From pleasure to peril: How unsafe sex is fuelling Ghana’s STI crisis and the need for action
Sex is not just a means of reproduction; it is also a fundamental aspect of human life that fosters intimacy and offers health benefits, such as reducing stress, improving heart health, and enhancing overall well-being.
However, when practised unsafely, sexual intercourse can have serious health, economic, psychological, and social consequences, potentially perpetuating cycles of poverty in some communities.
Unsafe sexual practices are a major pathway for sexually transmitted infections (STIs), which pose a growing public health challenge globally.
According to the World Health Organisation (WHO), more than 30 different bacteria, viruses, and parasites can be transmitted through sexual contact, including vaginal, anal, and oral sex. These infections affect over one million people worldwide every day.
WHO identifies eight pathogens as having the highest incidence of STIs, globally. Four of these — syphilis, gonorrhea, chlamydia, and trichomoniasis — are currently curable, while the others, including hepatitis B, herpes simplex virus (HSV), HIV, and human papillomavirus (HPV), are viral infections that pose greater health challenges. HPV is notably linked to cervical cancer.
Scientists have recently warned about the emergence of new infections that could be transmitted sexually, such as Mpox, Shigella sonnei, Neisseria meningitidis, Ebola, and Zika, as well as the resurgence of neglected STIs like lymphogranuloma venereum.
In Africa, an estimated 109.7 million people are affected by STIs, leading to a significant 17 per cent economic loss for the continent.
Ghana is no exception, grappling with a highly sexually active population and increasing ‘risky’ sexual behaviours. Approximately 3.4 per cent of the population, around one million people, are affected by STIs, with prevalence rates as high as 28 per cent among those showing symptoms.
Experts cite several contributing factors, including biological reasons, low awareness and knowledge, limited access to sexual and reproductive health services, and dwindling funds to support interventions.
Untreated STIs can result in major complications, such as an increased risk of HIV, congenital infections, infertility, permanent disability, and even death.
Mawuko (not his real name), a mason in his mid-thirties, experienced recurring discomfort during urination for nearly a year before seeking medical attention at the Ho Municipal Hospital.
He complained of urethral pain and discharge from his penis. After undergoing laboratory tests, he was diagnosed with gonorrhea, syphilis, and chlamydia simultaneously. Mawuko admits to having three sexual partners with whom he engaged in unprotected sex, making it difficult to trace the source of his infections. Fortunately, his co-infections were curable.
Mawuko’s experience mirrors the circumstances under which many individuals, particularly the youth, contract STIs, contributing to the rising burden of infections across Ghana.
Research published in the *PLOS Global Public Health* journal revealed that people aged 24 to 40 are at the highest risk of STIs. This finding is supported by 2023 data from Ghana’s national and sub-national HIV/AIDS estimates, showing that the majority of new HIV infections occur among people aged 15 to 49, with at least 50 new cases reported daily.
Furthermore, approximately 334,095 people are living with HIV in Ghana, with 17,774 new cases recorded last year.
The latest Demographic and Health Survey (DHS) paints an even more alarming picture, showing that a low percentage of males and females within the same age group used condoms during their last sexual encounter with someone they were not married to, living with, or in a close relationship with.
This trend reveals a looming threat to Ghana’s productive and economically active population, underscoring the urgent need for targeted interventions to reverse the trend.
Lead researcher and clinical pharmacist, Dr. Araba Hutton-Nyameaye, highlighted the critical need for policymakers to develop interventions aimed at improving public knowledge of STIs, with a focus on preventive measures and access to safe treatment options.
She expressed concern over the impact of the surge in STIs on antimicrobial resistance (AMR), citing self-medication among infected individuals as a contributing factor.
“There is concern that the practice of self-medication may be a factor in the emergence of antibiotic-resistant human pathogens and treatment failure. Close to half of the number of participants in the study resorted to taking medications without consulting a doctor.
Some of the pathogens of STIs, such as gonorrhea, are no longer responding to medicines, making it difficult to treat the infection. Infected persons end up having serious complications and spreading the disease to others, knowingly or unknowingly,” Dr. Hutton-Nyameaye explained.
Dr. Hutton-Nyameaye, a lecturer at the University of Health and Allied Sciences (UHAS), advised the public to seek proper medical advice from qualified health professionals if they suspect an STI.
“People should not be afraid to seek care for STIs from health facilities. STIs are real and can cause significant problems for individuals, society, and the country as a whole. Practising safe sex, including condom use is essential,” she advised.
Ghana’s National HIV/AIDS, STI policy recognizes the higher prevalence of HIV among STI clients and provides comprehensive guidelines to halt and reduce the spread of infections.
Key strategies include ensuring the accessibility and affordability of condoms and lubricants, not only for STI prevention but also as a contraceptive measure against unintended pregnancies.
During the height of the HIV epidemic in Ghana, condoms were widely promoted as the primary tool for STI prevention for those who could not abstain from unprotected sex. Public awareness campaigns led to widespread accessibility across the country.
However, recent studies indicate a decline in condom use due to factors such as perceived reduced risks of HIV/AIDS, a preference for modern contraceptives for pregnancy prevention over STI protection, and inadequate sex education.
This raises concerns about the need for urgent, multifaceted strategies to address the rising rates of STI transmission, which is becoming a significant public health threat in the country.
For Mawuko, the lessons from his treatment and recovery have served as a wake-up call. “Even if you trust the person you’re having sex with, even if you think the odds are in your favour, it’s always best to protect yourself from STIs.
“STIs can be incredibly painful, and waiting for the test results can feel like some of the longest days of your life. Anyone can get or have an STI. You may hear stories of people taking risks, but this is a fire you don’t want to play with. Always use a condom,” he cautioned.
BY ABIGAIL ANNOH
