Sexual Transmitted Infections (STIs) are a major health problem in South Africa, according to Dr Hester Alida Swart, and young people in Gauteng have been urged not to ignore the signs and symptoms.
An STI can occur after using fingers, other body parts or sex toys that have come in contact with another person's genitals or body fluids. STIs often don’t have any noticeable symptoms and people are can become infected without even knowing it.
According to a recent report by the provincial health department, the most common STIs reported in Gauteng are genital blisters without ulceration, genital ulcers and genital warts.
Read: The STI you most likely could have without knowing it
The report said 18 086 people visited public health facilities with STIs in 2014/15 compared to 19 416 patients in 2013/14.
The incidence of STIs in 2014/15 showed 33.4% males were infected compared to 66.4% of females, and the most affected age group was those between 25 and 29-years-old.
"Females comprise the majority of patients seen at health facilities as their biological anatomy makes them more susceptible to STIs than males," Gauteng Health spokesperson, Steve Mabona, told Health24.
In women, STIs most commonly present as genital ulcers, warts or a vaginal discharge, said Swart, who is an obstetrician and gynaecologist at the Faculty of Medicine and Health Sciences at Stellenbosch University and Tygerberg Hospital.
Genital blisters and ulcers
Swart explained that a blister is a fluid filled pocket in the upper layer of the skin while an ulcer is an open sore on the surface of the body. "Genital blisters can progress to ulcers and they can be painful or painless and can be accompanied by swellings in the groin area (lymphnode enlargement)," she said.
Genital blisters and ulcers can occur anywhere in the genital area and are also associated with mouth ulcers as a result of oral sex, she said.
"The most common infective causes are herpes simplex virus, syphilis and chancroid, which are all sexually transmitted," Swart explained.
However, Swart pointed out that not all ulcers are caused by infections;
they can also be caused by drug-reactions, trauma or cancer.
"A wart is a small, hard, non-cancerous growth on the skin caused by members of the human papilloma virus (HPV) family," said Swart.
Genital warts can be on the vulva, vagina, cervix, perineal area or in the mouth, said Swart adding they are caused by certain types of HPV that are sexually transmitted.
"These should not be confused with warts on other parts of the body. These are caused by other types of HPV that are not sexually transmitted," she cautioned.
If you have genital warts, you are also at increased risk of cervical, vaginal and vulvar cancer.
"These need to be actively excluded by the health care provider by careful examination, regular Pap smears and biopsies of the area if indicated," she advised.
Swart said most women have a normal vaginal discharge that may vary in volume and colour throughout the month. “If this discharge becomes foul smelling or is accompanied by symptoms like itching or burning, it might be indicative of an infection.”
The most widespread infections causing a discharge are thrush (candidiasis) and bacterial vaginosis but Swart said these are not STIs.
“The most common STIs causing a discharge are trichomoniasis, gonorrhoea and chlamydia.”
Women experiencing these symptoms should visit the clinic or general practitioner (GP), advised Swart.
What you can expect from a visit to the clinic
“They will ask you more about your complaint, sexual practices and birth control. You will need a full gynaecological examination that should include a speculum exam.”
She said it was not correct to be treated without being examined since serious conditions like cervical cancer can be missed.
"While most STIs present with relatively mild symptoms, they can have more dire consequences for example pelvic inflammatory disease (PID), cervical cancer and an increased risk of HIV transmission.
“They can also cause infertility, tubal pregnancies and chronic pelvic pain. In pregnant women, STIs can lead to miscarriages, early labour, diseases of the newborn and even stillbirths," Swart said.
Take our STI quiz
Referring to the decrease in the overall reported cases for 2014/2015 period, Mabona said this could be attributed to educational awareness campaigns.
"The department has embarked on a massive campaign to mitigate the impact of HIV/Aids, including STIs, using a combination prevention approach."
He said the campaign and all HIV/Aids and STI projects are implemented through a branding platform called PASOP, which translates to:
P - Prevent new HIV, STIs and TB
A - Avoid reinfection
S - Stop the spread of HIV, STIs and TB
O - Overcome fear, stigma and discrimination
P – Protect one’s loved ones and others
Mabona encouraged young people to download the PASOP application for androids devices.
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