“It’s Not What They Actually Do to You but the Shame You Would Feel By Going.” Young Men’s Reflections on Shame and Stigma Around Sexual Health Services.

Rates of sexually transmitted infections (STIs) continue to rise in Scotland, and are particularly common amongst younger age groups (16-24 years old). In a majority of cases, individuals infected with STIs do not exhibit symptoms, therefore active screening, particularly for Chlamydia (which is the most prevalent STI in Scotland), is an important part of preventive health care services. Men are less likely than women to attend sexual health services for screening tests, a common assumption being that this is because sexual health services are perceived by many men to be aimed at women. Drawing on a qualitative study with young men aged between 18 and 26 years old in Scotland, this paper discusses how stigma and shame influence attitudes towards accessing sexual health services. Participants expressed views about their general health that reflected hegemonic masculinity in terms of self-reliance, physical fitness, and being unwilling to seek help. This was reinforced for sexual health matters by narratives about guilt and shame that compounded the desire to resolve health matters as far as possible by themselves, without accessing formal health care, and while maintaining confidentiality about their sexual health. Young men are unlikely to be proactive in seeking out health information, particularly when they are asymptomatic and therefore see no reason to seek advice or help; because they fear being seen in a stigmatising and shameful place (the clinic), they are unlikely to access sexual health screening as a routine part of their health care. We discuss the implications of these findings for policies aiming to reduce STI rates amongst young people.