In a world where we post everything from our monotonous daily routines to some of our most intimate moments on social media, it’s surprising that we still don’t talk openly about sex. As a matter of fact, this thing we all do is the reason we are even here.
Everyone wants to do it. Oftentimes, it is glamorized. But who is really talking about sexual health and wellness? WE ARE!
This April, for National Marginalized Community Health Month and Stress Awareness Month, we are exploring the disturbingly disproportionate prevalence rate of sexually transmitted infections (STIs) in some communities of color, possible reasons, and how you can begin taking care of your sexual health.
Let’s Talk About Sex, Baby – The Facts!
In 2019, U.S. Health Departments reported that chlamydia, gonorrhea, and syphilis had risen significantly since 2015. Some marginalized groups had disproportionately more cases than whites.
Reports from the Centers for Disease Control (CDC) show that in 2015 through 2016, some ethnic groups had higher rates of herpes types 1 and/or 2 than Non-Hispanic whites. These ethnic groups included Non-Hispanic Asians, Mexican-Americans, and Non-Hispanic Black people.
Although the CDC also reported that the 2015 to 2016 rates decreased from the 1999 to 2000 rates, which is promising, the disproportionate prevalence rates in some marginalized communities are, nevertheless, concerning.
That need for concern is confirmed by reports as recent as 2023 from The National Library of Medicine (NLM), which shows that Black and Hispanic individuals have higher STI prevalence rates.
It’s important to note that the 2019 Health Departments report states that a rise in cases could be due to increased screening and testing or increased transmission. However, the health agencies still highlight that, despite increased testing in the overall population, STI prevention and treatment services historically have not been equitably distributed in people of color (POC) communities.
On the other hand, the NLM found that while some data report lower testing rates for these communities, other data demonstrate they have “the highest testing engagement compared to other ethnic groups.” So, what’s really going on?
One thing is for sure: high STI numbers in our community are not a reflection of identity. Studies offer multiple variables as possible reasons.
Access
People of color experience health disparities due to inaccessibility to regular and quality care.
Marginalized communities disproportionately experience poverty, unemployment, low income, and inadequate education opportunities — all barriers to acquiring needed health care.
Mistrust – Historical and Current Wounds
People of color have historically been stereotyped as dirty, disease-carrying, and promiscuous. This could cause some to be reluctant to test or share their sexual histories with medical professionals.
This brings to mind the infamous Tuskegee Syphilis Experiment by the U.S. Public Health Service (USPHS) conducted on African Americans. These and other past and current lived experiences of institutional racism and discrimination further suggest why people of color may not seek sexual medical care or other medical attention.
Stigma and Shame
STI stigma is another possible cause of higher STI prevalence rates. While biases exist in the general society, there is also culturally contextualized stigma.
For example, some women of color, particularly Hispanic women, may not get tested for STIs because of the shame associated with testing.
A study involving men and women of all ages and mixed races demonstrated evidence that a higher level of stigma and shame was inversely related to testing for STIs.
However, in some communities, stigma had more influence on testing behavior than shame. A study on 15 to 24-year-old African American males demonstrated evidence that those with higher levels of STI-related stigma, but not shame, were less likely to get tested. Another study on mostly black youth confirmed these findings: participants with higher STI stigma, not STI shame, were less likely to be tested.
This is not as ironic as it may seem. Stigma is the belief that others are thinking negatively or judging you. Shame is when you think you are a bad person or label yourself inherently negatively. Although most people willingly blast their business all over social media, they show themselves living their best lives, but not living real life. Stigma — the belief that others are judging and thinking negatively about you — can be more important than one’s self-opinion.
Equity, Access & Mental-Physical Connection
Not knowing you have an STI or not getting treatment both increase the chances of infecting a partner. Untreated STIs can turn into more serious illnesses and even be passed from mother to child.
Care is within reach. Choosing to get tested isn’t a sign that something is wrong — it’s a sign that you value your pleasure, your partner, and your peace of mind. Whether an STI is curable or considered lifelong, we don’t have to let stigma, shame, or inequitable prevention and treatment dictate our self-care. Check out these resources for culturally conscious sexual health services and more.
- GetCheckedDC: Free, at-home testing and other prevention resources.
- Us Helping Us, People Into Living Inc.: Holistic health services to the Black community.
- Whitman-Walker – Max Robinson Center: Inclusive, empathetic medical, dental, and mental health services.
- NovaSalud Inc. Culturally competent and language-appropriate comprehensive services.
- Latin American Youth Center (LAYC): Health and wellness services focusing on the unique needs of Latino and African American low-income youth.
- The DC Health and Wellness Center: Services insured and uninsured community members.
LaShonda Tucker
LaShonda Tucker is a freelance writer, poet, and spoken word artist in Atlanta. When she isn't writing, she enjoys playing her violin. She earned her master's degrees from the University of Georgia and Kennesaw State University, and her bachelor's degree in English from the University of Michigan.
