How to Shift Our Understanding of STIs Away from Shame and Toward Education

It’s not exactly a secret that some people consider sexually transmitted infections (STIs) to be dirty and shameful things. They might call those who get them grossly irresponsible and promiscuous sexual pariahs. According to a survey from Planned Parenthood, 11% of young people still use words like “gross” and “embarrassing” when talking about STIs. Just look at the letter “I” in sexually transmitted infections. Most people don’t use the word “infections,” opting instead for the word “diseases.” Even the Centers for Disease Control and Prevention (CDC) still casually refers to STIs as STDs on its website.

This is a problem in itself. The word “disease” implies something that is ongoing, shows physical symptoms, and cannot be cured. Not only is this definition not accurate for most STIs, the word “disease” is simply an ugly one, fraught with indignity. To be “diseased” is to be bad, unwanted, and unlovable. That is, to put it lightly, super messed up.

But it’s more than just the way we express the blanket term “STI” that matters. It’s nearly every way we choose to talk to young people (and all people) about STIs. Why is this so critical? Because rooting STI education in shame increases a population's vulnerability to STIs. “There is a correlation between states with inaccurate or abstinence-only sex education and increased STI rates,” Anne Hodder-Shipp, ACS, a certified sex educator and founder of Everyone Deserves Sex Ed, tells TheBody. “We know that shame and fear do not promote action; they often keep people stuck in a place of fear and avoidance, which is not an effective way to seek information, STI testing and treatment, support, prevention tools, or health care.”

Here is the good word: STIs are not bad things that only dirty people get—they’re a fact of human life just like every other kind of infection for which we have methods of protection, prevention, and treatment.

We need to reexamine the language we use around STIs, starting at very early ages with our first sex ed and parental experiences, and trade in the old “STI = bad, very bad, dirty human” adage for a new framework so that people can truly understand how they work, how common they really are (look at how many people have HPV), and how people can properly protect themselves without stigma and fear.

Language Is a Powerful Tool

Bringing focus to the language we use around STIs is a crucial piece in the larger puzzle. Without shame-free STI discussions, the shame lives on. When shame lives on, the lack of good information we have access to lives on, and when the lack of good information lives on, our infection risk increases. Language is “often used to shame, confuse, and frighten, and sometimes we don’t even know that that’s what we’re doing,” Hodder-Shipp points out.

We really don’t know that we’re instilling shame half the time. Look at the CDC, for instance. By keeping the word “disease” (as in, STD) at the top of their website, they’re reaffirming the idea that STIs are shameful and disgusting, even if their attitudes don’t correlate with this idea.

We need to be mindful not only of the facts we’re presenting, but how we’re presenting those facts. This means being cognizant of the words we use. We need to do away with words and phrases such as “outbreak,” “stop the spread,” “gross,” “embarrassing,” “clean,” and “disease.” Hodder-Shipp tells us that words like this “actually contribute to negative outcomes, promote fear, and even misrepresent [STIs]—many STIs are as common as [the] cold or the flu, and we can ‘stop the spread’ just as easily as we can ‘stop the spread’ of the common cold—that is, we can’t,” she says. “What we can do with our language use is stop the spread of STI stigma.”

The only way to shift the world into a sex-positive, collective mindset is by utilizing language. Things are only shameful when we decide they are shameful. That’s the lynchpin in this whole thing: The way we talk about things is what gives them meaning. If we suck the shame out of sexuality and discussions about STIs, they stop being shameful.

This might sound reductive, but that is truly what it boils down to. The Gentera Center for Regenerative Medicine’s medical director and sexual wellness expert, Katherine Zagone, N.D., tells TheBody that when we talk about STIs in sex ed discussions, we should discuss them in a “neutral way—very factual, without moral overtones.” Facts over shame, always.

STIs are Incredibly Common

Here is the thing many sex-negative, shame-loving people don’t want you to know: STIs are not some scarlet letter that only sluts get. They are incredibly common. There were more than 1.7 million cases of chlamydia reported in 2018. One in six people currently have genital herpes. The point is: STIs happen. This is just a fact of life.

We have so much shame around STIs that we can’t even understand the fact that most of them are really common, easily treated, and not the end of the world. Chlamydia is essentially a vagina cold. You take one dose of an antibiotic (yes, one single dose) and the infection is gone. Think about this for a second: When you get strep throat, you take a seven-to-10-day cycle of antibiotics to treat the infection. When you get chlamydia, you take one pill to treat the infection. And yet when you get strep, no one thinks you’re a nasty, diseased person. They simply think you’re a person who got a common infection and is seeking treatment. The only reason chlamydia is seen as something scarier than strep is because we’re so scared of sex and place so much shame on STIs.

When we keep young people in the dark about STIs, we discourage them from looking for the information they need to protect themselves. “The more we learn about our bodies, infections, pleasure, and how to measure what levels of risk we’re comfortable with, the more empowered we can feel navigating sex and relationships on our terms versus the terms that others have imposed on us,” Hodder-Shipp says. The more information people have on STIs, the more they’ll seek out ways to prevent them. It’s really not that complicated.

Talking About STIs in a Shame-Free Way

There is this truly bizarre misconception in our society that talking about STIs in a neutral way and explaining how common they are to young people is akin to saying: STIs are great! Go have sex with everyone you meet, and forget condoms, because who even cares?

This is not the case in the slightest. Shame-free and reckless are not synonymous.

We’re not suggesting that we should all have a free-for-all and tell people STIs are harmless. They aren’t harmless. There are over 20 million new cases of STIs in the U.S. every single year. HPV is the leading cause of cervical cancer among cervix-owning people. HIV, while now highly treatable, is still a serious infection that shouldn’t be taken lightly.

But taking STIs seriously doesn’t require making people feel like they’re a pile of human garbage for contracting one. Taking STIs seriously means presenting the facts as facts, not as an indictment of character. We need to end the stigma and take it out with the trash. Stigma doesn’t prevent people from getting STIs—information does.