“One million new STIs are transmitted daily” – WHO Report
Sexual activity is the leading cause of sexually transmitted infections (STIs). However, a sexually active person reduces his/her risk of contracting an STI through safe sex practices.
In a study conducted across four tertiary institutions in Ibadan, 90.8 per cent of the participants showed good understanding of safe sex yet, only about 9 per cent declined sex with partners of unknown sexual history.
This shows that many Nigerians have a good understanding of safe sex practices but the challenge is in the knowledge-practice gap. The high prevalence of STIs makes it imperative that we include sex education in today’s health discussions.
What are STIs and how do they affect us?
“HIV, a sexually transmitted infection, is one of the leading causes of death in Nigeria.”
Sexually transmitted infections include Human Immunodeficiency Virus (HIV), Human Papilloma Virus (HPV), Herpes Simplex Virus (HSV), chlamydia, syphilis, gonorrhoea, viral hepatitis, among others. These infections have profound effect on our health if left untreated.
Syphilis in pregnant women leads to adverse birth outcomes, or even infant mortality. Gonorrhoea and chlamydia are the major causes of infertility in women. HPV is the main cause of cervical cancer in women while viral hepatitis results in liver cancer (in both men and women). HIV, the most popular STI in the African community, remains a major global public health issue and a leading cause of death in Nigeria.
Practicing Safe Sex
It is possible to enjoy sex without putting your health at risk, especially on a day like this, when people usually throw caution to the wind all in the name of “love”. Here are some proven methods to reduce your chances of contracting an STI:
- Condoms: Condoms create a barrier that prevents semen and other body fluids from coming in contact with the vagina, rectum, or mouth. They are made of very thin rubber, polyurethane, polyisoprene. Condoms are also useful as a barrier method of contraception to prevent pregnancy.
- Vaccines (How does a vaccine confer immunity, Hepatitis B, HPV, progress with HIV Vaccine). Vaccines are useful to protect against viral STIs. Four of the known STIs with no known cure are viral infections and they include hepatitis B, HPV, HIV and HSV. Presently, there are vaccines available for hepatitis B and HPV and a vaccine for HIV is still in the works.
Although vaccines provide immunity against these infections, they will not help if you already have the disease.
- PrEP (Truvada and Descovy): PrEP represents pre-exposure prophylaxis, they are recommended for people who are at risk of HIV. PrEP is beneficial to people who are HIV-negative but have a sexual partners with HIV.
- Abstinence: People who abstain from sex have zero sexual contact. Abstinence is generally considered to be highly effective. Zero side effects and zero costs.
Contraception means the deliberate use of artificial methods or other techniques to prevent pregnancy as a consequence of sexual intercourse.
Some contraception methods currently in use include:
- Condoms/Female condoms: When used properly, male condoms are about 98% effective at preventing pregnancy. Some male condoms are coated with a spermicide, nonoxynol-9, which further reduces the risk of pregnancy. Female condoms also made from thin rubber are equally as effective as male condoms in preventing pregnancy.
- Intrauterine device (IUD): IUDs, like condoms also work by stopping the sperm from reaching the fallopian tunes to fertilise the eggs. Some IUDs contain the hormone, progestin, which is the one of the two hormones found in birth control pill. Intrauterine devices are highly effective and give long-term protection against pregnancy.
- Birth control pills: They come as combination pills (progestin and estrogen) or as progestin-only pills. They prevent pregnancy by inhibiting ovulation, thickening cervical mucus or by thinning the line of the uterus. However, they are not as effective as IUDS.
- Implants: Implants contain the hormone etonogestrel, and are placed under the woman’s skin. The hormone in the implant is responsible for its contraceptive effect. Etonogestrel inhibits the release of eggs from the ovaries and thickens the cervical mucus. Implants are as effective as IUDs as a contraceptive method.
- Sterilization (Vasectomy and Tubal ligation): This procedure in men is call vasectomy. In conventional vasectomy a doctor makes a cut in the man’s vasectomy deferens so that sperm is no longer able to reach the semen. Female sterilisation is known as tubal ligation—the fallopian tubes, where fertilization occurs, is tied. It is important to note that these two procedures are not easily reversible. They are not recommended for people who have plans to have children. Sterilisation is highly effective in preventing pregnancy.
What to do after you have had unsafe sex
For people who choose to engage in sex, it is important to be rational, responsible and to play safe. In any case that you fail to, and in the process expose yourself to an infection, here are steps you can take to prevent pregnancy and preserve your health:
- Avoid douching immediately after sex because it further irritates the tissues and increase you’re the risk of infection
- Take an emergency contraceptive pill
- See a doctor to get tested for STIs
- Take post-exposure prophylaxis if you suspect that you have been exposed to an sexual partner with HIV
If you are with someone you have no knowledge about their sexual history it’s best to avoid any form of sexual contact. It is not enough to trust someone. One time exposure with an infected person is all it takes to contract an STI.
Role of the community in reducing the prevalence of STIs and unwanted pregnancy
A major challenge facing promotion of safe sex practices is the stigma surrounding the conversations around sex in the African society. Countless times, we have seen that stigma associated with STIs are counterproductive. Sex is an essential part of our existence as humans and conversations around sex should be encouraged because they empower people to make good decisions in their sexual relationships.
Reference: Otobo D Daniel, Adikpe Edugbe, Okoro Ngozi, Mubarak Adewale, Luka Nehemiah, Tanko O Hayyatudeen, Peter S Oluwatobiloba. Gaps in modern contraceptive use and practice of safe sex in Nigeria. Int J Clin Obstet Gynaecol 2021;5(1):405-410. DOI: 10.33545/gynae.2021.v5.i1g.845