A comprehensive review of research reveals the intricate nature of disclosing a sexually transmitted infection (STI) diagnosis to a partner before engaging in sexual activity.
The peer-reviewed results, published in The Journal of Sex Research, shed light on the diverse feelings and emotions individuals experience when faced with the prospect of disclosure, with only around half or fewer feeling able to disclose their diagnosis to a partner before sexual engagement.
The expert team from the University of Tennessee emphasizes the need for comprehensive sex education throughout life, from youth to late adulthood, to curb the spread of STIs, excluding HIV. “Many individuals lack sufficient comprehensive sex education,” the authors state in the paper. “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 Complexity of Disclosure
The review highlights the vulnerability of individuals diagnosed with STIs and the difficult decisions they face, which can have harmful consequences for their identity and relationships. The authors note that “disclosure is an interpersonal process that involves not just the individual faced with the decision to disclose, but the intended receiver.”
The findings underscore the need for continuous comprehensive sexual health education throughout the life course and an increase in the number of U.S. states that offer comprehensive sex education. With around one in five people in the U.S. having an STI at any given time and more than 26 million incidents reported to health services, the rates of chlamydia, gonorrhea, and syphilis have been at record levels for several years and continue to rise.
Reasons for Non-Disclosure and Strategies Used
Despite public health agencies, including those in the U.S., recommending disclosure about an active STI, the review shows that fear can prevent many people from revealing their diagnosis. Other reasons for non-disclosure include the belief that condom use is sufficient protection, a lack of obligation in situations such as one-night stands, and fear of being broken up with. Some individuals even described “passing” as uninfected to avoid having to tell.
On the other hand, 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 various ways to reveal their STI status, while non-disclosers employed strategies to pass as uninfected, withdraw from relationships, and use STI outbreaks to time sexual activity.
The review also reveals 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 add. “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 authors suggest that future research should adopt a destigmatizing approach and emphasize that “initiating sexual health conversations is everyone’s responsibility.”
