Social Stigma and Negative Consequences: Factors that Influence College Students' Decisions To Seek Testing for Sexually Transmitted Infections.
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| Title: | Social Stigma and Negative Consequences: Factors that Influence College Students' Decisions To Seek Testing for Sexually Transmitted Infections. |
|---|---|
| Language: | English |
| Authors: | Barth, Karen R., Cook, Robert L., Downs, Julie S., Switzer, Galen E., Fischhoff, Baruch |
| Source: | Journal of American College Health. Jan 2002 50(4):153-159. |
| Peer Reviewed: | Y |
| Page Count: | 7 |
| Publication Date: | 2002 |
| Document Type: | Journal Articles Reports - Research |
| Descriptors: | College Students, Decision Making, Higher Education, Screening Tests, Sexuality, Social Influences, Student Attitudes, Student Behavior |
| ISSN: | 0744-8481 |
| Abstract: | Examined key factors that influenced college students to seek screening for sexually transmitted diseases. Data from student interviews indicated that social stigmas and negative consequences (particularly the negative consequences of testing and perceived vulnerability to infection) represented significant barriers to being tested. Many students stated they would rather not know than be tested. (SM) |
| Entry Date: | 2002 |
| Accession Number: | EJ646426 |
| Database: | ERIC |
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| FullText | Links: – Type: pdflink Url: https://content.ebscohost.com/cds/retrieve?content=AQICAHj0k_4E0hTGH8RJwT4gCJyBsGNe_WN95AvKlDbXJGqwxwFBx8XfrVD3F1QdTkC8hUrgAAAA4TCB3gYJKoZIhvcNAQcGoIHQMIHNAgEAMIHHBgkqhkiG9w0BBwEwHgYJYIZIAWUDBAEuMBEEDBfbMzzg4-FmZhay0wIBEICBmYiiHjnFY6wlmfiXN8qsxBVTe88KpYRmLaVgZZKrd-EPx8fs9oN4p2bU4J7Yz2fcY39UNC0A2sEj-qPYGBEWDleBcDHKJ91hdO5qhP5Y5tr06gW3TO3UX6nAd2DZW21izYma7fFVy1R7JYP8mmE8T9BJOpfUyKP4o9a7xT7djrEGGnkPfs_LYVaQEmrkl9ige37lnTOkCDn1yA== Text: Availability: 1 Value: <anid>AN0006437113;acl01jan.02;2002May26.16:10;v1.8</anid> <title id="AN0006437113-1">SOCIAL STIGMA AND NEGATIVE CONSEQUENCES: FACTORS THAT INFLUENCE COLLEGE STUDENTS' DECISIONS TO SEEK TESTING FOR SEXUALLY TRANSMITTED INFECTIONS </title> <p>Abstract. College students often delay or avoid seeking testing for sexually transmitted infections (STIs), even if the services are readily available. We used in-depth, semistructured interviews to survey 41 college students aged 18 to 23 years about factors that influence decisions about STI testing. We grouped statements into 9 themes that represent influences on the decision. The most frequently mentioned factors were negative consequences of testing and perceived vulnerability to infection; other issues that influenced decision making included perceived benefits, perceived severity of diseases, public knowledge and opinion, social norms, provider characteristics, test-site characteristics, and personal considerations. Social stigmas and negative consequences appear to represent significant barriers to college students' being tested, which could increase the risk of spreading infections to others. Clinicians and health educators should raise students' awareness of the need for screening and should work to reduce the barriers to screening, including social stigmas and negative consequences.</p> <p> <bold> Key Words: </bold> decision making, sexually transmitted infections, social norms, social stigma, vulnerability</p> <p>Each year, at least 3 million new cases of sexually transmitted infections (STIs) are reported among persons in the US who are under the age of 25 years.(<reflink idref="bib1" id="ref1">n1</reflink>) Although the exact number of STIs among college students is not known, college students frequently engage in sexual behaviors that place them at increased risk of STIs.(<reflink idref="bib2" id="ref2">n2</reflink>) Any delay in diagnosis and treatment can increase the risk of disease consequences, including spreading the infection to others. However, many college students, adolescents, and young adults delay seeking care when symptoms are present and do not seek STI screening when symptoms are absent.(<reflink idref="bib3" id="ref3">n3-n8</reflink>)</p> <p>It is important to understand college students' health-seeking behaviors regarding STIs so that barriers to students' use of testing services can be reduced or eliminated. Several health behavior theories, including the health belief model,(<reflink idref="bib9" id="ref4">n9</reflink>) the theory of reasoned action,(<reflink idref="bib10" id="ref5">n10</reflink>) and the theory of health services utilization,(<reflink idref="bib11" id="ref6">n11</reflink>) suggest that a broad spectrum of individual, societal, and health system factors may influence health-seeking behavior in general terms. However, very few studies provide objective data on factors that influence health-seeking behaviors among college students. To date, the studies have focused primarily on general health-seeking behaviors,(<reflink idref="bib6" id="ref7">n6</reflink>) noncollege-student populations,(<reflink idref="bib12" id="ref8">n12-n16</reflink>) or HIV testing,(<reflink idref="bib17" id="ref9">n17-n18</reflink>) which may not reflect the issues that college students consider. The few studies that have examined STI-related health-seeking behaviors among college students have sampled students who had already sought healthcare(<reflink idref="bib5" id="ref10">n5</reflink>) or had responded to a written survey in which possible barriers were restricted to those listed.(<reflink idref="bib19" id="ref11">n19</reflink>, n20)</p> <p>A qualitative study design allows the identification of issues from the perspective of students themselves. Such data may identify barriers that have not been adequately addressed by the healthcare community, including misperceptions that could be corrected through educational interventions. The primary purpose of the study we describe here was to identify and describe key factors that influence STI test-seeking behavior among college students.</p> <hd id="AN0006437113-2">METHOD</hd> <p>In the study, we used a qualitative research design that was approved by the University of Pittsburgh Institutional Review Board. Using hypothetical scenarios and open-ended questions, we sought to identify a broad range of perspectives and to simulate the conditions of making actual decisions about STI testing.(<reflink idref="bib21" id="ref12">n21</reflink>, n22) We developed a semistructured interview that contained open-ended questions and hypothetical scenarios to assess factors that influence STI test seeking. We pilot tested the interview with 8 students similar to the proposed sample group. After each pilot interview, we asked the students to comment about any unclear or awkward questions and revised interview questions accordingly.</p> <hd id="AN0006437113-3">Participants</hd> <p>The sampling frame included all undergraduate students aged 18 to 22 years who were enrolled in first or second summer session at an urban university in 1997. We obtained a list of 130 randomly selected students from the university's Computing and Information Service (n = 45) and Housing Office (n = 85). The selected students received a mailed invitation to arrange a confidential, face-to-face interview about their knowledge and opinions about STIs. Nonrespondents received a second letter; 66 students (50.3%) responded and agreed to participate, but we found it impossible to determine the exact response rate because some students were not enrolled during the second summer session, when we mailed the invitations. We sought to interview at least 44 students to identify beliefs held by at least 5% of the university population.</p> <hd id="AN0006437113-4">Procedures</hd> <p>We interviewed students primarily in the order that we received their responses, but some respondents were specifically selected to ensure that the sample included sufficient representation from students of different genders, ethnicities, numbers of sexual partners, and STI-testing history. Each participant received $15 for being included in the study. Three completed interviews could not be used because of transcription difficulties, so our data are therefore based on 41 coded interviews.</p> <p>All of the respondents provided written informed consent for their participation, and one of the study authors (KRB) conducted the interviews, which lasted approximately 30 to 45 minutes. The interview began with the following scenario concerning a hypothetical friend of the same gender as the participant:</p> <p>Your friend comes to you and tells you that she recently had sex with someone for the first time. At first she wasn't worried, but now she is wondering if she should be tested for any STI. What additional information would you want to know to help her decide whether to get tested?</p> <p>After their initial responses, we prompted participants to think of as many factors as possible that would be relevant to the decision and to elaborate on each suggestion. Subsequent open-ended questions addressed concerns people might have about testing, opinions about various test sites, differences between being tested for HIV versus other STIs, and the need for testing in the absence of symptoms. At all stages, participants were able to speak in their own terms and were encouraged to elaborate on their views. When necessary, the interviewer asked follow-up questions to clarify responses or obtain more details.</p> <p>We used qualitative content analysis(<reflink idref="bib23" id="ref13">n23</reflink>) to analyze the audiotaped and transcribed interviews; two trained research assistants assigned codes to each clause in the interview. The initial codes were based on a previously proposed model(<reflink idref="bib4" id="ref14">n4</reflink>) that incorporated ideas from the health belief model, the theory of reasoned action, and the theory of health services utilization.(<reflink idref="bib9" id="ref15">n9-n11</reflink>) We added additional codes based on previous research on STI-related behaviors (<reflink idref="bib4" id="ref16">n4</reflink>, n12-n20, n24, n25) and new ideas identified by participants. Reliability between the two coders was 81% overall, which was considered acceptable, given the large number of possible codes (n = 102). After coding all data, we combined codes with similar meanings and grouped them into 9 major themes. We validated the final coding sequence through presentation and feedback from college students, health educators, and a decision-sciences seminar group.</p> <hd id="AN0006437113-5">RESULTS</hd> <p>The data in Table 1 show the participants' characteristics. Most of the respondents were younger than 21 years; one third were nonwhite, and one fourth reported having had more than five previous sexual partners. Compared with the overall population of undergraduate students in 1997, the study participants were more likely to be women (61% vs 54%) and African American (29% vs 7%). The final coding scheme included 5 categories related to individual characteristics and attitudes, 2 related to societal factors, and 2 related to the healthcare system (see Figure 1).</p> <hd id="AN0006437113-6">Individual Factors</hd> <p>Perceived Negative Consequences were among the most commonly mentioned reasons for rejecting STI tests, with the greatest concern respondents expressed centering on what other people would think. Participants were specifically concerned about being perceived as "loose," "dirty," "stupid," "irresponsible," and "not caring about yourself." The effects of gossip were mentioned often, and a few participants said that women were judged more harshly than men were. Embarrassment was specifically mentioned by 61% of the participants. Many discussed the fear of receiving a positive test result, using phrases such as "scared to find out," "fear that you might have it," "scared of having a disease," and "fear that it might come back positive."</p> <p>Negative Personal Emotions associated with testing or having a disease (eg, shame, guilt) were also listed. Finally, fear about the test itself, as well as the idea that one's future might be affected, were mentioned by some participants. Examples of statements in the negative personal emotions category include the following:</p> <p>"You don't want to tell people you are getting tested. I mean, it's that telephone effect. If person A tells person B he is getting tested, then person B tells person C that person A thinks he has an STI, and by the time it gets to person F, person A has AIDS."</p> <p>"It might change your life some. A rumor might get spread about her; people can be pretty cruel sometimes. They might look at her different, like she was loose, doesn't really care about herself. Maybe that she's cheap."</p> <p>"If a guy gets something it's like, 'so what, you da man!' But if a woman gets something, it's like she sleeps around."</p> <p>"I think that a lot of people are embarrassed about sexually transmitted diseases because they feel that that reflects poorly on them. It means that they were promiscuous or that they weren't well informed or that they did something stupid."</p> <p>"She would feel guilty, ashamed, fearful ... ashamed because she heard all about using contraceptives and now look what happened. People would be like 'that is dumb. You should have known better.' Guilty because you think it's your fault."</p> <p>"If you've never been through a Pap smear, you might be scared about the procedure."</p> <p>"No one would want to sleep with you, no matter how good you looked."</p> <p>Examples from this category included the following: "I would advise her to get checked out. Just so she could feel good about knowin' I'm definitely OK."</p> <p>"One girl's boyfriend cheated on her, and she just wanted to make sure that she didn't get anything."</p> <p>"The earlier you catch an STI, the more likely you'll be able to treat it more effectively without further damage to the body."</p> <p>"You wouldn't want to infect someone that you cared about. I mean, that would be my nightmare about it."</p> <p>Perceived Vulnerability to contracting an STI appeared to play a substantial role in the decision about whether to be tested. The most commonly cited issue in this category was the characteristics of the sexual partner (eg, identity, reputation, sexual history, histories of testing and drug use). The presence of symptoms was consistently cited as a reason to test, and the absence of symptoms was reassuring to some but not to others. Many participants believed that vulnerability to infection would be influenced by specific activities that might occur during sexual encounters, including with drugs or alcohol, condom use, and ejaculation. Participants commonly mentioned past sexual history. A few respondents mentioned nonsexual exposures: 2 believed that STIs could be contracted from donating blood, another was worried she might contract herpes by sharing a washing machine with someone infected with the virus. Below are a few representative quotations from this category.</p> <p>"In different situations, you feel differently about the person, like if you met him in a church or a bar."</p> <p>"I'd ask her if she knew this person well or if it was a 1-night stand .... If you don't know the person at all, then you don't know who they've been with."</p> <p>"I'd ask him how much he knew about the girl. If it was someone who wasn't very promiscuous or just had sex for the first time, you wouldn't need to be worried as much as if it was someone who was always having sex."</p> <p>"If she wasn't having any symptoms, I would probably think there's nothing to worry about."</p> <p>"Just because you don't have any symptoms and you feel fine doesn't mean you don't have an STI."</p> <p>"If you have a cut in the mouth or something like that, if he shoots off--you know, ejaculates in her mouth or whatever--there's a chance you can pass it. But if there's no ejaculation, it can't be transferred. The same is true in her vagina. You have to ejaculate."</p> <p>"The more partners you have, the more you are at risk of contracting an STI. No matter if you have one partner or 20 partners, you need to be tested."</p> <p>Perceived Severity of Diseases was discussed by most of the participants. Few, if any, commented that specific STIs were serious medical problems. Rather, most described STIs as not very serious, especially when compared with human immunodeficieny virus (HIV) and AIDS. A commonly cited theme was, "[AIDS] is the number one killer. People don't care about the other STIs, just AIDS."</p> <p>The Personal Characteristics category reflected unique qualities of a person, rather than individual attitudes or beliefs. Two personality traits were often identified as potential barriers to seeking a test: denial that one might contract an STI, and preferring not to know, despite an awareness of being at risk. For example, a few people mentioned not donating blood because they did not want to know their HIV status. Interestingly, none of the participants identified demographic characteristics such as age, race, or gender as being important in STI-testing decisions (although we did not specifically probe for these issues). Examples of personality traits follow:</p> <p>"A lot of people still have the attitude 'It can't happen to me. Somehow, I am magically immune to everything bad. My actions don't matter, I will still be healthy tomorrow.'"</p> <p>"Maybe she is in denial and doesn't want to deal with it."</p> <p>"He'd rather be walking around not knowing than walking around knowing that he has something."</p> <hd id="AN0006437113-7">Societal Factors</hd> <p>The Social Norm Category represented general societal expectations or norms, rather than individual feelings or beliefs. Many participants specifically mentioned a social stigma surrounding the idea of sexually transmitted diseases. Others commented on societal norms promoting privacy about sexual behaviors. For example,</p> <p>"I don't know, there's just something, an aura, around getting tested for an STI. You'd rather get tested for mono rather than AIDS. Even though mono is just as contagious or maybe even more so ... someone who has herpes is going to be avoided more than the person who has mono."</p> <p>"STIs are not nice things. They are disgusting, they are not something you want to show with pride."</p> <p>"You have to talk about things that you do under the covers, which is generally bad or wrong because of the Christian morality."</p> <p>The Public Knowledge and Opinion category incorporated concerns about what the general public knows, believes, and hears about STIs. Three quarters of our sample said that it is more common to get tested for HIV than other STIs because HIV and AIDS receive an enormous amount of media attention, whereas other STIs may be relatively ignored. Lack of knowledge about STIs also seems to be a barrier to testing. Examples in this category included the following:</p> <p>"I think people have just forgotten about the other STIs. It's like the only STI people regard anymore is HIV. Like if you don't have HIV, then you're fine. Which is not the case."</p> <p>"People hear a lot of talk about HIV and so they want to get tested to make sure they don't have that ... they think it's good they don't have HIV, but they don't realize they should get tested for the other stuff."</p> <p>"As far as public health announcements, [they are] geared toward HIV and AIDS, because if you get that, then you will die."</p> <p>"A lot of people don't even know about chlamydia or know enough to get tested for it."</p> <hd id="AN0006437113-8">Health System Factors</hd> <p>Participants mentioned several factors about clinics, providers, and testing methods that could influence testing decisions. Most of the health system factors seemed to affect decisions about where, rather than whether, one seeks a test.</p> <p>Provider Characteristics, such as gender, training background, and comfort were each mentioned, although fewer than half of participants discussed each of these topics. A few expressed skepticism about the training level of nurses and nurse practitioners and would choose a facility at which a physician such as a gynecologist would see them. Several participants mentioned preferring to see one's own physician, rather than someone new, because they felt comfortable with that provider. The following are examples of these comments:</p> <p>"Someone who was abused by a man might not want a male doctor or vice versa. Or women feel like the male gynecologists don't understand a woman's body like another woman would."</p> <p>"I see a female gynecologist because I feel more comfortable that way. I don't think a man or woman physician is better ... but I just feel that I don't want a man looking at my body the way a gynecologist does."</p> <p>"Your own doctor would be the best thing because this is somebody that you've been going to and somebody that really knows you. You'll feel more comfortable with that person."</p> <p>Test and Setting Factors included reputation, cost, and confidentiality. Other clinic-related factors included convenience (eg, ease of obtaining an appointment and getting to the test site) and the availability of other services. For example, some participants preferred a public STI clinic because counseling and free condoms are available, whereas others preferred clinics in hospitals because they might be equipped with "better technology" than a public clinic. Finally, 20% of the respondents mentioned not knowing where to go as a barrier to seeking a test. Some statements about test and clinic characteristics follow:</p> <p>"Student Health, don't go there. Like my one friend was told she had chlamydia and she didn't even have chlamydia."</p> <p>"Our college health clinic, they cater to college students so they know how to treat you well ... they know what you are going through."</p> <p>"[The county STI clinic is] there for that. You know they're going to know what they're doing."</p> <p>"[The county STI] clinic has a lower standard. It might be for lower class or homeless people. It might not be as up-to-date as if you went to a hospital or a doctor's office."</p> <p>"If it was a family doctor and the doctor knew the parents really well, her parents would find out."</p> <p>"You might be able to go to a clinic and not run into somebody, whereas if you went up to the student health services, you might see fellow students and they'll say. 'Oh, what are you doing here?' and might cause a little bit of a scene, or else it might go on your record and you might not want that to be in your record."</p> <hd id="AN0006437113-9">COMMENT</hd> <p>Delays in diagnosis and treatment of STIs have serious individual and public health consequences.(<reflink idref="bib3" id="ref17">n3</reflink>) Our findings indicated that many factors contribute to college students' delays in seeking testing or screening for STIs.(<reflink idref="bib5" id="ref18">n5</reflink>, n6, n12-n20, n24, n25) The qualitative nature of this study expands on previous literature by providing specific examples of issues that may limit test seeking, including the social stigma and negative consequences of testing. Our data also suggest that the minimal media attention paid to STIs other than HIV may convey a message that these infections are unimportant or inconsequential, thus reducing interest in STI screening.</p> <p>One of our most striking findings was the number and diversity of comments related to perceived negative consequences of testing, such as concern about what others might think, embarrassment and other negative emotions, and fear of receiving a positive test result. In fact, many of the respondents stated they would "rather not know" than take an STI test. The social stigmas related to STIs, mentioned directly by more than half of the people in our sample, may underlie many of the perceived negative consequences of testing. Indeed, some public health authorities believe that social stigmas are the most powerful existing barrier to seeking healthcare for STIs.(<reflink idref="bib4" id="ref19">n4</reflink>) Our data allow us to describe STI-related social stigmas in detail; seeking testing may cause an individual to experience guilt, shame, and fear and to worry that others will see them as dirty, loose, disgusting, or dumb.</p> <p>Health-system factors regarding the clinic, provider, or actual testing method were also cited frequently. Participants appeared to be particularly concerned about confidentiality and the reputation of the clinic. Thus, even if STI-related services are readily available to college students through on-campus health systems, students may not seek testing or may delay in seeking care, and these delays can result in adverse health outcomes.</p> <p>Several study limitations warrant mention. We asked participants about hypothetical scenarios and did not assess actual behaviors, although we attempted to identify a broad range of issues that are pertinent to real-world settings. The study population was limited to college students at a single university, and the sample was not a random selection of all students. Although we attempted to interview students from various ethnic backgrounds and sexual histories, we may not have fully identified issues that could affect persons from sexual minorities, those who are married, or those from different geographic regions. Therefore, caution must be used before generalizing the findings to college students or adolescents from these other backgrounds. Despite these limitations, our having used qualitative data enabled us to identify several levels of barriers that might limit the acceptability of STI testing and screening. The next step should be to quantify the proportion of students who hold these beliefs and determine whether they are correlated with actual testing behavior.</p> <p>To reduce barriers to STI-related care, college health clinicians, health educators, and other professional staff may need to increase their emphasis on STI prevention at both campus and national levels.(<reflink idref="bib26" id="ref20">n26</reflink>) University health services can (a) provide outreach on the campus, (b) stress STIs in communications with students, (c) provide education during clinical visits, and (d) offer screening services when students present with other health issues.</p> <p>Interventions may also address broader societal issues through college-health campaigns, the media, and promotion of STI testing as a social norm. The best way to reduce the STI-related social stigmas is not clear, although programs that increase knowledge and encourage more positive attitudes toward individuals with STIs may have some effect. Finally, health-system factors such as accessibility and confidentiality may prove more amenable to change than individual behavior.(<reflink idref="bib3" id="ref21">n3</reflink>) By addressing these individual, societal, and system barriers, college health professionals might be able to reduce the barriers to STI testing, resulting in increased access and use of these important preventive services.</p> <p>NOTE</p> <p>For further information, please address correspondence to Robert L. Cook, MD, University of Pittsburgh, E820 UPMC Montefiore, 200 Lothrop Street, Pittsburgh, PA 15213 (e-mail: cookrl@msx.upmc.edu).</p> <hd id="AN0006437113-10">ACKNOWLEDGMENTS</hd> <p>The authors thank Ingrid Macio and Tara Peeler for coding the interviews; Deborah Seltzer and Shirley Haberman for helpful comments on the manuscript; Jessica Bruce for assistance in manuscript preparation; and the CMU Social and Decision Sciences Seminar Group for advice on the final model. The research was supported in part by grants K23 AA-00303-01 and U01 AI-47638-02 from the National Institutes of Health.</p> <hd id="AN0006437113-11">TABLE 1 Characteristics of 41 College Students Interviewed in a Study of the Decision to Seek Testing for Sexually Transmitted Infections (STIs), in Percentages</hd> <ct id="AN0006437113-12"> Legend for Chart: A - Characteristic B - Participants (%) A B Age (y) 18--20 58 21--23 42 Race Black 29 White 63 Asian 5 Hispanic 3 Gender Men 39 Women 61 Previous sexual partners (n) 0 29 1--2 34 3--5 12 &gt; 5 25 Ever tested for STI? No 61 Yes--routine screening 27 Yes--symptoms noted 7 Yes--exposure to STI 5</ct> <p>DIAGRAM: FIGURE 1; Factors That Influence Decisions to Seek STI Testing Among 41 Surveyed College Students, Showing Percentage of Respondents Who Identified Each Factor During Open-Ended Interviews</p> <ref id="AN0006437113-13"> <title> REFERENCES </title> <blist> <bibl id="bib1" idref="ref1" type="bt">(n1.)</bibl> <bibtext> Eng T, Butler W. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: National Academy Press, 1997.</bibtext> </blist> <blist> <bibl id="bib2" idref="ref2" type="bt">(n2.)</bibl> <bibtext> Douglas KA, Collins JL, Warren C, et al. Results from the 1995 National College Health Risk Behavior Survey. J Am Coll Health. 1997; 46:55-66.</bibtext> </blist> <blist> <bibl id="bib3" idref="ref3" type="bt">(n3.)</bibl> <bibtext> Aral S, Wasserheit J. STI-related healthcare seeking and health service delivery. In: Holmes KK, Sparling PF, Mardh P, et al, eds. 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Some people's psychological experiences of attending a sexual health clinic and having a sexually transmitted infection. J R Soc Health. 1998;118:94-96.</bibtext> </blist> <blist> <bibl id="bib26" idref="ref20" type="bt">(n26.)</bibl> <bibtext> Rothenberger JH, Buck H. College health needs to participate in the national STI debate. J Am Coll Health. 1998;47: 140-142.</bibtext> </blist> </ref> <aug> <p>By Karen R. Barth, MD; Robert L. Cook, MD, MPH; Julie S. Downs, PhD; Galen E. Switzer, PhD and Baruch Fischhoff, PhD</p> <p></p> <p>Karen R. Barth is with the University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.</p> <p>Robert L. Cook is with the Student Health Service and Department of Medicine at the University of Pittsburgh</p> <p>Julie S. Downs is with the Department of Social and Decision Sciences, Carnegie Mellon University, Pittsburgh</p> <p>Galen E. Switzer is with the Departments of Medicine and Psychiatry, University of Pittsburgh;</p> <p>Baruch Fischhoff is with the Departments of Social and Decision Sciences and of Engineering and Public Policy at Carnegie Mellon.</p> </aug> |
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| Items | – Name: Title Label: Title Group: Ti Data: Social Stigma and Negative Consequences: Factors that Influence College Students' Decisions To Seek Testing for Sexually Transmitted Infections. – Name: Language Label: Language Group: Lang Data: English – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Barth%2C+Karen+R%2E%22">Barth, Karen R.</searchLink><br /><searchLink fieldCode="AR" term="%22Cook%2C+Robert+L%2E%22">Cook, Robert L.</searchLink><br /><searchLink fieldCode="AR" term="%22Downs%2C+Julie+S%2E%22">Downs, Julie S.</searchLink><br /><searchLink fieldCode="AR" term="%22Switzer%2C+Galen+E%2E%22">Switzer, Galen E.</searchLink><br /><searchLink fieldCode="AR" term="%22Fischhoff%2C+Baruch%22">Fischhoff, Baruch</searchLink> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="SO" term="%22Journal+of+American+College+Health%22"><i>Journal of American College Health</i></searchLink>. Jan 2002 50(4):153-159. – Name: PeerReviewed Label: Peer Reviewed Group: SrcInfo Data: Y – Name: Pages Label: Page Count Group: Src Data: 7 – Name: DatePubCY Label: Publication Date Group: Date Data: 2002 – Name: TypeDocument Label: Document Type Group: TypDoc Data: Journal Articles<br />Reports - Research – Name: Subject Label: Descriptors Group: Su Data: <searchLink fieldCode="DE" term="%22College+Students%22">College Students</searchLink><br /><searchLink fieldCode="DE" term="%22Decision+Making%22">Decision Making</searchLink><br /><searchLink fieldCode="DE" term="%22Higher+Education%22">Higher Education</searchLink><br /><searchLink fieldCode="DE" term="%22Screening+Tests%22">Screening Tests</searchLink><br /><searchLink fieldCode="DE" term="%22Sexuality%22">Sexuality</searchLink><br /><searchLink fieldCode="DE" term="%22Social+Influences%22">Social Influences</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Attitudes%22">Student Attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Behavior%22">Student Behavior</searchLink> – Name: ISSN Label: ISSN Group: ISSN Data: 0744-8481 – Name: Abstract Label: Abstract Group: Ab Data: Examined key factors that influenced college students to seek screening for sexually transmitted diseases. Data from student interviews indicated that social stigmas and negative consequences (particularly the negative consequences of testing and perceived vulnerability to infection) represented significant barriers to being tested. Many students stated they would rather not know than be tested. (SM) – Name: DateEntry Label: Entry Date Group: Date Data: 2002 – Name: AN Label: Accession Number Group: ID Data: EJ646426 |
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| RecordInfo | BibRecord: BibEntity: Languages: – Text: English PhysicalDescription: Pagination: PageCount: 7 StartPage: 153 Subjects: – SubjectFull: College Students Type: general – SubjectFull: Decision Making Type: general – SubjectFull: Higher Education Type: general – SubjectFull: Screening Tests Type: general – SubjectFull: Sexuality Type: general – SubjectFull: Social Influences Type: general – SubjectFull: Student Attitudes Type: general – SubjectFull: Student Behavior Type: general Titles: – TitleFull: Social Stigma and Negative Consequences: Factors that Influence College Students' Decisions To Seek Testing for Sexually Transmitted Infections. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Barth, Karen R. – PersonEntity: Name: NameFull: Cook, Robert L. – PersonEntity: Name: NameFull: Downs, Julie S. – PersonEntity: Name: NameFull: Switzer, Galen E. – PersonEntity: Name: NameFull: Fischhoff, Baruch IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 01 Type: published Y: 2002 Identifiers: – Type: issn-print Value: 0744-8481 Numbering: – Type: volume Value: 50 – Type: issue Value: 4 Titles: – TitleFull: Journal of American College Health Type: main |
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