Mirror of Justice

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Tuesday, August 31, 2010

The disappearing social stigma of STDs

I am not at all opposed to sexually active teenagers getting tested for STDs.  (I'm pretty sure that sentence has never begun a post on MoJ.)  I am troubled, though, that casual sex is such an accepted part of our youth culture -- a youth culture that is shaped in many ways by adults -- that MTV is running a sweepstakes in which prizes are given for announcing your presence at an STD clinic to all your social media contacts on Foursquare.  Much of the social stigma associated with STDs, I have always assumed, is not just that you contracted one, but that you were engaged in behavior that potentially exposed you to one.  Even accounting for the different social expectations of young men and young women when it comes to sexual "conquests," I would find it jolting to find a teenager who considered it a badge of honor worthy of proclamation to the world that he finds himself in the position of needing to visit the clinic.  I find this development to be a fascinating (in a car-crash sort of way) snapshot into the confluence of diminishing private/public boundaries and increasingly permissive sexual norms.

http://mirrorofjustice.blogs.com/mirrorofjustice/2010/08/the-disappearing-social-stigma-of-stds.html

Vischer, Rob | Permalink

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I think the point is not for teenagers to announce to the world that they think they may have a sexually-transmitted disease, but rather to encourage teenagers -- whom I am sure MTV assumes already to be sexually active and at risk -- to get tested when they might otherwise not do so. I have seen in several places the estimate that 1 in 5 people who are HIV+ don't know it. By my calculations (which I wouldn't want anyone to rely on too heavily), that would be over 200,000 people. The idea is not to make it a badge of honor to possibly have a sexually transmitted disease. It's to remove the stigma from getting tested, which I think is a good thing.

Some interesting statistics can be found here
http://www.guttmacher.org/pubs/FB-ATSRH.html

Among them are the following (the first one of which is surprising):

•Teens are waiting longer to have sex than they did in the past. Some 13% of never-married females and 15% of never-married males aged 15–19 in 2002 had had sex before age 15, compared with 19% and 21%, respectively, in 1995.
•Ten percent of young women aged 18–24 who have had sex before age 20 report that their first sex was involuntary. The younger they were at first intercourse, the higher the proportion.
•Of the 18.9 million new cases of STIs each year, 9.1 million (48%) occur among 15–24-year-olds.
•Although 15–24-year-olds represent only one-quarter of the sexually active population, they account for nearly half of all new STIs each year.
•Human papillomavirus (HPV) infections account for about half of STIs diagnosed among 15–24-year-olds each year. HPV is extremely common, often asymptomatic and generally harmless. However, certain types, if left undetected and untreated, can lead to cervical cancer.

Posted by: David Nickol | Aug 31, 2010 8:27:54 PM

By the way, the average age at marriage in the United States is 26.8 years for men, and 25.1 years for women. That's a very long time after the onset of puberty.

Posted by: David Nickol | Aug 31, 2010 8:42:56 PM

The social stigma around STD testing does not derive from embarrassment about sexual acts. It comes from (1) embarrassment about *talking* about sex, and (2) a feeling of invincibility (getting tested seems equivalent to being stupid about unsafe sex).

Both of those sources of stigma deserve to go.

Posted by: Andrew MacKie-Mason | Sep 1, 2010 3:28:38 AM

Robert J Araujo, SJ, says: "But something new is added to the mix when a major voice in contemporary culture offers rewards for that which physically and morally endangers every member of our society who lives the life that the culture exhorts."

The reward is for getting checked for STDs, not for engaging in risky behavior or actually getting infected. Going to the doctor does not physically and morally endanger every member of our society. NOT going to the doctor is the problem.

The GYT campaign is sponsored by MTV and the Kaiser Family Foundation. They have been working together since 1997 to inform young people of sexual health issues.

Diseases, and testing for diseases, should not be stigmatized.

Posted by: David Nickol | Sep 1, 2010 7:56:01 AM

The way "testing" is promoted promotes pre-marital sexual activity by not condemning it. This in turn leads to more STDs and more need for "testing." MTV and everyone else should be encouraging abstinence, which is 100% effective against STDs and, even more importantly, promotes holiness (or, in secular terms, "psychological wellbeing").

Posted by: Dan | Sep 1, 2010 12:36:40 PM

David Nichol said: "The reward is for getting checked for STDs, not for engaging in risky behavior or actually getting infected."

Although there are some ways in which STDs can be contracted without engaging in sexual activity, most of the "risky behavior" that leads to transmission of STDs involves sex acts. Indeed, as a general matter, one would have few reasons for getting tested for STDs unless one were engaged in such conduct. The two are linked.

So if the idea is to remove the social stigma from getting tested for STDs as a matter of public health (i.e. as a way of encouraging treatment and preventing the further spread of the disease) all well and good. But is that the only message of the MTV sweepstakes? Does the campaign succeed in communicating the idea that "One shouldn't be ashamed of getting tested" without at the same time sharing the message that "One shouldn't be ashamed of the conduct that led one to getting tested in the first place"?

Posted by: John Breen | Sep 1, 2010 1:50:49 PM

I'm not taking a position here one way or the other. But it should be noted in response to Dan's comment, even if it's obvious to most, that abstinence is only 100 percent effective against STDs if followed to the letter; if it is not, and if the non-abstinent individual is also ignorant about safer sexual practices, then the rate of STDS may be higher still than for those who are sexually active but take precautions. Of course there are moral and/or prudential reasons to favor abstinence that have nothing to do with STDs, and they may be especially powerful or mandatory for many readers of this blog. But if we are taking a purely instrumental view that is focused on STDs, we must be sure to do so in a careful and credible way.

Posted by: Paul Horwitz | Sep 1, 2010 3:16:13 PM

Dan says: MTV and everyone else should be encouraging abstinence, which is 100% effective against STDs and, even more importantly, promotes holiness (or, in secular terms, "psychological wellbeing").

John Breen says: Does the campaign succeed in communicating the idea that "One shouldn't be ashamed of getting tested" without at the same time sharing the message that "One shouldn't be ashamed of the conduct that led one to getting tested in the first place"?

I think preaching abstinence -- and shame for engaging in sexual conduct -- is better suited to EWTN than MTV. I think MTV does a pretty good job of providing unbiased information on its web site. Check out this link, for example.
http://www.mtv.com/onair/ffyr/protect/std_faqs.jhtml

If you think being nonjudgmental is a problem, then you probably won't like MTV's approach. But I am not exactly sure how you put out the message that being tested for STDs is nothing to be ashamed of, but engaging in behavior that might put you at risk for STDs is shameful.

At work today I mentioned to someone that this topic was being discussed on a Catholic blog. He said, "Why, they can't even control their own priests!" I'd say it's an unfair remark if one is thinking only of the sex-abuse crisis, but according to Richard Sipe, at any given time, 50% of priests are sexually active.
http://www.richardsipe.com/Dialogue/Dialogue-19a-2009-06-16.html

Also, a majority of Catholic (and even a majority of Catholics who attend church regularly) do not think sex between an unmarried man and woman is morally unacceptable. In fact, a majority approves of same-sex marriage.
http://www.gallup.com/poll/117154/catholics-similar-mainstream-abortion-stem-cells.aspx

I think one just has to face the fact that large numbers of people, no matter who they are, and no matter how much moral pressure you put on them, are going to be sexually active. (Do you really expect teenagers to be holier than priests?) I know the Catholic Church is always concerned about giving "mixed signals," but MTV, the Kaiser Family Foundation, and the CDC should not be expected to speak on behalf of the Catholic Church while trying to inform people about public health issues. I think it is unacceptable to say, "If everyone just followed the teachings of the Church, everything would be alright, so let's just teach what the Church teaches and not educate people about condoms or sexually transmitted diseases. It will only give mixed signals." Are public service announcements about not drinking and driving unacceptable because they give "mixed signals"? Should there just be PSAs that say, "Never drink so much that you can't drive safely -- getting intoxicated is a sin"?

Posted by: David Nickol | Sep 1, 2010 7:21:43 PM