Abstract
BackgroundAs stigma is a socially constructed concept, it would follow that stigma related to sexual behaviours and sexually transmitted infections would carry with it many of the gender-based morals that are entrenched in social constructs of sexuality. In many societies, women tend to be judged more harshly with respect to sexual morals, and would therefore have a different experience of stigma related to sexual behaviours as compared to men. While a variety of stigma scales exist for sexually transmitted infections (STIs) in general; none incorporate these female-specific aspects. The objective of this study was to develop a scale to measure the unique experience of STI-related stigma among women.MethodsA pool of items was identified from qualitative and quantitative literature on sexual behaviour and STIs among women. Women attending a social evening program at a local community health clinic in a low-income neighbourhood with high prevalence of substance use were passively recruited to take part in a cross-sectional structured interview, including questions on sexual behaviour, sexual health and STI-related stigma. Exploratory factor analysis was used to identify stigma scales, and descriptive statistics were used to assess the associations of demographics, sexual and drug-related risk behaviours with the emerging scales.ResultsThree scales emerged from exploratory factor analysis – female-specific moral stigma, social stigma (judgement by others) and internal stigma (self-judgement) – with alpha co-efficients of 0.737, 0.705 and 0.729, respectively. In this population of women, internal stigma and social stigma carried higher scores than female-specific moral stigma. Aboriginal ethnicity was associated with higher internal and female-specific moral stigma scores, while older age (>30 years) was associated with higher female-specific moral stigma scores.ConclusionDescriptive statistics indicated an important influence of culture and age on specific types of stigma. Quantitative researchers examining STI-stigma should consider incorporating these female-specific factors in order to tailor scales for women.
Highlights
As stigma is a socially constructed concept, it would follow that stigma related to sexual behaviours and sexually transmitted infections would carry with it many of the gender-based morals that are entrenched in social constructs of sexuality
Stigma has long been a part of our social existence, with the original Greek translation referring to a physical sign exposing a moral imperfection[1]
The median age was 42 years, approximately 40% identified as Aboriginal, Inuit or Métis, and approximately 40% reported having completed high school
Summary
As stigma is a socially constructed concept, it would follow that stigma related to sexual behaviours and sexually transmitted infections would carry with it many of the gender-based morals that are entrenched in social constructs of sexuality. Women tend to be judged more harshly with respect to sexual morals, and would have a different experience of stigma related to sexual behaviours as compared to men. The topic of sexually transmitted infections (STIs) presents a good example of the dynamic and socially fluid nature of stigma, as opposed to the stationary, objectified definition it is sometimes given [2]. Today's views on sexual behaviours and STIs may not be as overtly imbalanced, but there remains an underlying gender bias in the stereotypes and the meanings associated with STIs, resulting in different stigma experiences and generally higher negative impacts among women [8,9]
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