Gleaner's Health Article
The scenario is played out frequently in my medical practice. A man walks into the office; often unwilling to make eye contact and when asked the reason for the visit, states sheepishly, "Doc, I have picked up a leak!" or "It's my back, doctor!" This is the introduction to a consultation on sexually transmitted infections (STIs).
Sexual activity begins at an early age among males in Jamaica. 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 infections.
Many young males are ignorant of sex, sexual intimacy, the way females become pregnant, STIs and condom use. A recent study revealed that about one-third of males have had two or more sexual partners in the last year. It is worrying that even males who have some knowledge do not adhere to safe sexual practices.
Agents 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 also be transmitted during sexual intimacy.
Syphylis causes a sore on the penis which resolves spontaneously. It later reappears as a rash. If untreated, syphylis will cause nerve damage. Chlamydia causes an abnormal discharge from the penis and may cause a chronic infection in the prostate. It is also responsible for infertility among couples. Gonorrhoea is suspected when the man complains of burning when he passes urine or he gets pus from the penis within a few days of sexual intercourse.
The human immunodeficiency virus (HIV) is the causative agent of HIV infection and Acquired Immune Deficiency Syndrome. Human papillomavirus (HPV) causes cervical cancer in females. HPV also causes warts in males and females. Genital herpes causes a recurrent, painful rash for which there is no cure. However medication is available for suppression of the attacks.
Fortunately, condom use has increased steadily among males. This is a major weapon in the fight against most sexually transmitted infections. 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: firstname.lastname@example.org.