​With Valentine’s Day around the corner, the Gauteng Department of Health (GDoH) wishes to caution the public from engaging in risky sexual behaviour as this increases the transmission of Sexually Transmitted Infections (STIs) and HIV infection. 

Between April and December 2023, a total of 167 109 males presented at public health facilities across the province and 67 400 (40%) were treated for Male Urethritis Syndrome (MUS). The MUS data accurately reflects newly acquired STIs. 

Symptoms of MUS include discharge from the penis and burning urination. If left untreated complications can include pain and swelling of the testes. Gonorrhoeae and chlamydia are the most predominant cause of MUS in South Africa. 

In 2020, the MUS incidence in the province was recorded at 12% and has increased over the years to 15% in 2023. This data reflects an increase of STI incidence in sub-district E (Alex/Sandton) and F (Inner City/Braamfontein/Hillbrow) in Johannesburg, Merafong sub-district in West Rand, Katlehong, Ekurhuleni South (Germiston, Katlehong and Vooslorus), Lesedi in Sedibeng and Region 7 (Bronkhorstspruit) in Tshwane. 

Sub-district E and F in Johannesburg has tertiary institutions and high-risk individuals such as sex workers and people who inject with drugs. Merafong is a mining area with a majority of the male population, Region 7 has farming areas where cultural norms hinder uptake of services especially amongst men, while Ekurhuleni South and Lesedi have TVET colleges, informal settlements, truck stops and hostels. 

The GDoH has implemented a combination of prevention intervention approaches which incorporate STI components in these areas such as the promotion of consistent use of male and female condoms which are free and available in health facilities, encouraging the reduction in the number of sexual partners, increased uptake of HIV counselling and testing, STI screening, delayed sexual debut, as well as the promotion of sexual wellbeing. 

MEC for Health and Wellness, Nomantu Nkomo-Ralehoko has urged people that are sexually active to use male and female condoms which they can access for free at their local healthcare centres to protect themselves against STIs and HIV. 

“In terms of the high MUS incidence recorded in the mentioned areas we have identified behavioural factors that contribute to the high Male Urethritis Syndrome. The contributory factors include high rates of unsafe behaviour such as non-use of condoms whilst engaging in vaginal or anal sex, multiple sexual partners, inconsistent condom use, high levels of substance use and cultural norms. 

“Our clinics provide free condoms and STI and HIV prevention, testing and treatment services. We should not let STIs go untreated as they increase the risk of HIV infection and transmission which will hamper the province’s goal to reduce new HIV infections by 2030,” emphasised MEC Nkomo-Ralehoko. 

In addition, the MEC encouraged women to start early antenatal care as soon as they realise that they are pregnant for thorough screening of any STI, and appropriate and timely treatment for those who test positive. 

“Between April and December 2023, 1 255 out of 66 377 pregnant woman who presented at our facilities for antenatal care for the first time tested positive for Syphilis. 

“If left untreated in pregnant women, Syphilis can have adverse outcomes for the growing baby as well as increase morbidity in the mother. It can be passed from mother to baby during pregnancy (congenital syphilis), leading to stillbirths, health complications, congenital deformities and even infant death,” said the concerned MEC Nkomo-Ralehoko. 

The MEC also said that there has been a noticeable increase in women that are presenting at health facilities to be initiated on Pre-Exposure Prophylaxis (PrEP), which is an antiretroviral drug prescribed for HIV-negative people to prevent them from becoming infected with HIV. Between April and November 2023, a total of 38 305 females aged 15 to 49 years were initiated on PrEP in comparison to 11 988 males. 

“We believe that the high uptake of PrEP among women has led this group to having unprotected sex resulting in high incidence of MUS. The studies have reported that STI incidence is also high among young women receiving PrEP. 

“We would like to encourage more males to get initiated on PrEP to protect themselves against STI. Additionally, both men and women who are on PrEP should use condoms to protect themselves against STIs, HIV and unwanted pregnancies,” stated the MEC.

February is Sexual and Reproductive Health awareness month and is also the period in which the country observes STI/Condom Week (6-10 February) which is used to raise awareness on the significance of practising safe and protected sex. Pregnancy Awareness week also falls during this period. 

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Issued by the Gauteng Department of Health