Chlamydia

Michelle Jelinek ** Chlamydia ** ** Background ** Chlamydia was first recognized by medical experts as a sexually transmitted disease (STD) around 1970 (Yancey, 2002). It is a non-viral STD that is caused by tiny bacteria and can infect the urinary-genital area, the anal area, and sometimes the eyes, throat, and lungs. Towards the end of the twentieth century, it was the “most common, fast-spreading” STD in the United States (Yancey, 2002). Chlamydia can be easily transferred through unprotected oral, genital, or anal sex with an infected partner. The bacterium is spread through semen and vaginal fluids and primarily infects the mucous membranes of the cervix in women and the urethra in men (Yancey, 2002). ** Symptoms and Treatment ** People often do not experience symptoms when they have chlamydia. Approximately 70 percent of chlamydia cases are asymptomatic (Balfe, Brugha, O’Donovan, O’Connell, & Vaughan, 2010). This absence of symptoms leads to many cases remaining undiagnosed. In fact, of the 3.5 million Americans infected with chlamydia each year, 85 to 90 percent do not show any symptoms (Ojcius, Darville, & Bavoli, 2005). When individuals do have symptoms, they tend to be mild. Women may experience a need to urinate, burning during urination, and a vaginal discharge. Men may have a clear, thin discharge, burning with urination, and an irritated feeling in the urethra (Yancey, 2002). Since many cases go undiagnosed, serious complications can occur if chlamydia is not treated. Men may develop an infection in the prostate gland and epididymis which could cause scarring and infertility. Women may develop pelvic inflammatory disease which affects the uterus, fallopian tubes, and ovaries. Scarring from pelvic inflammatory disease can result in infertility or ectopic pregnancies, which is when the fertilized egg implants in the fallopian tubes instead of the lining of the uterus (Yancey, 2002). Many times, a woman is not diagnosed with chlamydia until later in life when she is unable to get pregnant, due to the scarring of her fallopian tubes (Yancey, 2002). Despite the serious effects that chlamydia can have, it is easy to treat if diagnosed early. Chlamydia can be cured with an antibiotic treatment such as azithromycin, doxycycline, or erythromycin (Yancey, 2002). However, the antibiotics cannot reverse effects of scarring or infertility if the disease is diagnosed too late. An expert from the Centers for Disease Control and Prevention stresses that chlamydia is a “fully preventable and fully curable disease” (Yancey, 2002). ** The Stigma Associated with Chlamydia ** As mentioned in the previous section, most cases of chlamydia are asymptomatic. So, in order to receive a proper diagnosis, an individual must be tested. The Centers for Disease Control and Prevention recommends an annual screening for chlamydia in all sexually active women under the age of 26 (Friedman & Bloodgood, 2010). However, several individuals never get tested even if they are believed to be at risk due to the stigma or shame that can result from a STD test. According to a study done by Balfe et al. (2010), most females would react negatively if their healthcare provider offered an unexpected chlamydia screening. When interacting with physicians, women believe they need to maintain identities as ‘normal’; in other words, they want to appear to be ‘good girls’ who are sexually responsible individuals and are not promiscuous (Balfe et al., 2010). If a healthcare provider were to offer a STD screening, it would threaten a patient’s ‘good girl’ identity. Women often have negative images of the types of individuals whom they think would need chlamydia testing, often referring to them as ‘sluts’ or ‘skanks’ (Balfe et al., 2010). However, the reality is that women are just reinforcing the stigma that comes with STD screening by associating STDs with promiscuity, low class status, and dirtiness. If women perceived the screening as another routine checkup, they may be more willing to get tested on a normal basis. According to Friedman and Bloodgood (2010), patients would feel less stigmatized or insulted by a doctor’s recommendation to get tested for chlamydia if it were a routine test.  Similarly, the characteristics of the healthcare provider often influence whether or not a patient may feel stigmatized from receiving a STD screening. Patients would feel least stigmatized by a physician of the same sex who is similar in age. Balfe et al. (2010) explains how these physicians would be more likely to empathize with them and understand their identity related concerns since they may have similar concerns in their own lives. In addition, differences in generations can affect how people feel stigmatized or judged by physicians when receiving a test for chlamydia. Older physicians typically have more conservative attitudes about sexuality than younger people do. As a result, these physicians tend to communicate negative judgments about patients to patients, typically without realizing it (Balfe et al., 2010). So, by reducing the stigma associated with STD screening, individuals would feel more comfortable getting tested which could lower the rates of chlamydia. ** Communication Regarding Chlamydia ** Due to the stigma that was described in the previous section, many individuals have a difficult time talking about chlamydia with their providers and their partners. According to a study done by Friedman and Bloodgood (2010), although most individuals said that they would consult their doctor first if they had any concerns regarding STDs, over a quarter had never discussed STDs with their provider. Barriers to this communication include having a physician of the opposite sex, feeling rushed during office visits, or having a parent present if they were younger patients (Friedman & Bloodgood, 2010). If patients do not discuss chlamydia with their providers, they tend to discuss it with family members or friends.  If an individual does decide to get tested and discovers that they have chlamydia, they typically tend to have a difficult time revealing these results to their sexual partner or partners. Barriers to communicating these results to partners include the stigma of having an STD, the age and cultural background of the infected individual, and relationship factors such as if it was a long-term relationship or casual dating and whether they are still currently in a relationship or if it has ended (Pavlin et al., 2010).  Several lines of communication exist to inform partners of chlamydia test results and with the development of technologies, individuals are beginning to use things like email and text messages. According to Hopkins et al. (2010), only 40 to 60 percent of partners are being notified of positive test results. Studies indicate that face-to-face partner notification is the best method since it demonstrates respect and consideration for the partner (Hopkins et al., 2010). However, people are also using email and text messages to disclose information to partners. Reasons for these methods of communication include that the relationship was brief and superficial, the individuals wanted to avoid personal contact and shame, and the individuals felt they could communicate more calmly and clearly by email (Hopkins et al., 2010). However, the negative aspects of these approaches tend to outweigh the positive ones. These negative aspects include appearing impersonal, rude, or uncaring, the question of whether the message would be taken seriously, and the possibility that the message would be showed to other individuals (Hopkins et al., 2010). Since STDs are a personal and sensitive issue and involve an intimate relationship with another person, Hopkins et al. (2010) concludes that personal communication such as face-to-face interaction is the best method for telling a partner they may be at risk for chlamydia. ** References **  <span style="font-family: 'Times New Roman','serif'; font-size: 12pt; line-height: 200%;"> <span style="font-family: 'Times New Roman','serif'; font-size: 12pt; line-height: 200%;">
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