STIs a challenge

Shamiso Yikoniko
MUCH to the chagrine of public health officials, controlling the three common sexually transmitted infections (STIs) continues to be a challenge, especially among adolescents.  Syphilis, chancroid and gonorrhea are the most commonly recorded STIs among the adolescents.

A total of 3 193 STI cases were recorded among the age groups of 10 and 14 between January and December last year, according to the National Annual 2016 Core Output Indicator Report. Inter-generational relationships, sexual abuse, low-risk perception, adolescents not empowered to negotiate for safe sex, nude parties, peer pressure and economic challenges have been attributed as the key drivers of the high numbers of STI cases among adolescents.

In the same year, 622 STI cases were recorded among the zero to four years age group and 1 085 for the five to nine years. However, health experts attribute cases of STIs recorded among the zero and nine year olds to sexual abuse while some children are reported to have been born with the infections.  For the year 2014, ages between 10 and 19 recorded a total of 6 070 STI cases, with an average of at least 1 500 cases being recorded every quarter for that age group.

The surge in STIs across the country among the adolescents automatically points to the prevalence of unprotected sex being practiced despite the HIV dangers it poses. This is also despite the prevention gospel preached almost on a daily basis by the responsible ministry-Ministry of Health and Child Care and its partners.

The Ministry of Health and Child Care’s director for Aids and TB unit, Dr Owen Mugurungi, attributed the high numbers of STIs cases documented among adolescents to a number of factors. “Due to economic challenges, a number of adolescents are indulging in unprotected sex in inter-generational relationships where they lack the power and skills to negotiate for safe sex,” he said.

Overally, the country recorded 181 154 cases of STIs in the aforementioned year. In the year 2015, the country recorded a total of 288 127 STI cases while in 2014 268 353 cases were recorded (NAC Report). The rise in STI cases in the country are a contradiction to the assertion that Zimbabwe’s condom usage now tops that of any other country in the world, with over 105 million condoms used in 2016.

Southern African HIV and Aids Information Dissemination Service (SAfAIDS) head of media, marketing and public relations, Mrs Tariro Makanga-Chikumbirike, said STIs are increasing because young people are more scared of falling pregnant than contracting STIs and HIV. “From dialogues we have had with young people, it is evident that young people are using family planning against pregnancy and not condoms to prevent them from STIs,” she said. “Risk perception amongst young people keeps going down. Peer pressure, nude parties and inter-generational relationships are also contributing a lot,” the report added.

The same report indicates that STI cases are more prevalent in Masvingo, Harare and Manicaland provinces.

Harare constituted 31 657 cases, Masvingo 32 137 cases and Manicaland recorded 23 350 cases.  Zimbabwe is one of the few countries in Africa that have scored successes in the fight against the HIV and Aids pandemic on the back of the innovative Aids Levy.

This success, however, can be easily reversed by the surge of STIs reported in the country’s towns and cities. The figures are projected to be higher than the ones published since some men seek treatment from private hospitals and doctors, or use traditional concoctions.

National Aids Council monitoring and evaluation director, Mr Amon Mpofu, concurred with Dr Mugurungi and said the rise in STIs is a health time bomb. “The continued high STI cases recorded among adolescents is worrying,” he said. “It shows that we are sitting on a time bomb of which we will expect to see an increase in new cases of HIV,” he said.

Despite Zimbabwe being regarded as an internationally acclaimed best practice in condom distribution, gaps in consistent condom use persist, particularly within concurrent sexual relationships.

Mrs Makanga-Chikumbirike said there is need for engagement for young people in STI prevention. “We can never give young people enough information, hence there is need to engage them in STI prevention,” he said. “We also have to make it a must to re-engineer our prevention interventions.”

Dr Mugurungi, however, added that there is need for more sexual education among young people. “There is need for more sexual education about the dangers of engaging in unprotected sex by all stakeholders involved,” he added.

A disturbing viewpoint is the natural link between STIs and HIV infection. Studies have proved that testing and treatment of STIs is an effective tool in preventing the spread of HIV, the virus that causes Aids. An understanding of the relationship between STIs and HIV infection also helps in the development of effective HIV prevention programmes.

People infected with STIs are at least two to five times more likely than uninfected individuals to acquire HIV if they are exposed to the virus through sexual contact. In addition, if an HIV-infected individual is also infected with another STI, such a person is more likely to transmit HIV through sexual contact than other HIV-infected persons.

Mr Mpofu said STIs increase chances to HIV infection. “People infected with STIs are at least two to five times more likely than uninfected individuals to acquire HIV if they are exposed to the virus through sexual contact. In addition, if an HIV-infected individual is also infected with another STI; such a person is more likely to transmit HIV through sexual contact than other HIV-infected persons,” he said.

Health experts have warned that the development suggests people are shunning condom use thereby undermining the fight against HIV. Zimbabwe suffered a devastating economic meltdown for the past decade but its HIV response has remained steadfast in giving hope to the nation.

Government, however, says it remains committed to the national response and has put in place appropriate policies, strategies, structures and instruments to ensure the country achieves the 90-90-90 target.

Earlier this year, Government through the Health and Child Care ministry and the Zimbabwe National Family Planning Council (ZNFPC) launched the second National Adolescent Sexual Reproductive Health Strategy (2016-2020) on the backdrop of both national and international recognition of the plight of adolescent and young people between the ages of 10 and 24 years in relation to their sexual and reproductive health challenges.

Speaking at the launch, the Minister, Dr David Parirenyatwa, said Government is concerned about the high rate of STIs and pregnancies among youths. “The blue-print intends to improve the service provision of adolescent sexual reproductive health and development of young people in Zimbabwe,” he said.

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