Perceptions of Chlamydia and Gonorrhea Among Young Latina and African-American Women: Findings from Qualitative Research

Background:
Young African-American and Latina women experience disproportionately high rates of chlamydia (CT) and gonorrhea (GC). These groups have over four times their expected rates in Los Angeles. Regular testing could dramatically reduce these disparities.

Objective:
To better understand young African-American and Latina women's perceptions of CT and GC to help create more effective testing programs.

Method:
32 Los Angeles women participated in five focus groups (three African-American, two Latina) in March-April 2007 to inform a social marketing campaign promoting STD testing. Groups were run by a professional moderator using a discussion guide designed by researchers and a community advisory board. Researchers observed the groups and later analyzed videotapes using emergent codes and theory.

Result:
CT and GC were highly stigmatized in all groups. The diseases were seen as “nasty” and “scary”. Patients were seen as “stupid,” “irresponsible,” or promiscuous. These beliefs made it difficult for many to discuss STDs with sex partners or friends. While all groups conceded that anyone could potentially get infected, infection was usually related to blame for themselves, or more often, for an unfaithful partner. While participants discussed a wide range of relationship types, from monogamous to casual, even those with multiple partners believe their risk of infection stems from a partner's infidelity. Many would only test if they found out about a partner's cheating.

Conclusion:
Participants distanced themselves from feelings of personal vulnerability for CT and GC by stigmatizing the diseases and those who get infected and by externalizing their vulnerability. These are significant barriers for regular testing.

Implications:
Chlamydia and gonorrhea prevention and testing efforts must address the ways young women conceptualize the diseases. High levels of stigma and varying concepts of perceived vulnerability may affect the propensity to test. Sustained social marketing and education are needed to de-stigmatize CT and GC.