Why might someone be worried about STIs?
As a Health Promotion Officer at WAAC, I ask this question every time we run a workshop on sexually transmitted infections (STIs), testing and prevention. Why might someone be worried about STIs?
In face-to-face workshops we’ll have a whiteboard and markers and get people to call out some of their responses. 
“Okay, yes. They might be worried about telling their friends and family.” I write it down on the board and look to another person in the group. “What else?”
Another person pipes up “Yes, they might be worried about fertility and some of the longer-term effects on the body.”
In each session I get different answers; there are a lot of reasons why people are worried about STIs. Sometimes they are worried about their bodies and health. Sometimes they are worried about the health of their sexual partners. The most frequently occurring answer though, is a narrative about shame, discrimination and stigma.
It doesn’t always come out as the word stigma. Sometimes it sounds something like “I’m worried my parents or friends will find out”. Or “I’m worried about what people will think of me, especially my partner.”
Holding the space for others
As a sexual health educator, it’s important that we hold space for people to acknowledge how this feels, to not be reductive of the very real possibility that someone might face stigma or discrimination at a positive diagnosis, and at the same time offer an alternative narrative.
An example of something we would say
“Yes, you bring up a really good point. If someone is diagnosed with an STI they can face shame or judgement. That’s actually really unfortunate because it doesn’t need to be that way. STIs don’t need to be treated differently from other infections.
Most of the judgement and shame comes from the way they are transmitted. As a society, we aren’t very good at talking about sex and sexuality and we often carry some, or a lot of shame about it. That doesn’t need to be the case though, because expressing our sexuality and talking openly about the enjoyment and pleasure of sex is a beautiful and wonderful thing.”
We all can play a role in reducing STI stigma
In education sessions, we build rapport with icebreakers and give participants an opportunity to laugh and enjoy the conversation. We use language that de-stigmatises and take time to clarify common misconceptions around sexual health, for example, we explain the difference between HIV and AIDS.
So, as a health professional, what role can you play in reducing the stigma and educating about the profound impacts of discrimination? Here’s a few ideas we came up with as a team to take away with you:
Don’t be afraid to start the conversation
Sometimes, participants in our education sessions disclose that they don’t ask the doctor about their sexual health, because they believe the doctor will bring it up if it’s important.
When you initiate the conversation, it demonstrates to your patient that looking after their sexual health and wellbeing is important and normal and can help reduce stigma and discrimination as a barrier to accessing health care.
You could say something like “My job is to support people with their health, which means lots of different things but can include sexual health and wellbeing too. Is that something you’d like to talk about?” 
Demonstrate that you are safe to talk to
You can do this verbally with sentences like “I want this to be a place where you feel safe and comfortable to talk about these things and know that I will not judge you.”
You can also take the time to explain their right to confidentiality.
Offer opportunistic STI tests
For example, “I know you’ve come in for XYZ, but regular STI testing is something that is recommended. Would you like to talk about that with me today?”
Remove your assumptions and use inclusive language
For example, when taking a sexual health history, you could use language such as “what bits do you have, what bits do they have and how do they fit together?” ‘Bits’ is an inclusive word, easily understood by patients, that refers to anyone’s body parts or genitals without assuming their sex, sexuality, and gender.
When we remove our assumptions about how people present, we get more accurate information to assist them.
Keep growing and learning
There are many things we can do to reduce stigma, discrimination and shame around STIs. 
These are just a few practical tips that may suit the time-poor spaces general practitioners and healthcare workers often find themselves in. If you would like additional tips on how to reduce STI stigma, shame and discrimination, you can call WAAC on 9482 0000 or send us an email.
We hope that this story, and our experiences and tips, can help you feel more confident to incorporate sexual health and wellbeing in your practice and de-stigmatises the conversation about sexually transmitted infections.
Bridget is a Health Promotion Officer at WAAC.