STIs are a major health problem

Sexually transmitted infections (STIs) are frequent complaints presented by men attending health care facilities. In the lifestyle survey (2000), one in three Jamaican men, aged 15 to 45 years, had a previous history of an STI. This problem affects young people in particular, with 25-per-cent of the 10 to 19 year olds reporting at least one previous STI.

Risk factors for STIs

Sexual activity begins at an early age for Jamaican males. The Ministry of Health reports that the median age for sexual initiation of boys is about 13 years. Early onset of sexual activity, frequent change in partners and multiple partners increase the risks of transmission of HIV/AIDS, unwanted pregnancies and cervical cancer in females. Many young males are ignorant of sex, sexual intimacy, the way girls become pregnant, STIs and condom use. It is worrying that about one-third of our males have had two or more sexual partners in the last year. Even males who have some knowledge do not adhere to safe sexual practices. However, condom use has increased steadily among young males.

Men who have sex with men are at increased risk of STIs. They suffer trauma to the anus and rectum resulting in mucosal tears, fissures and inflammation. This is evidenced by their increased rates of infection with HIV/AIDS. Alcohol abuse, crack/cocaine use and sex with prostitutes increase the likelihood of suffering from an STI.

Types of STIs

Commonly recognised STIs include gonorrhoea, syphylis and chlamydia. These infections affect primarily the genital parts but may also affect the throat, rectum and anus. Viruses are important causes of STIs such as HIV, hepatitis A, B and C, herpes simplex and human papillomavirus. Parasites such as lice and scabies can be transmitted during sexual intimacy too.

Signs

Mucopurulent (like pus) discharge, along with burning pain on urination, are the most common signs of an STI. Men may present with sores or rashes on the penis as well as swellings in the groin area. Pain in the back is often interpreted by men as a sign of an STI. Men should remember that STIs may be present without any sign or symptom of a problem. The knowledge that they had unprotected sex should be reason enough to seek medical attention.

AIDS epidemic

STIs are a major problem worldwide and this has been highlighted by the HIV/AIDS epidemic. In Jamaica, 25,000 persons are living with HIV and the death rate is decreasing with 514 persons dying in 2005 compared to 665 in 2004. Prevention of infections is the only mean of stopping the epidemic since there is still no cure and there are only drugs to suppress the virus. The presence of other STIs promotes the transmission of HIV and so, the prevention of all STIs will help to halt the epidemic.

Cancers

Cervical cancer is the second major cancer among Jamaican women; this is an STI spread by the human papillomavirus (HPV). A 1990 survey (Ministry of Health data) found that 28.7 per cent of women over the age of 15 years had HPV. Women are infected by men during their teens or 20s and then manifest the malignancy in the 35 to 54 age group. Long-term infections with hepatitis viruses can lead to cancer of the liver.

Prevention

Prevention is the best protection against STIs and is often the only means of controlling their spread. Safe sexual practices, adherence to one sexual partner and condom use will reduce heartaches for both men and women.

Dr Pauline Williams-Green is a family physician and president of the Caribbean College of Family Physicians; email: yourhealth@gleanerjm.com.