Psychosocial factors influencing the disclosure of sexually transmissible infection diagnoses among female adolescents

Background: Individuals diagnosed with a sexually transmissible infection (STI) often face psychosocial concerns through which they must navigate to arrive at disclosure decisions. The objective of this study was to qualitatively explore the decision-making process for disclosure of STI diagnoses to sex partners among adolescent females in Baltimore City, MD. Methods: Semi-structured interviews were conducted with 21 African American adolescent females who tested positive for chlamydia and/or gonorrhoea in the previous 3 months. Three individuals also provided audio diaries in which they tape recorded a daily journal discussing their lives and experiences with STIs. Results: Female adolescents often do not notify all potentially infected sex partners or tell sex partners all of the STIs to which they may have been exposed. Although participants recognised the importance of informing their sex partner(s) of their STI diagnosis, there were other competing psychosocial factors that influenced their decisions to disclose, such as perceptions of the social consequences of having an STI including fear of stigmatisation and loss of relationship. Such concerns appear to vary by disease and partner type as well as previous STI experience. Conclusions: To increase disclosure of STI diagnoses, clinic counselling strategies to encourage partner notification should seek to engage patients in a dialogue regarding their fears related to their diagnoses, how this might affect their relationships with different types of partners and the individual and social meanings their specific STI diagnosis(es) might hold.