Only around half or fewer individuals felt able to disclose their STI (sexually transmitted infection) diagnosis to a partner before sexual engagement.
This is according to a study – “Disclosure of Sexually Transmitted Infections to Sexual Partners: A Systematic Critical Literature Review” by Kayley D. McMahan and Spencer B. Olmstead – that appeared in The Journal of Sex Research.
Around one in five people in the US alone have a STI at any one time with more than 26 million incidents reported to health services. Specifically, chlamydia, gonorrhea and syphilis have been at record levels for several years and continue to rise, according to data.
Methods recommended by the Centers for Disease Control and Prevention to prevent infections include talking to partners about sexual histories such as disclosure of an active STI, as well as using prophylaxis (such as using condoms, oral dams, vaccines.
Disclosure is the voluntary or involuntary sharing of personal information with another individual such as the fact they have an STI. This differs from partner notification, which is similar to contact tracing and can involve the use of anonymous messaging services.
While public health agencies recommend disclosure about an active STI is ideal, this study, which looked at 32 papers, showed fear can prevent many people revealing their diagnosis.
Other reasons included: people believing that condom-use is protection enough; a lack of obligation such as a one-night-stand situation; and fear of being broken up with. Some even described ‘passing’ as uninfected to avoid having to tell.
People who disclosed to their partner did so out of love, feelings of moral obligation, or relationship-related reasons, such as greater levels of commitment, relationship quality, length of time together, and feelings of closeness.
Disclosers used a variety of ways to tell people their STI status. Non-disclosers used strategies to pass as uninfected, withdraw from relationships, and using STI outbreaks to time sexual activity.
In the review, herpes and HPV were featured the most, while chlamydia, gonorrhoea and trichomoniasis were also common. The results also revealed that the experiences of people on the receiving end of STI disclosures are not well-represented in such studies.
“One of the key factors that determines whether an individual will disclose is the intended receiver. How the receiver will react and respond and the relationship with the receiver can be critical influences on the discloser,” the authors added.
“As such, it is imperative that we investigate the experiences of receivers to understand the process of STI disclosure more comprehensively. This is so that we may continue to improve sexual health education and care for all.”
The researchers emphasized the need for “comprehensive sex education to be provided throughout life: from youth to late adulthood” since “many individuals lack sufficient comprehensive sex education. Rather than being taught how to correctly use prophylaxis, identify its limitations, and understand the scope and transmissibility of STIs, youth are only encouraged to be abstinent.”
The added that “individuals diagnosed with STIs may be in vulnerable positions and may face difficult decisions, the outcomes of which can be harmful to their identity and relationships. The process of disclosure is complex. Certain contexts, particularly committed relationships, elicit disclosure, whereas others inhibit disclosure. Disclosure is an interpersonal process that involves not just the individual faced with the decision to disclose, but the intended receiver.”
