Despite increased awareness and understanding, genital herpes continues to be a taboo subject. The social stigma attached to people with the virus still points to promiscuity, contagiousness, lack of judgment and personal fault. For people with genital herpes, the shame and fear of isolation that can accompany the virus, may even affect their decision to tell sexual partners, so increasing the risk of spreading the virus.
There's also something of an irony about stigma as applied to genital herpes. When people have herpes, support agencies often go to great lengths in their attempts to de-stigmatize the condition. Yet, for people without herpes, the threat of infection is also a device used within public health to help prevent the spread of the virus. It's an uneasy relationship, so in this Sharepost I've chosen to examine stigma as it relates to genital herpes, and to question whether the safe sex message needs to be updated.
The ancient Greeks referred to a mark that was cut or burned into the body as ‘stigmata'. It was a visible and outward sign that the person was shamed and was to be avoided. Today, we think of stigma as a characteristic, but one that still has the effect of devaluing the person in the eyes of others.
Genital herpes is a very common infection. Its effects, whilst sometimes very uncomfortable, are rarely much more than this. However, the stigma that can accompany genital herpes seems way out of proportion to the infection itself. The root cause of this disparity probably lies in or around the word ‘genital'. Anything related to sexual behavior is affected by a number of moral and social codes. Sexual behavior is seen as a voluntary act and the responsibility of the people involved. Following this line of logic, the person who becomes infected with genital herpes, is interpreted as showing some lack of judgment and a potential danger to others.
Herpes-related stigma is, or can be, associated with a rather complex set of perceptions and behaviors. As herpes is not a static condition, the stigma relating to it may vary over time and in response to the treatment and support an individual receives. In studies of the time taken between initial symptoms and seeking treatment, around 20 percent of women and 16 percent of men take over a week, with women taking three days longer than men. In the women studied, stigma was a key factor in the delay for seeking treatment.
All of which brings us to a question about the role of stigma in public health messages. Can we continue to promote the safe-sex message by emphasizing (directly or indirectly) the stigmatizing effects of non-compliance, yet at the same time work to de-stigmatize sexually transmitted infections? Medical understanding of genital herpes has gradually become more refined and sophisticated. Perhaps it's also time to take another look at how the safe sex message is both constructed and conveyed, in order to take account of our greater understanding of stigma?
Published On: December 18, 2008