LAUSR

Sexual and reproductive health work relies heavily on communication. Clinicians communicate diagnoses and prevention messages to their patients. Disease intervention specialists must develop rapport and trust to identify sexual and needle sharing partners whomay be benefit from an STD or HIV test or treatment. Prevention programs must strike a balance in describing the consequences of an untreated STD or HIV without stigmatizing populations burdened with these infections. The need for clear, precise, culturally appropriate communication is needed now more than ever, as HIV prevention is no longer always STD prevention. The remarkable effectiveness and impact of biomedical prevention and harm reduction approaches for HIV such as treatment as prevention, U=U (undetectable = untransmittable), preand post-exposure prophylaxis) dictate that sexual behaviors that were once “risky” in terms of HIVacquisition and transmission, now are “safer”. But this is not the case for other STDs. In their excellent commentary “WordsMatter: Putting an End to ‘Unsafe’ and ‘Risky’ Sex,”Marcus and Snowden highlight the inherent limitations of these terms as both imprecise and stigmatizing. Without anchoring specific behaviors to a health outcome, the terms “risky” and “unsafe” lack meaning. For example, condomless anal sex among persons who are virally suppressed or actively taking PrEP may be risk free for HIV transmission or acquisition, but this same behavior probably fosters transmission of gonorrhea and other STIs. Importantly, Marcus and Snowden also note that defining behaviors as inherently risky perpetuates entrenched sexuality based-stigma. Describing sexual behaviors and practices with stigmatizing terminology may discourage people from seeking sexual and reproductive health services and from referring partners who may benefit from intervention. The American Sexually Transmitted Disease Association (ASTDA) and its journal, Sexually Transmitted Diseases, are committed to promotion of sex-positivity, social justice, and a culture of inclusion, equity, safety, professionalism, and respect (www.astda.org). ASTDA’s mission is to foster scientific knowledge, develop leadership, and champion practice in the field of sexually transmitted infections. The Editors of Sexually Transmitted Diseases strongly recommend that authors who submit manuscripts for publication carefully consider the language that they use in their submissions and employ precise language for sexual behaviors, such as “condomless anal sex” and “multiple anal sex partners” in lieu of “risky” or “unsafe” sex. Every effort should be made to ensure that language used in submissions is neutral and non-stigmatizing. The Editors of Sexually Transmitted Diseases, as well as the ASTDA executive committee, are dedicated to ensuring that best practices are modeled in the articles we publish and that the excellent science that the journal disseminates is clear, precise, and sex-positive.