Sexually transmitted infections (STIs) are infections that are commonly spread by sexual contact. These infections are usually passed from person to person through vaginal intercourse, anal sex, oral sex or skin-to-skin contact. Some STIs can also be spread through non-sexual means such as via blood or blood products. STIs have a great impact on sexual and reproductive health.
Worldwide Statistics of STIs
According to the World Health Organization (WHO), more than one million STIs are acquired every day. Each year, it is estimated that 376 million new infections occur with 1 of 4 STIs such as chlamydia (127 million), gonorrhea (87 million), syphilis (6.3 million) and trichomoniasis (156 million). More than 500 million people are living with genital HSV (herpes) infection and an estimated 300 million women have an HPV infection. STIs occur worldwide with the highest rates among 20-24 year old, followed by 15-19 year old. One in 20 young people is believed to contract a STI each year.
Malaysian Statistics
According to Malaysian AIDS Council, there are 87,581 people infected with HIV in Malaysia. In 2019, it was estimated that Gonorrhea had a prevalence rate of (3130), Syphilis (3077) and AIDS (919).
Contributing Factors to STIs among young people
STIs take a heavier toll on certain populations and communities; women and young people in particular. The following are a few contributing factors to STIs among young people.
Biological factors
Young women, girls and boys are biologically more susceptible to STIs, but often experience few or no symptoms.
Early onset of puberty and sexual encounters
Adolescents are attaining puberty at a much younger age these days. This leads to early sexual exploration and sexual encounters. Although peer pressure may play a big part in this, curiosity and the interest to explore their sexuality may also encourage sexual activities at a young age. However, many may not be completely aware of the risks involved or the various ways of protecting themselves against STIs and unplanned pregnancies.
Poverty and economic
Young people, particularly girls, living in poverty are more vulnerable to sexual exploitation. They may be subjected to early/forced marriages or become victims of sex trafficking. Many are lured into sex work with the promise of a better life for them and their families. In such cases, they are exposed and become vulnerable to STIs.
Limited Preventive and Treatment Services
The higher prevalence of STIs among adolescents could be attributed to the many barriers to adolescent-sensitive STIs prevention services, including lack of health insurance or other inabilities to pay, lack of transportation to STI clinics, embarrassment with facilities and services designed for adults, and apprehensions about confidentiality.
Demographic and Ecological Factors
Demographic and ecological variables put certain groups of adolescents at greater risk of STIs, especially gay, lesbian and transgender youths, homeless, runaways, commercial sex workers, and pregnant or incarcerated young people.
Types of STIs
The following are types of STIs that are caused by bacteria, virus, parasite and fungal infections:
Bacterial Infections
Syphilis
Syphilis is a highly contagious STI ca caused by a bacterium known as Treponema pallidum. The disease is normally transmitted through sores that are in genitals. It is transmitted through vaginal, anal or oral sex. A pregnant woman can transmit syphilis to her infant through the placenta. Syphilis is normally called “the great imitator” because there are many symptoms that are almost similar with other infections. Symptoms of syphilis include swollen lymph nodes, sore throat, muscle aches and hair loss.
Gonorrhea
Gonorrhea is caused by bacterium knows as Neisseria gonorrhea; which can grow and multiply easily in a warm and moist area especially in the reproductive tract, including the cervix, uterus and fallopian tubes in women. Gonorrhea can infect both men and women. In most men, gonorrhea is asymptomatic at early infection. However, the symptoms; which may appear 1 to 14 days after infection; include burning sensation during urination and discretion of white, yellow or green discharge from the penis. Sometimes infected men will feel pain or have swollen testicles. In women, the symptom is mild and not easily detected. The early symptoms in women are similar to men; burning sensation during urination, increase in vaginal discharge (yellowish or greenish), bad vaginal or vaginal bleeding between their monthly periods.
Chlamydia
Chlamydia is caused by the bacterium known as Chlamydia trachomatis. Apart from infecting the genitals, Chlamydia can also infect the throat, rectum and eyes. Some men with Chlamydia may show no symptoms upon infection. However, for other men, this infection will produce symptoms that are similar to gonorrhea and these includes burning sensation during urination, white or cloudy watery discharge from the penis or rectum, testicular tenderness, pain or swelling, and rectal discharge. According to WHO, approximately 30% of those infected will have symptoms. These symptoms include burning sensation during urination, pain or bleeding during sexual intercourse, rectal pain or discharge, vaginal discharge, low abdominal pain which comes together with nausea.
Viral Infections
Hepatitis B
Hepatitis B is a vaccine-preventable liver infection caused by the Hepatitis B virus. It attacks the liver and can cause both acute and chronic diseases. The virus is most commonly transmitted when blood, semen or other body fluids from an infected person with the virus enters the body of someone who is not infected. This can happen through sexual contact, sharing needles, syringes or from mother to baby at birth. Most people do not experience any symptoms when newly infected. However, some people have acute illness with symptoms that last several weeks, including yellowing of the skin and eyes (jaundice), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.
HIV
The Human Immunodeficiency Virus (HIV) targets the immune system and weakens people’s defense against many infections. As the virus destroys and impairs the function of immune cells, infected individuals gradually become immunodeficient. The most advanced stage of HIV infection is known as “Acquired Immunodeficiency Syndrome (AIDS)” This can take many years to develop, depending on the lifestyle of the individual and their adherence to treatment (if needed). People who are HIV+ can live with no symptoms of the infection. Only a blood test can confirm a person’s HIV status.
As the infection progressively weakens the immune system, HIV+ individuals can develop other signs and symptoms, such as swollen lymph nodes, weight loss, fever, diarrhea and cough. Without treatment, they could also develop severe illnesses such as tuberculosis (TB), meningitis, severe bacterial infections, and cancers such as lymphomas and Kaposi’s sarcoma. Apart from unprotected sex (sex without condoms), the virus can only be transmitted through sharing of needles with an infected person and from a mother to her child during pregnancy, delivery and breastfeeding.
Human papillomavirus (HPV)
Human papillomavirus (HPV) is the most common viral infection of the reproductive tract. Most sexually active women and men will be infected at some point in their lives and some may be repeatedly infected. HPV infection doesn’t cause any noticeable symptoms or health problems. In some cases, HPV may cause genital warts and lead to cervical cancer. As a method of prevention, HPV vaccination is recommended for girls and boys and can be given as early as age 9, before they have sexual contact and are exposed to HPV.
Herpes simplex
The herpes simplex virus is categorized into 2 types which is herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). HSV-1 is mainly transmitted by oral-to-oral contact and may cause oral herpes and may also cause genital herpes. HSV-2 causes genital herpes. Symptoms of oral herpes include painful blisters or open sores called ulcers in or around the mouth. Sores on the lips are commonly referred to as “cold sores.” Infected persons will often experience a tingling, itching or burning sensation around their mouth, before the appearance of sores. Symptoms of genital herpes infections often include fever, body aches, and swollen lymph nodes.
Parasitic infections
Pubic lice
Pubic lice is caused by the Pthirus pubis pathogen. It can move easily from one person’s pubic hair to another person’s pubic hair either during close physical contact or sexual intercourse. The most common symptom of pubic lice infection is intense itching in your pubic area. The inflammation and irritation are caused by your body’s reaction to the crabs’ bites.
Scabies
Scabies is caused by mites known as Sarcoptes scabiei. They’re normally spread through sexual contact, but they can also be spread through infested bedding, clothing, and towels. Symptoms of scabies include small bumps or rashes, small curling lines, especially on the penis, between the fingers, on buttocks, breasts, wrists, thighs, and around the navel. These visible signs are accompanied by intense itching, especially at night.
Trichomoniasis
Trichomoniasis is caused by the Trichomonas vaginalis parasite. It spread through sexual contact, sharing sex toys, and touching your own or your partner’s genitals with infected hands. Trichomoniasis can easily infect the vulva, vagina, penis, and urethra. Common symptoms include swelling around your genitals, abnormal vaginal discharge, pain during sex and burning sensation during urination.
Fungal infections
Candidiasis
Candidiasis is classified into two types which is oral and vaginal candidiasis. Oral candidiasis is also known as oral thrush. It is a condition in which the fungus Candida albicans accumulates on the lining of your mouth. Candida is a normal organism in your mouth, but sometimes it can overgrow and cause symptoms. Common symptoms include creamy lesions on tongue, redness at the corner of mouth and bleeding. Vaginal candidiasis may cause irritation, itchiness at vagina. Other symptoms include abnormal vaginal discharge, redness and swelling of vulva.
Effects of STIs
- Infertility can occur when the fallopian tubes become blocked or damaged by STIs.
- Undiagnosed and untreated STIs can lead to pelvic inflammatory disease (PID), ectopic pregnancy, as well as adverse fetal and neonatal outcomes.
- Having an STD/STI increases a person’s risk for several types of cancer. Certain high-risk types HPV can cause cervical cancer in women. In men, HPV infection can lead to the development of penile cancers. HPV also can cause cancers of the mouth, throat, and anus in both sexes.
Prevention
Abstinence is the only sure way of preventing STIs. However, this is not a practical advice. Practicing safe sex is the most effective way of preventing STIs for those already engaging in sexual activities. Condoms must
be used consistently and correctly. Being faithful to one partner and being certain of your partner’s sexual history will help in preventing STIs. In addition to that, go for regular STIs screenings and Pap smear.
Where to get help?
You may call us at 03-227433289 or Whatsapp us on 017-3561049 for STIs screening and Pap smear. You can also book us for talks and sessions to learn more about this topic or any other topics relating to Sexual and Reproductive Health and Rights.
References
World Health Organization: Sexually transmitted infections
The Star (20 August 2020)
www.mac.org.myhttps://www.who.int/maternal_child_adolescent/documents/9241562889/en/
https://www.cdc.gov/std/life-stages-populations/stdfact-teens.ht