Words Matter: Minimizing STI Stigma in Healthcare Settings

A doctor talking to a patient who appears uncomfortable

Despite the scale of the sexually transmitted infection (STI) epidemic and the number of people affected, talking about STIs is still considered taboo and conversations about sexual behavior are often uncomfortable—even in a healthcare setting.

Many patients report experiencing stigma, whether that’s being subjected to the judgement and disapproval of health care providers or being denied services. Stigma increases patients’ experiences of shame and undermines their access to diagnosis, treatment, and successful health outcomes.

While most providers don’t mean to make anyone feel bad about their identity, behavior, or diagnosis, the messages they give and the words they use often do just that.

Understanding and Reducing Stigma in Healthcare Settings

ASHA has developed five e-learning modules that explore the stigma around STIs, the ways bias and assumptions can impact patient care, and the importance of language choices to minimize stigma. Included is a self assessment module that allows you to examine your own beliefs and values around sexual behavior, sexual orientation, gender identity, and STIs. The content concludes with a series of patient scenarios to help you put the ideas into practice.

The modules should take less than 30 minutes to complete.

This section explores:

  • different types of stigma
  • stigma specific to STIs
  • the ways stigma manifests in healthcare settings
  • how racism, systematic bias, and social determinants of health impact STI outcomes.

The goal of the self-assessment is to offer an opportunity for you to reflect on your own beliefs surrounding sexual behavior, gender and sexual orientation, STIs, and social norms.

This section is designed to help you consider the ways in which language commonly used in clinical settings may perpetuate stigma. It explores common pitfalls and offers alternatives so you can communication with patients without:

  • Excluding people or groups
  • Making assumptions about patients
  • Passing judgment

This section is designed to help you take a detailed sexual health history and offer screening/testing in a way that minimizes stigma. It focuses on:

  • Understanding screening guidelines
  • Recognizing perceived bias
  • The 6 Ps of a sexual health history
  • The GOALS Framework for screening

This section offers an opportunity for you to put what you’ve learned into practice by presenting fictional examples of patients. For each patient you will be asked to reflect on:

  • How you would approach conversations with each patient
  • What information you would need to make screening recommendations
  • What STIs tests you would suggest to each

Advisory Committee

ASHA would like to offer our sincerest thanks to the members of our advisory committee for their help in the writing and review of this e-learning course. Their advice and ideas were invaluable.

Teresa Batteiger, MD, MS
Teresa Batteiger, MD, MS
Keosha Bond
Keosha T. Bond, EdD, MPH, CHES
Courtney W. Brame
Courtney W. Brame
Khalil G. Ghanem, MD, PhD
Khalil G. Ghanem, MD, PhD

Webinar

On November 16, 2023, ASHA conducted a webinar to discuss the ways in which stigma is perpetuated in health care settings; explore how the language clinicians routinely use may be considered judgmental, exclusionary, or patronizing; and consider alternatives. Language is always evolving, and this webinar can help providers and others working in public health communicate more clearly and without stigma. Speakers include Leandro Mena, MD, MPH, Director of the Division of STD Prevention at the Centers for Disease Control and Prevention, Keosha T. Bond, EdD, MPH, CHES, Assistant Medical Professor at the CUNY School of Medicine and the Director of the LOVE Project Lab, and Martha Kempner, MA, a writer, sexual health expert, and ASHA consultant.

This online course and accompanying webinar were supported by an educational grant from Roche Diagnostics.

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