Destigmatizing Sexually Transmitted Diseases & Mental Illness

Published on December 13, 2017 by Dr. Pamela Ovadje

Fiery sex is no joke. That burning sensation might be a sign that you might have a sexually transmitted infection (STI) like gonorrhea or chlamydia, but don’t worry – there’s a condom, cream, pill or shot for that. Even though STI’s pose a serious and very real public health problem, the World Health Organization (WHO) estimates that over 448 million new cases of curable STIs, such as syphilis, chlamydia, gonorrhea and trichomoniasis, occur worldwide, we need to keep perspective that many are STIs are both preventable and easily treated.

I say this because while the physical side effects of STIs are typically well documented by health and medical professionals, one of the biggest impacts of STIs that is not given enough discussion is the mental and emotional impact.

Severe stress and depression are two of the most common conditions that affect people living with STIs; for some, an STI diagnosis might be even more traumatic. There is also the “chicken or the egg” theory surrounding risk factors for contracting STIs and mental illness, among health professionals. Studies suggest that depression can increase the likelihood of engaging in unsafe sexual practices, which reduce STI prophylaxis. On the other hand, studies have also shown that having an STI can increase your chances of experiencing mental health issues, even if there was no pre-existing condition.

Public perception and understanding about mental illnesses play a significant role in the prevention and treatment of mental illness. This is transparent in this subset of the population diagnosed with an STI. The strong correlation between STI diagnosis and mental health concerns is underscores the importance of understanding and destigmatizing both sexual health and mental illnesses. The relationship between mental illness and STIs tend to exist due to complex and varied social and sexual interactions between sexual partners, as well as with health care providers because of shame and fear of judgement. The presence of mental illness also could

limit the success different forms of therapy and adherence to treatment. The point being, it is unlikely to change overnight, and we must be diligent about investigating each of these factors.

What is important to consider is that no one is completely immune to STIs or mental illness; epidemiological data may indicate trends in various populations which may increase the risk for exposure, or the level of adherence to preventative measures for certain individuals or groups. However, the bacteria and viruses causing these infections are not discriminating hosts based on age, race, sexual orientation. In this respect, perhaps we can alleviate some of the blame assigned to infected individuals mitigating their guilt.  Open communication free of shame and judgement, between sexual partners and between doctors and patients provides much needed perspective and will lead to a change in how we approach sexual and mental health. Without diminishing the context of STI’s in our current culture, perhaps we need to start looking at these like many other common infections. For example, if we all treated individuals with an STI like they had the flu, we would remove a lot of the stigma. You still avoid the flu when you can, and you actively take measures to prevent exposure to the flu, but if you caught it you would not blame yourself for being weak, or doom yourself to isolation you would treat it with the treatments available, and society would not “immune shame” you because you caught the flu.

Here are 4G’s for taking charge of your sexual, mental and physical health: 

  • Get Protected: practice safe sex by understanding your risk factors, limiting exposure, and engaging in preventative behaviours i.e. using condoms, dental dams, or getting vaccinated.
  • Get Tested: Regular check ups are a MUST, especially when there is a new partner in the picture. This is also important, as some STIs may be asymptomatic. Perhaps if this was a regular part of our health routines the “have you been tested?” talk wouldn’t be half as awkward as it seems to be.
  • Get Treated: If you contract an STI then #treatyourself do NOT wait. Get treated as soon as possible. Also, let your sexual partners know that you have contracted something, so they can get tested (and treated, if needed). It is respectful to yourself and any partners. Thankfully there is a plethora of resources online with creative options for how we can normalise and support these discussions. For a less awkward way to inform your partners, visit inspot.org for personalized Tell Cards.
  • Get Talking: TALK!!! Talk with your partners (it might be uncomfortable/awkward but you will be glad you did it); Talk with health care professionals and providers – there are many resources available for this – Don’t be shy!

For more information, please see the references below;

  1. Dutra MRT, Campos LN, Guimaraes MDC. Sexually Transmitted Disseases Among Psychiatric Patients in Brazil. Braz. J. Infect Dis. 2014; 18(1): 13-20
  2. Khan MR, Kaufman JS, Pence BW, Gaynes BN, Adimora AA, Weir SS, Miller WC. Depression, Sexually Transmitted Infection and Sexual Risk Behaviour Among Young Adults in the United States. Arch Pediatr Adolesc Med. 2009; 163(7): 644–652
  3. Girma E, Tesfaye M, Froeschl G, Mo¨ ller-Leimku¨ hler AM, Mu¨ ller N, Dehning S. Public Stgma Against People with Mental Illness in the Gilgel Gibe Field Research Center (GGFRC) in Southwest Ethiopia. 2013; PLoS ONE 8(12): e82116. doi:10.1371/journal.pone.0082116
  4. Rein DB, Anderson LA, Irwin KL. Mental health disorders and sexually transmitted diseases in a privately insured population. Am J Manag Care. 2004 Dec;10(12):917-24.
  5. Erbelding EJ, Hutton HE, Zenilman JM, Hunt WP, Lyketsos CG. The prevalence of psychiatric disorders in sexually transmitted disease clinic patients and their association with sexually transmitted disease risk. Sex Transm Dis. 2004 Jan;31(1):8-12.
  6. http://www.mentalhealthy.co.uk/lifestyle/features/sexually-transmitted-infections-the-lowdown.html
  7. https://www.sexualhealth.com/sexually-transmitted-diseases-may-affect-mental-health_n_1483/
  8. https://www.jwatch.org/id200402130000006/2004/02/13/mental-health-and-stds-whats-connection
  9. http://www.ashasexualhealth.org/stdsstis/myths-and-facts/
  10. https://www.optionsforsexualhealth.org/sexual-health/sexually-transmitted-infections/can-i-get-sti-if
  11. http://www.fraserhealth.ca/health-info/health-topics/sexual-health/
  12. http://www.inspot.org/Default.aspx
  13. https://sexualhealthontario.ca/en/home