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Open Access Short Report

Triggers of self-conscious emotions in the sexually transmitted infection testing process

Myles Balfe1*, Ruairi Brugha1, Diarmuid O' Donovan2, Emer O' Connell2 and Deirdre Vaughan2

Author Affiliations

1 Department of Epidemiology and Public Health, Royal College of Surgeons in Ireland, Dublin, Ireland

2 Department of Health Promotion, National University of Ireland Galway, Galway, Ireland

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BMC Research Notes 2010, 3:229  doi:10.1186/1756-0500-3-229

Published: 17 August 2010



Self-conscious emotions (shame, guilt and embarrassment) are part of many individuals' experiences of seeking STI testing. These emotions can have negative impacts on individuals' interpretations of the STI testing process, their willingness to seek treatment and their willingness to inform sexual partners in light of positive STI diagnoses. Because of these impacts, researchers have called for more work to be completed on the connections between shame, guilt, embarrassment and STI testing. We examine the specific events in the STI testing process that trigger self-conscious emotions in young adults who seek STI testing; and to understand what it is about these events that triggers these emotions.

Semi-structured interviews with 30 adults (21 women, 9 men) in the Republic of Ireland.


Seven specific triggers of self-conscious emotions were identified. These were: having unprotected sex, associated with the initial reason for seeking STI testing; talking to partners and peers about the intention to seek STI testing; the experience of accessing STI testing facilities and sitting in clinic waiting rooms; negative interactions with healthcare professionals; receiving a positive diagnosis of an STI; having to notify sexual partners in light of a positive STI diagnosis; and accessing healthcare settings for treatment for an STI. Self-conscious emotions were triggered in each case by a perceived threat to respondents' social identities.


There are multiple triggers of self-conscious emotions in the STI testing process, ranging from the initial decision to seek testing, right through to the experience of accessing treatment. The role of self-conscious emotions needs to be considered in each component of service design from health promotion approaches, through facility layout to the training of all professionals involved in the STI testing process.