SA is sitting on a sexually transmitted time-bomb
Study reveals more than 60% of young women in Soweto and Cape Town townships have the cancer-causing HPV
Nosipho Mavubengwana was so desperate to keep her boyfriend that she continued to have unprotected sex with him even after being diagnosed with four sexually transmitted infections.
When she gave him a letter from the clinic inviting him for treatment, he refused to go.
“I asked him to use a condom, but he wouldn’t. He insisted that we must have it skin-to-skin, as a condom is boring,” said the 21-year-old from Cape Town.
“Because we had been seeing each other for quite some time – about 18 months – I thought, let me just let him be, so I gave in.”
Even though Mavubengwana was treated, when she went back to the clinic the infections – chlamydia trachomatis, human papillomavirus (HPV), gonorrhoea and another she cannot remember – were still there.
“That’s when I realised that this thing was serious. I went back to him and demanded that he goes to the clinic. He still refused and came up with excuses why he can’t go … even suggesting that he will go to a different clinic,” she said.
Mavubengwana ended the relationship.
“I couldn’t continue with someone who put my life at risk like that,” she said.
“He either had to seek treatment, wear a condom or lose me. He chose to lose me, and I’m totally fine with that … as long as I’m no longer at risk of reinfection.”
Mavubengwana is one of hundreds of thousands of young women caught up in a silent epidemic of sexually transmitted infections that make them prone to HIV and put them at heightened risk of cancer and infertility.
A new study has revealed that more than 60% of young women in Soweto and Cape Town townships had the cancer-causing human papillomavirus (HPV), which is responsible for most cervical cancer deaths in SA.
Almost one in three (30%) have chlamydia – a treatable STI that causes infertility. Women with this infection tend to have fallopian tube blockages, ectopic pregnancies and premature births.
The prevalence of chlamydia among the 300 women in the study was three times higher in Cape Town, at 42%, than in Soweto, at 18%. In other parts of Africa, chlamydia affects only 2.6% of women, while in the US it affects 4.7%.
The study, in the International Journal of STD & Aids, also revealed that young women in Cape Town were not keen on condoms, and only 16% used them regularly compared with 47% in Soweto.
The Capetonians’ sexual behaviour was generally riskier than their Soweto counterparts, possibly due to a high incidence of multiple sexual partners and smaller sexual networks.
More than three-quarters (76%) of women with STIs, including those with chlamydia and gonorrhoea, did not know they were infected, said researchers from the universities of Cape Town and the Witwatersrand.
Prof Linda-Gail Bekker, head of the Desmond Tutu HIV Foundation, said the results proved it was not enough to rely on symptoms alone when managing STIs.
“This is problematic, as many of these treatable conditions, which are known to enhance HIV risk, could be missed,” she said.
“STIs might not light the match but could help fan HIV’s flames. The high levels of chlamydia are of huge concern, as it increases the risk of HIV, pelvic inflammatory disease and infertility.”
Women aged between 15 and 24 have the country’s highest incidence of HIV, with about 1,750 new infections a week.
Bekker said SA had no dedicated screening programmes for STIs because the costs were prohibitive. “But if it were possible to offer STI screening at family planning clinics, this could help improve the uptake of both contraception and STI screening,” she said.
Lead researcher Shaun Barnabas, from UCT, said the screening of men as well as women was an essential part of the problem and the solution. “It would be great to screen, diagnose and treat both partners simultaneously,” he said.