For whom the bell tolls: experimentally-manipulated disgust and embarrassment may cause anticipated sexual healthcare avoidance among some people.

This study was designed to experimentally determine whether disgust and embarrassment predict anticipated delay and avoidance in sexual healthcare decision-making and for whom. In the study, 90 participants, aged 18-30, completed web-based questionnaires assessing demographics, current health, and past health behaviors before being gender block randomized to conditions in which disgust, embarrassment, or control (no emotion) were induced. Participants completed health decision-making vignettes covering the disgusting and embarrassing aspects of sexual healthcare. Factorial ANOVAs showed that although there were some complexities in the manipulation, disgust and embarrassment predicted greater anticipated delay and avoidance of elicitors, but only among specific groups. Embarrassment predicted anticipated help-seeking delays for embarrassment elicitors (i.e. sexual history assessment and physical examination), while disgust predicted anticipated help-seeking delays involving disgust elicitors (i.e. collecting genital discharge). However, these effects were moderated, with embarrassment only predicting anticipated delays among individuals reporting multiple sexual partners and disgust predicting anticipated delays and avoidance among persons reporting poorer subjective health. In sum, the current report provides among the first empirical demonstrations that emotions such as embarrassment and disgust may be causally implicated in anticipated delays and avoidance in sexual healthcare. Emotion frameworks may be usefully incorporated into clinical and public health efforts to reduce sexual healthcare delays and avoidance.