The spread of sexually transmitted infections (STIs) continues to be an urgent public health issue in South Africa. While prevention will always be better than a cure, the prevalence of STIs, especially among women, makes it important to understand early warning signs.
A study conducted in 2017 showed that there was an estimated 2.3 million women – aged between 15 and 49 – infected with gonorrhoea. Almost 2 million women made up new chlamydia cases and 23 175 of syphilis.
Among men of the same age, there were 2.2 million new cases of gonorrhoea, 3.9 million new cases of chlamydia, and 47 500 new cases of syphilis.
Lack of prevention methods
In 2019, Tendesayi Kufa-Chakezha from the National Institute for Communicable Diseases (NICD), reported that the high numbers of infections were partially due to the gaps in the treatment programs and a lack of adequate prevention methods.
STIs contributed to the increase of the risk of HIV infection and transmission, raising the serious concern for SA – with 7.7 million people who were living with HIV in 2021.
According to the World Health Organization (WHO) more than a million people are diagnosed with one or more STI’s like gonorrhoea, chlamydia, or syphilis on a daily basis.
Women affected most
Dr. Jireh Serfontein from Pretoria confirmed that women are more commonly affected by STIs than men.
“This is because of the biological factors. The vagina and surrounding areas that are exposed to possible infection are much larger compared to the penis. The penis is mostly covered by normal skin, and because of that, the chances of contracting infections are lower compared to women,” she explained.
Serfontein has been working exclusively in the field of sexual medicine for nine years. Her focus is on sexual health, screenings, and sexual dysfunctions, as well as, STIs and HIV.
She talked us through the important answers to questions that aim to remind women of their warning signs and symptoms for different infections, and, to encourage them to get tested.
Why do women take longer than men to show symptoms?
Serfontein said that one of the main reasons why women take longer than men to show symptoms is because up to 60% of women are asymptomatic for chlamydia and gonorrhea. This means that they don’t show any symptoms.
“Symptoms of infections like chlamydia and gonorrhea can cause abnormal discharge, spotting, or bleeding after sex, and a lot of women think that it’s normal. Although it might look slightly different, they don’t think much of it. For women, the symptoms are often part of the normal ways that the vagina reacts, and so it is not easily identified as a problem,” she said.
What are some of the common STIs affecting women?
Serfontein noted that there is not one infection that is more prominent in women in comparison to men.
“There are common bacterial infections that we see, such as chlamydia, gonorrheoa, and trichomoniasis. Those are the infections that can be asymptomatic. Then, there are viral infections like the herpes virus, specifically herpes type two, but type one herpes is can also be transmitted sexually. And then the other viral infection that’s quite common is HIV, Human papillomavirus (HPV), and hepatitis B.”
Are there STIs that are not curable?
Yes. After the medical professionals have distinguished if you have a bacterial or viral infection, they are then able to prescribe the correct treatment methods. Serfontein said that bacterial infections can be cured with antibiotics. Viruses, on the other hand, cannot be killed and only the symptoms can be managed.
What happens when an STI goes untreated?
“The main concern is that if you have chlamydia or gonorrhea, and you don’t know or leave it untreated, it’s going to spread to the fallopian tubes and the ovaries. This could lead to a condition called pelvic inflammatory disease (PID) which is very dangerous. Abscesses can form and you can get really sick. It can also lead to infertility or increase your chances of having an ectopic pregnancy,” said Serfontein.
She added that HPV is another dangerous STI if it goes untreated.
“You can develop cervical cancer or it can even lead to death. Pap smears are one way to check for this virus. If you don’t treat it then you can die from it.”
Can you get an STI even when you used a condom?
Although condoms decrease the chance of the transmission of STIs, you can still get infected. This is because some STIs are transmitted through close skin-to-skin contact, and a condom does not cover the whole pubic area.
HPV, syphilis, and herpes can still be transmitted through skin-to-skin contact.
How does HPV affect women?
According to Serfontein, HPV is common because of how easily it is spread – through close skin-to-skin contact. One doesn’t have to have penetrative sex; if genitals are rubbing against each other, transmission is possible.
“The main concerns about how HPV can affect women are genital warts and cervical cancer. It can sit on the cervix and lead to abnormal pap smears that can lead to cervical cancer later in life,” she said.
Why is HPV such a concern?
According to the Cancer Association of SA (CANSA), 80% of the general population will have HPV somewhere in their lives.
“This means that majority of people will have HPV, while only 10% of those that have the virus will develop the disease. This means a lot of people have the virus but they don’t have any symptoms. They just end up being carriers of the virus for years,” said Serfontein.
How does the HPV vaccine work?
Serfontein said that the vaccine uptake in SA has been slow.
“We want to vaccinate men and women before they become sexually active. By the time they are sexually active, they may have developed full immunity against certain HPV strains. There are over 100 types of HPV strains, some of which cause genital infections. We’ve got two vaccines registered in SA; Gardasil and Cervarix. The Gardasil covers the four strains that bore genital warts and cervical cancer. The Cervarix only covers the two strains that cause cervical cancer. We hope to get more women getting the vaccines to prevent cervical cancer.”
— ExploreSexTalk (@ExploreSexTalk) February 3, 2022
Can I use home remedies to treat an STI?
Serfontein advises against the use of products that are not medically approved or recommended. She listed a few things related to home remedies that women should and shouldn’t do if they think they might have an infection.
“Do not use any steaming or cleansing remedies for the vagina because they can actually disturb the whole pH in the vagina and cause infection. Rather go and see a doctor. If there’s pain and discomfort due to a break in the skin or if it burns when you’re urinating, sit in a bath and urinate. This will ease the discomfort. You could also take a glass of water and rinse the vulva while you’re urinating so that it doesn’t burn as much,” she advised. – Health-e News