How can Stigmatization behaviors prevent unhealthy activities from occurring.

There could also be a moralistic aspect here—a kind of hangover from America’s Puritan founding. I raised this possibility with Shaun Miller, a philosopher at Marquette University who focuses on love and sexuality. “I'm not sure if it relates to our Puritan values,” he told me, “but I do think the stigma is a proxy for moral judgment. Sexuality has always had to do with one's moral character, and so if one has an STI, it suggests that one's character is ‘infected’ as well.” Continue...

To test this idea that sex-related risks are more stigmatized than other types of risk, Conley and her colleagues ran a follow-up study. In the study, they wanted to control for some of the differences between driving cars and having sex—two activities that both carry risk, sure, but which are different in other ways.

If these differences could somehow explain the weird estimates that participants gave in the first study—without having anything to do with sex-related stigma, specifically—it would undermine Conley’s theory.

Conley and her team designed a test that would compare “apples to apples”—two cases where a health threat was transmitted through sex, but only one of which was an actual STI.

They gave a collection of 12 vignettes to a large number of participants—one vignette per person. All of the vignettes told the same basic story: Someone transmits a disease to someone else during a casual sexual encounter, without knowing that they had something to transmit. There were two diseases: either chlamydia, a common STI that rarely causes serious health problems (and that can be completely cured with a course of antibiotics), or H1N1—commonly known as the swine flu—which can be seriously bad for your health or even kill you.

The main thing they manipulated between the different vignettes was the severity of the outcome caused by the disease. A “mild” outcome was described as getting sick enough to have to see the doctor, and then take a week’s worth of medicine. A “moderate” outcome was the same, except that you had to go to the emergency room first. A “serious” outcome was getting hospitalized and nearly dying. And a “fatal” outcome was, well, dying.

The last two conditions only applied to H1N1, because chlamydia rarely gets that bad.
Once the participants read their vignette, they had to say what they thought about the person who transmitted the disease. The participants would rate the person on how risky and how selfish their behavior was, as well as how dirty, bad, and immoral, and dumb they were for doing what they did.
The results were surprising. Participants who read the story about someone unknowingly transmitting chlamydia—with a “mild” outcome—judged that person more harshly than participants who read about the swine-flu case where the other person actually died!

Even Conley didn’t expect to see this. “Why would there be so much culpability surrounding a ‘sex disease’ but not a non-sexual disease transmitted through sex?” she said.

It’s a good question. Unjustified stigma about STIs—Conley’s preferred explanation—could be one answer. But there’s another possible answer as well, and it’s one that points to a potential weakness in the methodology of this second study.

There’s an important difference between chlamydia and swine flu in terms of how you can prevent them from being transmitted, and it has to do with condoms. Using a condom will dramatically reduce your chances of transmitting an STI like chlamydia, but it would have no effect on transmitting the swine flu. This is because swine flu isn’t passed on through genital contact, but rather through the respiratory system (so you could get it through kissing, or coughing).