Attributed shame and negative attitudes towards STI-testers: a threat management perspective

Abstract

Background: Perceived shame and stigma, involving individuals’ fears of being labelled with negative attributes, are proposed barriers limiting STI-testing uptake. But does negative labeling of STI-testers actually occur? And what motivates them? Evolutionary psychologists (functionally) characterize social life as a ‘double-edged blade’ - involving affordances and threats. We hypothesized two motivations underlying potential negativity towards testers: 1) motivations to avoid promiscuous individuals, and 2) a disease-avoidance motivation. Design: Using an online vignette method (negative attitudes and attributed shame as outcomes), two studies were conducted (n= 245 and n=793). Study 1 examined whether perceptions of ‘infectiousness’ and ‘promiscuity’ depended on testing behavior (tested vs. untested). Study 2 followed-up and manipulated vignette description on infectiousness (risky vs. safe sex), promiscuity (low vs. high), and testing behavior (tested vs. untested). Results: Strong correlations (r’s in the .36 to .54 range) between study variables were observed in Study 1, and testing led to a reduction in these outcomes (ω2=.05). In Study 2, substantially ‘large’ effects were observed for the infectiousness (ω2 = .23), promiscuity (ω2 = .066), and testing manipulations (ω2 = .06). The effect of infectiousness on the outcomes was moderated by testing condition (ω2 = .01). Discussion: Despite perceived stigma and shame forming a barrier limiting testing uptake, we found no evidence of negative labeling of testers. STI-testing may in fact decrease negative labels associated with risky and promiscuous sexual behavior. Therefore, fears of being labeled negatively when testing for STI may be ‘unrealistically pessimistic’.