On the third episode of HBO’s new series, Girls, the protagonist Hannah (played by creator Lena Dunham) is diagnosed with human papilloma virus (HPV). Distraught, she tells her best friend, who replies with the most revolutionary phrase ever uttered on television regarding STI stigma: “All adventurous women do.”
STI stigma is not difficult to understand. Since STIs are sexually transmitted, they’re easy to interpret as punishment for promiscuity. People with STIs are often characterized as slutty, dirty, trashy, or stupid and reckless. And when someone is diagnosed with HPV–no matter how confident she is in her choices, no matter how careful she is–she’s faced with the crushing weight of this stigma. She must try her darndest not to internalize it–not to believe that she is being punished for her sexuality, not to believe that she brought this upon herself, or that this viral infection is indicative of poor moral character. This is extremely difficult because no one has prepared her for this, and she will almost certainly go through it alone.
Since HPV and STIs are treated as a shameful secret, we don’t ever talk about what the process of diagnosis and its aftermath is like, and as a result, we never hear what it was like for someone else. We each have to figure out how to cope on our own, in silence, without the comfort or guidance of those who have been there and can understand. There are no celebrity spokespeople for HPV. No star athlete role models. And so very few narratives in television, film, or literature.
It’s rare to see STIs on television. Rather, it’s rare to see STIs on television outside of medical and crime dramas where STIs are used as a “who done it” plot device to reveal some unexpected twist regarding infidelity or some otherwise inappropriate sexual behavior. It’s rare to see a character simply living with an STI–getting diagnosed, experiencing treatment, navigating relationships, and dealing with shame and stigma in every day life. It’s rare, but it shouldn’t be.
HPV is the most common STI in the United States. The CDC approximates that 20 million Americans currently have HPV, with six million new infections occurring each year. (For reference, 20 million people is roughly the population of Beijing, New York state, and the entire country of Australia.) The CDC estimates that 50% of sexually active Americans (men and women) will contract HPV at some point in their lives, although the American Social Health Association thinks it’s closer to 75-80%. For women, the rates are even higher: the CDC estimates that, by the age of 50, at least 80% of women will have acquired sexually transmitted HPV.
So, if at least 50% of Americans will one day have the experience of being diagnosed with HPV, shouldn’t we be doing something to prepare them for that moment so that the bottom doesn’t drop out from under them? Shouldn’t we let them know that this is a shared experience and that they don’t have to feel so alone? Shouldn’t we be working to combat stigma at the social level so that we can reduce the emotional damage it inflicts?
Writing HPV and other STIs into television narratives is a great way to challenge and combat stigma. Especially when the character is able to make peace with the diagnosis, providing a model for the rest of us.
“All adventurous women do.”
In that one glorious sentence, Girls let us know that HPV is common and that instead of a being a sign of poor character, it’s a mark of an adventurous spirit. This one line erases the stigma and reframes HPV as something normal, even positive. “All adventurous women do” allows Lena Dunham’s character Hannah to own the diagnosis, to embrace it, to wear it as a badge of honor. And it teaches the rest of us–all of us girls who have felt the waves of shame and guilt crashing on top of us, suffocating us–that we are okay. That HPV, much like traveler’s diarrhea, is just another part of the experience of being an adventurous woman in the 21st Century.