completed on the connections between shame, guilt, embarrassment and STI testing. We examine the specific events in the STI testing process that trigger self-conscious emotions in young adults who seek STI testing; and to understand what it is about these events that triggers these emotions.

Semi-structured interviews with 30 adults (21 women, 9 men) in the Republic of Ireland.

Findings

Seven specific triggers of self-conscious emotions were identified. These were: having unprotected sex, associated with the initial reason for seeking STI testing; talking to partners and peers about the intention to seek STI testing; the experience of accessing STI testing facilities and sitting in clinic waiting rooms; negative interactions with healthcare professionals; receiving a positive diagnosis of an STI; having to notify sexual partners in light of a positive STI diagnosis; and accessing healthcare settings for treatment for an STI. Self-conscious emotions were triggered in each case by a perceived threat to respondents' social identities.

Conclusion

There are multiple triggers of self-conscious emotions in the STI testing process, ranging from the initial decision to seek testing, right through to the experience of accessing treatment. The role of self-conscious emotions needs to be considered in each component of service design from health promotion approaches, through facility layout to the training of all professionals involved in the STI testing process.