Sexually Transmitted Infections (STIs) do not discriminate or respect boundaries; they can affect anyone who is sexually active regardless of nationality, race, ethnicity, religion, gender, sexual orientation, and economic status.
STIs are among the most common communicable diseases and constitute a major global public health burden. The World Health Organization (WHO) estimated that, in 2016, there were approximately 377 million people aged 15-49 years newly infected with gonorrhoea, chlamydia, syphilis or trichomoniasis (four common, treatable STIs). This corresponds to just over 1 million new STI cases worldwide every day. In South Africa, estimates of people newly infected with STIs in 2017 were approximately 4.5 million for gonorrhoea, 6 million for chlamydia and 71 000 for syphilis.
South Africa commemorates STI/Condom week this between February 10 and 16 every year to raise public awareness around condom usage and STDs as well as to root out stigma and discrimination relating to these.
People become infected with STIs through having unprotected vaginal, anal or oral sexual intercourse with infected partners. A large proportion of people with STIs may not have any signs or symptoms, and so maybe unaware that they are infected. Common symptoms and signs of STI include abnormal vaginal or penile discharge; pain during urination; ulcers in the genital area; swellings in the groin, and genital warts. Untreated STIs result in long-term complications such as ongoing lower abdominal pain, infertility and adverse pregnancy outcomes like stillbirths and preterm delivery. Treatment for STIs is given free of charge at primary healthcare clinics across South Africa.
People infected with STIs may be at increased risk of acquiring HIV, and also of transmitting HIV to partners if they have STI-HIV co-infection. Therefore, HIV testing and linkage to care is an important part of STI management. Elimination of mother-to-child transmission of both syphilis and HIV through the screening and treatment of pregnant women is a public health priority.
Condom effectiveness for STD and HIV prevention has been demonstrated by both laboratory and epidemiologic studies. Evidence of condom effectiveness is also based on theoretical and empirical data regarding the transmission of different STDs, the physical properties of condoms, and the anatomic coverage or protection provided by condoms. Laboratory studies have shown that latex condoms provide an effective barrier against even the smallest STD pathogens.
Epidemiologic studies that compare rates of HIV infection between condom users and nonusers who have HIV-infected sex partners demonstrate that consistent condom use is highly effective in preventing transmission of HIV. Similarly, epidemiologic studies have shown that condom use reduces the risk of many other STDs. However, the exact magnitude of protection has been difficult to quantify because of numerous methodological challenges inherent in studying private behaviours that cannot be directly observed or measured.
Condoms can be expected to provide different levels of protection for various STDs, depending on differences in how the diseases or infections are transmitted. Male condoms may not cover all infected areas or areas that could become infected. Thus, they are likely to provide greater protection against STDs that are transmitted only by genital fluids (STDs such as gonorrhea, chlamydia, trichomoniasis, and HIV infection) than against infections that are transmitted primarily by skin-to-skin contact, which may or may not infect areas covered by a condom (STDs such as genital herpes, human papillomavirus [HPV] infection, syphilis, and chancroid).
Source: NICD and CDC