Quick question: If you had unprotected sex, how likely do you think it is that you would contract HIV and die? Is the likelihood higher or lower than your risk of dying in a car accident traveling the 300 miles from Detroit to Chicago?
According to a new study by Terri D. Conley and colleagues at the University of Michigan, who asked 681 participants this question, most people believe that 17 times as many people would die as a result of contracting HIV from sex as would die in a car accident. Though the truth is, a person is 20 times more likely to die in a car accident while driving a 300-mile distance than from getting HIV after a night of unprotected sex. Conley says that this misestimation points to a larger, persistent stigmatization of STIs—and puts it into context.
To test this theory further, Conley asked more questions. In a second experiment, she attempted to isolate people's attitudes toward STIs specifically by asking participants to respond to two different scenarios by rating them on a risk scale. In the first, a person who unknowingly had chlamydia, an easily curable STI that has minimal health effects, transmitted the disease to a sexual partner during intercourse. In the second, a person who unknowingly had H1N1, a flu virus that can be fatal, transmitted the disease to a sexual partner during intercourse. Overwhelmingly, the study's participants responded more negatively to the hypothetical person who transmitted chlamydia than to the person who transmitted H1N1.
And just to be sure, Conley did a third experiment, in which she clearly outlined the potential effects of both chlamydia and H1N1. Still, study participants rated the person who transmitted H1N1 to a sexual partner who literally died as a result less harshly than they rated the person who transmitted chlamydia to a sexual partner, resulting in the partner having to take medication for a week.
"Participants also perceived the target that transmitted chlamydia with mild outcomes to be riskier and dumber than the target that transmitted H1N1 with the fatal outcome," the authors explain in the study. "That is, a target who gave someone chlamydia through sexual intercourse and caused the person to see a doctor and take antibiotics for a week was perceived as riskier, negative, selfish, and dumber than a person who gave someone H1N1 through sexual intercourse and caused the person to die."
Recently, the WHO announced new research that indicates two-thirds of the earth's population under 50 has HSV-1, which means that the majority of the world's population has herpes. And according to the CDC, chlamydia is the most frequently reported sexually transmitted infection in the US. Given the commonality of sexually transmitted diseases, you'd think that the assumption that an STI is an indication of moral failing or even necessarily bad behavior is outdated, but that's clearly not the case.
Ascribing undue levels of risk to sexually transmitted disease is simply bad for public health, Conley says. We all know that stigmatization makes people less likely to report having an STI and less likely to seek out treatment. Studies have shown that the perceived stigma around STIs is associated with decreased odds of STI testing. "Stigmatizing infections and slut shaming the people who contract them only serves to worsen the problem," says founder of the STD Project and spokesperson for Positive Singles, Jenelle Marie Davis. "Actual prevention is only possible once we stop branding people who have contracted an infection with a scarlet letter and start looking at these things practically. STIs are an inherent risk of being sexually active."
"Yes, it can be risky (though not nearly as risky as driving)," Conley adds, "but of course, young adults need to learn how to manage these risks."
What's promising, however, is that Conley's study reveals that when it comes to shaming people about STIs, there is no discernible gender bias. Or in Conley's words: "It may just be that people who spread STIs are perceived so negatively that there is not a lot of room for gender differences."