STBBIs – For This Ugly Face, Do Not Turn Away
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Sexual health wears many faces; the most classic is the gory, discomfiting of sexually transmitted and blood-borne infections (STBBIs). STBBI rates are rising globally; this includes Canada, the United States, and other developed countries despite increased access to condoms and more comprehensive sexual education (Adhopia & Zafar, 2019). Though increased testing is likely to contribute to these increased rates, it is noted that a decline in condom use and other unknown factors are driving this trend as well (Zeidler, 2019).
The current research on the sexual health of the South Asian diaspora emphasizes, first and foremost, the gaps of knowledge in this field; South Asians are, at worst, wholly ignored or, at best, aggregated into the greater Asian and Pacific Islander category (Ali et. al, 2020). The fact that racism, minority stress, microaggressions, and marginalization, all experienced differently among different communities, shapes sexual experiences makes this distinct lack of nuance troublesome (Ali et. al, 2020). Research about the community’s safe sex practices and STBBI rates is particularly understudied (Ali et. al, 2020). South Asian researchers in this field postulate that this is a consequence of the model minority myth. The lack of information in this area directly impacts the sexual health and well-being of South Asians – how would communities or healthcare professionals know how to respond to the rise of STBBIs without knowing where the issue lies? It is also quite possible for the model minority myth to permeate into and poison the wells of healthcare – whose to say that it does not influence healthcare professionals in their recommendations and discussions of safe sex practices and testing? It is paramount for sexually active South Asians to be familiar with safe sex practices and maintaining their sexual well-being.
It is uncommon for those aged twenty to twenty-four, the most sexually active demographic and those with the highest rates of STBBIs, to practice safe sex (Asenso, 2021). For example, a national sample of Canadian postsecondary students found that less than half of those surveyed used a condom the last time they had vaginal sex (Moraros et al., 2018). Another survey of eight Canadian universities found that 62% never tested for STBBIs and 85% never tested for HIV (Moraros et al., 2018).
A recent mixed-methods study of access to chlamydia prevention resources in Southwest Calgary explored several social barriers to these preventative resources in his study, many of which arguably impact South Asians to an even greater extent. The key levels of barriers found were intrapersonal, relating to ignorance, perceived irrelevance of resources, and uneasiness accessing resources; interpersonal, relating to stigma about STBBIs; organizational, relating to silence about the matter, the nature of information from online resources, and the nature of facilities; and community, relating to the spatial feasibility of accessing resources (Asenso, 2021). Given that the heavily entrenched silence about sex in South Asian societies and cultures and the enhanced stigma against sex and STBBIs that comes as a consequence, it is likely that intrapersonal, interpersonal, and organizational level barriers pose a greater threat to South Asians’ sexual health. Indeed, the three main barriers concluded from this author’s research was:
Stigma.
Intimidating healthcare spaces, which can be made worse by the fact that there may be little in the way of support from adults.
The potential to feel uneasy accessing resources, which may be heightened due to the taboo on sex in South Asian societies.
It is likely that South Asians assigned female at birth are at a greater risk of STBBIs. Females as a whole are more difficult to diagnose with an STBBI as they have a greater chance of being asymptomatic and the general pitfalls of healthcare for females (Moraros et al., 2018). Furthermore, it is thought that female genitalia are more vulnerable to STBBIs due to the delicate nature of vaginal mucosa and physiological processes of the cervix (Moraros et al., 2018; The Centre for Communicable Diseases and Infection Control, 2017). Beyond the biological aspect, sexual behaviour tends to be more acceptable or encouraged in South Asian males than females (Thamotharan et al., 2017). This lends to the social barriers to preventative resources being a heightened phenomenon for South Asian females and, therefore, pose a greater risk.
It can be easy to shield one’s eyes and not face the looming figure of STBBIs, especially with social and physical barriers to accessing the appropriate resources to prevent and or treat them. However, with their rapidly increasing rates and the increasing commonality of antibiotic resistance in previously treatable infections, it is crucial for everyone, particularly those who are overlooked and marginalized as South Asians are, to be as educated as possible about safe sex practices and what resources are available.
References
Adhopia, V., & Zafar, A. (2019, August 1). 'Alarming' increase in sexually transmitted infections found across Canada | CBC News. CBCnews. https://www.cbc.ca/news/health/sti-rates-canada-1.5230987.
Ali, S., Keo, B. S., & Chaudhuri, S. (2020). Critically Understanding South Asian Sexual Health: A Call for a Holistic and Sex Positive Approach. International Journal of Sexual Health, 32(3), 177–187. https://doi.org/10.1080/19317611.2020.1768197
Asenso, O. (2021). “It’s for sure conscious that we stay central”: Barriers in Accessing Preventive Resources for Chlamydia among Youth in Southwest Calgary (thesis). Carleton University, Ottawa.
The Centre for Communicable Diseases and Infection Control. (2017). (rep.). Report on sexually transmitted infections in Canada, 2017. Ottawa: Public Health Agency of Canada.
Moraros, J., Haghir, E., Madampage, C., & Mahmood, R. (2018). Risk factors associated with SELF-REPORTED sexually transmitted infections among postsecondary students in Canada. International Journal of Preventive Medicine, 9(1), 49. https://doi.org/10.4103/ijpvm.ijpvm_444_17
Thamotharan, S., Hall, S. K., Hahn, H., Blake, J., & Fields, S. (2017). Contextualizing Gender and Acculturative Influences on Sexual Initiation of Asian Indian Emerging Adults. Sexuality & Culture, 22(2), 380–390. https://doi.org/10.1007/s12119-017-9472-4
Zeidler, M. (2019, July 14). Chlamydia, Syphilis Rates Increase in Canada - and Experts Say Declining Condom Use is Partly to Blame. CBC news. https://www.cbc.ca/news/canada/british-columbia/world-sti-hiv-congress-1.5209028.
