Updated 20 October 2016

The STI you most likely could have without knowing it

Sexually transmitted infections often don’t have any noticeable signs or symptoms and people often get an STI without even knowing it.


It is Valentine’s Day and for most people, it is ideal to end the night on a steamy note. But before you get cosy under the sheets, this is what you should know about sexually transmitted infections (STIs).

A sexually transmitted infection is an infection that is spread during any sexual activity be it intercourse, anal sex or oral sex. It can also occur using fingers, other body parts, or sex toys that have come in contact with another person's genitals or body fluids.

"Although HIV is the most notorious sexually transmitted infection in South Africa, there are several other STIs affecting the population," according to Dr Judith Kluge, who heads the Family Planning Unit at Tygerberg Hospital.

Read: What is the intimate condom?

STIs often don’t have any noticeable signs or symptoms and people often get an STI without even knowing it. "But even when there are no symptoms, STIs can cause serious problems, such as infertility, complications during pregnancy or increase the risk of certain kinds of cancers."

Dr Kluge said that STIs commonly occur on the genital organs, anus, and throat. She highlighted some facts you need to know about STIs to mark Sexually Transmitted Infections Week and Condom Week that runs from 10 to 16 February 2015.

Gonorrhoea - This is the most common STI seen at South African clinics, with between 36% and 68% of people presenting with it. It does not necessarily cause symptoms at first. Gonorrhoea may present with a vaginal discharge.

Chlamydia - This is most often a silent infection and it also doesn't necessarily cause symptoms at first.

Both Gonorrhoea and Chlamydia can lead to long-term problems in women, such as severe pain, difficulty falling pregnant, and complications during pregnancy.

Human Immunodeficiency Virus (HIV) – HIV is a lifelong condition that affects the body’s immune system, which fights infection. The last stage of HIV is called Aids. Being infected with other STIs makes it easier to get HIV.

Human Papillomavirus (HPV) – HPV doesn’t usually cause symptoms at first, but it can lead to cervical cancer in women, and genital warts in men and women.

Herpes – Infection with herpes can cause blisters and open sores in the genital area.

Trichomonas or “trich – This can cause genital itching and discharge.

Hepatitis B – This can lead to long-term liver problems.

Syphilis – This STI can occur at different stages over many years and can affect any part of the body. It can be defined in three stages:

Primary syphilis can present with a painless ulcer on the genitals (chancre) a few weeks after acquiring the infection and can go unnoticed.

Secondary syphilis occurs a few months later and here one can get skin rashes and swollen lymph nodes/glands.

Tertiary syphilis can occur three to 15 years after the initial infection. At this stage you may develop tumours on the skin, bone or liver. And you may also develop neurosyphilis, where the brain and nerves are affected and can result in dementia or general weakness, loss of balance and shooting pains in legs.

Dr Kluge answers some common questions:

What symptoms should I watch for? 

In general, watch out for any genital itching, burning, sores, or discharge. But be aware that many STIs do not cause any symptoms.

What if I have an STI?

If you have an STI, you will need treatment. The right treatment will depend on the type of STI you have. Treatment might include antibiotics or antivirals, which fight viruses. Treatment will cure your infection or keep it from getting worse. It will also reduce the chances of spreading the infection to others.

If you do have an infection, you might need to tell the people you could have infected. Your doctor or nurse can help you figure out which partners you need to tell based on when you last had sex with them.

How can I protect myself from getting an STI?

The only way to be sure you won’t get an STI is by not having sex. If you do have sex, you can lower your chance of getting an STI by using a condom every time you have sex. But be aware that male condoms made out of “natural materials,” such as sheep intestine, do NOT protect against STIs.

Are there are vaccines?

There are vaccines for two STIs — HPV and hepatitis B. Vaccines are treatments (usually injections) that can prevent certain infections. Hepatitis B vaccines are part of the South African vaccination program of babies and since 2014 young girls aged 9 to 12 years are receiving the HPV vaccine at school.

If your partner has herpes, he or she can reduce the chances of infecting you by taking medicine.

Can I pass on STIs to my baby while pregnant?

Yes. A woman can infect her baby with STIs either while pregnant or when the baby passes through the vagina during birth. Syphilis is a common cause of babies dying inside the womb (stillborn or miscarriage), and babies born with it may have no symptoms and only present with problems a couple of years later.

It is routine to test all pregnant women for syphilis when they first present to any government clinic. Sadly in South Africa, many women still present late to “book” their pregnancy or not at all. And therefore syphilis is still common cause for women having stillborn babies in South Africa.

Chlamydia and gonorrhoea can causes eye infections and even blindness, while hepatitis B can cause long-term liver damage in the new born baby.

In South Africa, every HIV-positive pregnant woman is offered antiretroviral therapy (ARVs) while pregnant to decrease the chance of her passing HIV on to her baby. The earlier a pregnant woman starts taking ARVs, the better the chance that her baby will not be infected with HIV.

Also read:

Viagra linked to higher STI rates

The STI most men get without knowing it

Apps for gay and bi men tied to STI risk

(Image: Couple kissing from Shutterstock)


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HIV/Aids expert

Dr Sindisiwe van Zyl qualified at the University of Pretoria before working for an HIV/AIDS NPO in Soweto for many years. She was named one of the Mail & Guardian's Top 200 Young South Africans in 2012.

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