Philadelphia-area STI disparities still fueled by stigma and misinformation, health care leaders say

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Despite advances in treatment and prevention, sexually transmitted infections remain a stubborn public health challenge in Pennsylvania, according to health experts who say stigma, misinformation and uneven access to care continue to fuel infections.

Those issues were the focus of a panel discussion Wednesday titled “Facing the Facts: HIV, STIs, and Health Equity in the Philadelphia Region,” where public health leaders discussed the barriers they encounter in reaching underserved populations. The event was hosted by the Parkway Central Library in Philadelphia, presented by WHYY’S Bridging Blocks and moderated by Maiken Scott, host of WHYY’s weekly health and science show, “The Pulse.”

In her opening remarks, City Councilmember-at-large Nina Ahmad spoke about the public health barriers that young people face in Philadelphia, citing “the lack of comprehensive education in schools and the state of Pennsylvania itself.”

“We are in a purple state,” Ahmad said, referring to an electorate divided between voters who support sex education in primary schools and those who don’t. “As a nation, we have become a country that does not value science. We live in a disturbing time, and we have to bridge spaces in our communities to remedy these issues.”

Ahmad said that, for her, Philadelphia has always been a place of refuge, and the city should be ready to offer the same feeling of support to anyone who is looking.

The focus of the conversation was the persistence of STI rates. The number of cases of chlamydia, gonorrhea and syphilis nationwide declined by 9% since 2023, according to the CDC’s 2024 Sexually Transmitted Infections Surveillance report. However, the rate of cases is still 13% higher now than it was 10 years ago.

Panelists had some good news about the communities they serve, pointing to their ability to specialize the care they provide, and to diversify the partner organizations that support their work.

However, they said some of their main challenges include fleeting financial resources for initiatives such as testing sites and education programs in schools and communities, and lack of representation in underrepresented communities.

One problem common to every panelist was what they characterized as a lack of interest among everyday people in having the open conversations about sexual health that can normalize the topic.

“If there were not as much stigma around it, let’s say you go to the hairdresser and they say, ‘I have tests here,’ or you’re going to your dentist. Sometimes it’s about putting the test in a space and going ‘By the way, when was the last time you were tested?’” Scott said.

Panelist Walter DeShields, the lead facilitator of Philadelphia Area Sexual Health Initiative, said that, through his work, he has seen that teens and adults share a number of misconceptions about how STIs and HIV are spread.

While plenty of information is available online, DeShields said, there are significant gaps in what his clients understand about their risk of sexually transmitted infection.

“I think there is ignorance, and some of the folks I work with know [transmission] is possible. Some of them even know it’s probable. They understand when they are being risky,” DeShields said.

Panelist Caryelle Lasher, director of Camden County’s Department of Health and Human Services, said there is a lot that people don’t know about their own bodies, a problem that carries into all aspects of health care.

Without adequate education about human anatomy, there can be no room to learn about proper care and other topics relating to sex, such as consent, Lasher said.

“People will ignore a burn or an itch for so long because they don’t know their bodies,” Lasher said.

The stigma and discomfort of conversations about sex for some people can sometimes lead to fear, panelists said. Individuals who are seeking care and information are often afraid of the stories and rumors they imagine will follow them.

Dr. Stacey Trooskin, executive medical officer at Mazzoni Center in Philadelphia, said she believes that, even though people know HIV is a treatable chronic condition, they are still concerned about what that infection says about them.

“I think they hear the stigma, and it correlates with what that means about them and how they interpret that word,” Trooskin said. “I think we have a lot of work to do as a society to combat that.”

In Delaware County, there are public kiosks where people can get STI self-testing supplies 24/7. Lora Werner, director of the Delaware County Health Department, said some residents pushed back against the kiosks because they said they didn’t want to see them. But Werner said that kind of visibility was exactly the point.

“This is a way to really increase accessibility. You can feel very powerful with that kind of convenience,” she said.

DeShields said it’s a matter of people in power setting an example.

“I think if our leaders continue to scare around the topic because of their own hangups around sex, then they can’t convince communities that this is worth funding,” DeShields said.

While statistics show not much has changed in diagnosis rates, treatments have evolved, yielding options people couldn’t have imagined 20 years ago. “There is a lack of true appreciation for the diversity of options [surrounding] prevention. Now there is more than just pills, there are acting injectables. They prevent chlamydia and syphilis as well too,” Trooskin said.

Luis Otano, a health care professional who works in the region, attended the talk to learn how the city of Philadelphia is advancing health care initiatives.

“I feel a little bit more empowered, knowing they are focusing on harm reduction and comprehensive sex education,” Otano said.

However, Otano said, overcoming stigma and educating people about prevention will still take work to evolve. “People don’t know what kind of health services they need, because they are not educated on it,” he said. “I hope in the future we keep filling these gaps.”