Why Do Medical Students Avoid STI Tests? The Surprising Barriers

by Jon Scaccia October 15, 2024

Imagine this: You’re training to become a doctor, someone who will one day advise others on their health. You’re taught about the risks of infections, the importance of prevention, and the necessity of routine screenings. And yet, when it comes to your own health, you hesitate to undergo the very tests you’ll recommend to others. This is the reality for many medical students in Pereira, Colombia, where sexually transmitted infections (STIs) pose a significant public health risk. Despite being on the frontlines of healthcare, these future doctors show a troubling reluctance to be tested for STIs.

In a recent study of 284 medical students from two universities in Pereira, researchers found a startling contradiction: while 84.5% of these students engaged in risky sexual behaviors, only 32.4% intended to get tested for STIs. The reasons behind this avoidance shed light on deeper social and psychological barriers that we may not expect from a population so well-versed in health.

The Silent Threat of STIs

STIs are not just a health issue for the general public—they’re a growing concern for young adults worldwide, including those pursuing medical careers. According to the World Health Organization, over 1 million people acquire an STI every day, most of them between the ages of 15 and 49. But what happens when the very individuals expected to lead the charge in preventing these infections don’t follow their own advice?

In the study conducted between March and June 2020, researchers uncovered that although medical students have extensive knowledge about STIs—especially the importance of using condoms—this knowledge doesn’t always translate into action. In fact, many of these students admitted to engaging in unprotected sex, one of the most common risk factors for STIs. Why is there such a gap between understanding the risks and actually getting tested?

Barriers to Testing: Social Pressure and Fear

One of the study’s most striking findings was how deeply social factors influenced the students’ decisions about testing. Medical students, despite their training, are not immune to peer pressure and the fear of judgment. The study revealed that 64.1% of participants experienced high social pressure related to STI testing. What does this mean? It means that friends, family, and even sexual partners can make or break a person’s decision to get tested.

For example, some students worried about how their partners or family members might react if they tested positive. This fear isn’t just a passing concern—it’s a major reason why many people avoid testing altogether. After all, in many cultures, there’s still a stigma attached to STIs. A positive result can carry the weight of judgment from others, making it easier to bury one’s head in the sand and hope for the best.

This fear is compounded by what the researchers referred to as “social fear,” which affected 43% of the students. Imagine worrying not only about the result but also about who might find out. Even in a medical school environment, where health should be prioritized, the fear of gossip or reputational damage was enough to stop many students from getting tested.

Past Experiences and Risky Behaviors Influence Future Choices

Interestingly, those who had been previously tested for STIs were more likely to express an intention to get tested again. The researchers found that students who had already undergone screening were 2.5 times more likely to intend to be tested again compared to those who had never been tested. This shows that experience plays a huge role in breaking down the barriers to testing.

Moreover, the study showed that risky sexual behaviors—such as having multiple partners or not using condoms—also influenced students’ likelihood to get tested. Those who engaged in riskier behaviors were 3.5 times more likely to express a willingness to be tested. Why? It could be that these students, knowingly or unknowingly, recognize their vulnerability and are more inclined to seek out testing.

However, this leads us to another paradox: Why are those who know they’re at risk still not overwhelmingly willing to get tested? Could it be that the fear of a positive result outweighs the desire to know?

Knowledge vs. Action: Why Medical Students Aren’t Getting Tested

You might think that medical students, of all people, would be first in line for STI tests. After all, they have the knowledge, access to resources, and understand the consequences of untreated infections. However, this study suggests that knowledge alone isn’t enough. In fact, while 76.1% of participants had a high level of knowledge about STIs, many still chose not to act on that information.

So, what’s holding them back? It’s not just about knowing the risks—it’s about feeling empowered to act despite the fear and pressure. The study highlights the importance of self-efficacy, or the belief in one’s ability to take action. Students with higher self-efficacy were more likely to intend to get tested, but even among these students, significant social and psychological barriers remained.

Breaking Down the Barriers

What can we learn from these findings? First, we need to recognize that even highly educated individuals can struggle with health decisions when social pressure and fear come into play. If medical students—our future doctors—are hesitant to get tested, what does this mean for the broader population?

Interventions aimed at increasing STI screening rates must go beyond simply providing information. We need to address the social and emotional hurdles that prevent people from getting tested. This could mean creating more private, judgment-free opportunities for testing or launching campaigns that tackle the stigma surrounding STIs head-on.

It’s also crucial to create environments where testing is normalized and encouraged—not just for the general public, but for healthcare professionals themselves. After all, the first step to improving public health is ensuring that those who lead it are healthy, informed, and willing to act.

Conclusion: A Call to Action

If we want to reduce the spread of STIs, we need to change the conversation around testing. It’s not just about providing education—it’s about empowering individuals to take control of their health, even when it’s uncomfortable.

Now, I turn to you: What are your thoughts on the role of social pressure in health decisions? Have you ever hesitated to get tested for a health condition because of fear or judgment? Share your experiences, and let’s start a conversation!