More than Usher: stigmatizing STDs is bad for everyone

Three weeks ago, celebrity gossip headlines were filled with one topic: R&B singer Usher tested positive for genital herpes. A woman, whom Usher is accused of giving herpes to, has brought suit against the singer, suing him for $20 million. The details are perfect for a media frenzy: a popular celebrity, sex, drama, lots of money, and a lawsuit. What has not been conveyed effectively are the medical realities of sexually-transmitted infections (STIs), and the ensuing socio-political realities.

I would like to preface with two caveats: I am not a doctor. If you or someone you know has a medical concern, do not consult this blog or me for medical advice. As with all of my articles, I try to use as many citations from reputable sources as possible. However well-cited this post may be, it is no substitute for an accredited medical professional.

Second, in this article I use the term sexually-transmitted infections, or STIs. This is more accurate than the title of “sexually-transmitted disease” (STD) or the outdated term “venereal disease” (VD). According to the University of Maryland, “some infections are curable and may not cause any symptoms,” however, “if the infection results in altering the typical function of the body, it is then called a disease.” Sexually-transmitted diseases are always preceded by sexually-transmitted infections, but many infections do not go on to become diseases. In the title of this post, I used the term “STD” due to its widespread use, despite it being a less accurate term.

Sexually transmitted infections are, by nature, serious medical conditions. However, life for people with STIs is perceived by many as being much worse than it actually is. Most STIs are curable, and for those who carry incurable STIs, medical treatments can generally enable these people to lead normal lives. The brunt of the concern is that many people lack access to proper health care and sex education, or are needlessly stigmatized against seeking out such services.

To be perfectly clear, STIs can be dangerous and life-threatening for many people without access to healthcare. What I discuss in this article is what life with STIs entails if one has access to health services. Sadly, this is a privilege deprived to all too many people. Luckily, organizations such as Planned Parenthood, are fighting to change that.

Planned Parenthood’s website lists eleven of the most prevalent sexually transmitted infections: chlamydia, gonorrhea, hepatitis B, herpes, HIV/AIDS, HPV, molluscum contagiosum, pubic lice, scabies, syphilis, and trichomoniasis.

Of these eleven, seven are curable: chlamydia, gonorrhea, molluscum contagiosum, pubic lice, scabies, syphilis, and trichomoniasis. With proper medical attention, these STIs can generally be completely cured.


Photo captured July 16, 2017.

That leaves four STIs that cannot be cured: HPV, hepatitis B, HIV/AIDS, and herpes. Let’s break them down.

The most common STI is HPV, which is short for human papillomavirus. While it is prevalent, it is also mostly harmless. “Almost everyone who has sex gets the HPV virus at some point in their lives,” notes Planned Parenthood, “Most people with HPV have no symptoms and feel totally fine, so they usually don’t even know they’re infected.” In rare cases, it can cause cancer. However, a vaccine for HPV exists and high-risk HPV can be easily treated before developing into something more serious.

Hepatitis B cannot be cured, but more than 90% of adults who have it totally recover. In rare cases, it can lead to serious diseases of the liver. A small percentage of adults develop long-lasting hepatitis B and risk spreading it to others, but medication can be used to help control this. There are vaccines for hepatitis B.

HIV/AIDS makes headlines frequently. HIV, or human immunodeficiency virus, is a virus that attacks a body’s immune system, and can lead to AIDS, or acquired immunodeficiency syndrome, the severe phase of HIV. No cure exists, but most HIV-positive people can lead normal lives. Planned Parenthood advises:

Antiretroviral therapy (ART) is a combination of medicines that lower the amount of HIV in your blood — sometimes to the point where your HIV won’t show up on tests. ART can help you stay healthy for many years, and lower your risk of giving HIV to anyone else.

HIV is perhaps the most deadly STI, but a large part of its deadliness is lack of access to effective healthcare. This is made worse by social stigma many HIV-positive people face.

Last, the topic du jour: herpes, which Usher is accused of carrying. Including all forms of herpes, 90% of the global population has it. (No, that was not a typo.) Herpes is spread by skin-to-skin contact; myths about contracting herpes from toilet seats are unscientific.

Herpes manifests itself in itchy, painful sores or blisters around the mouth or genitals. For some people, the symptoms are so mild that they are unaware that they have herpes, although results vary. While scientists are searching for cures, none currently exist. Treatment, known as suppressive therapy, can help prevent future outbreaks and can drastically reduce the chance of transmitting it to a partner.

To reiterate: all of these are serious infections that should not be taken lightly. Even curable STIs, such as syphilis, can have serious repercussions if gone untreated. While the negative aspects of STIs are widely known, many people are unaware that the vast majority STI-positive people who receive treatment are able to live normally, pursue fulfilling romantic relationships, and have healthy sex lives.

This brings us back to the allegations about Usher. Rachel Cote at Jezebel penned a great commentary about the public response to the lawsuit:

I’m not hear to pass judgment on either Usher or this woman; after all, the details regarding the case are murky. I will say, however, that the enduring stigma attached to sexually transmitted infections and diseases obstructs open dialogues about sexual health. People are far less likely to speak candidly about their sexual history if they fear demonization. Clearly transparency is important to any sexual relationship, and every partner is entitled to it. And while that’s ultimately the responsibility of the individual, we shouldn’t encumber lines of communication with ideologies of slut-shaming and the moral crucifixion of those with STIs or STDs.

Cote is on point: people who have sexually transmitted infections are often stigmatized and demonized. A few years ago, Jim Carrey’s ex-girlfriend committed suicide after they argued about her getting tested for herpes.

A casual Google search reveals that many other STI-positive people have similar thoughts. According to Cosmopolitan, “quality of life plummets after diagnosis, per research in the journals Sexually Transmitted Infections and Genitourinary Medicine, and low sexual self-esteem and anxiety about sex linger for years.” Given what we know about the effectiveness of STI cures and treatments, it is clear that this stigma leads many people to have a skewed perception of the medical reality.

Dr.  Jaime Myers at Monmouth University notes:

Stigma has consequences […] It can discourage people from getting tested or seeking treatment if they have sores, from talking to their partner or doctor, and from taking part in studies, which would help find better treatments or vaccines or cures.

If people are concerned with alienating judgement, they are less likely to do what is best for them and the people around them.

In doing research for this piece, I had a realization: as I do not test positive for any sexually-transmitted infection, I am speaking from a place of personal ignorance. British publication Daily Mail posted a piece featuring interviews with a number of herpes-positive people. It is a great piece, but one quotation stood out to me in particular: “You don’t have to wear a scarlet letter H across your chest for the rest of your life.”

This stigma is made worse by a lack of political will in Washington D.C., as well. Planned Parenthood (quoted many times in this article!) is one of the most available, widely-known, well-regarded health clinics in the United States that offers testing, treatments, and referrals for sexually-transmitted infections. Planned Parenthood offers a “sliding fee scale”, which means that people are charged according to what they can pay. These services require millions of dollars, much of which come from governments, to provide essential health services.

Funding Planned Parenthood and other similar clinics is a public health victory. And given that every $1 invested in these clinics saves $7 of taxpayer money, it is an economic victory as well. While Planned Parenthood may also be the country’s largest abortion-providing medical organization, only 3% of its total services account for abortion. To be clear, a 1970s law prevents federal money from paying for abortion services.

As Republicans scheme to gut federal funding for Planned Parenthood, states that have adopted such policies are already feeling the effects. After Indiana cut funding, an HIV outbreak occurred. Texas also cut funding, which lead to entire counties with untested citizens. Take the cultural stigmatization of STIs and reduce access to health services, and public health crises are the logical conclusion.

Sexually transmitted infections are serious medical concerns. However, modern medicine allows people with STIs to live normal, functioning lives–assuming they have access to healthcare. Everyone should be regularly tested, and legislatures should strengthen people’s ability to do so. The stigma surrounding STIs can not only harm individuals, but also leads to public health issues. Given all of this, perhaps the memes about Usher aren’t quite as funny as some people believe.


In Post Notes, I add some additional thoughts or context to a blog post I’ve previously written. That can be found here.