Background The stigma of sexual health services is pervasive and affects all user groups. It is likely to affect access to and satisfaction with the service. Reducing stigma has to be an essential aspect of improving sexual healthcare. Stigma has four domains: disclosure concerns, negative self-image, public attitudes and positive (non-stigmatising) aspects. It is currently not known which of these domains is perceived as most relevant by service users.
Objective To determine which aspect of stigma of the service was felt most intensely by service users in a level 3 integrated sexual health service (ISHS).
Method Application of a validated 15 item quantitative tool to assess stigma among 200 unselected patients attending an ISHS in outer London.
Results A total of 77 strong agreement with a statement describing stigma of the service were recorded. Of them nearly half were given in response to two statements: statement (S) 5: “I am careful whom I tell that I have been in this clinic” (14) and S 10 “I am concerned that I bump into someone I know when I am at this clinic” (16). No other statement attracted >6 positive strong responses. Of the 171 responses indicating a moderate stigma of the service 24 were given to the S1 “I won't tell anyone that I came to this clinic because I am concerned about their reaction”. Statement 5 and S10 received 22 moderate agreements each while S6 “I worry that people who know that I have been here tell others that I have been to this clinic” attracted 17 moderate positive responses.
Discussion Our research indicates that disclosure concerns are the key source of stigma for the ISHS. Other aspects like self-image or public attitudes were less relevant. The high level of concerns expressed in S10 throws a new light on the issue of time spent in the waiting room. It suggests that waiting can be very stressful as stigmatising encounters are anticipated.
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