Housewives not immune to STDs

Housewives not immune to STDs

JAKARTA (JP): Women with reproductive tract infections are
often suspected of being sex workers, who are at a high-risk of
contracting sexually transmitted diseases (STDs). Many housewives,
however, believe they have nothing to worry about getting similar
infections.

The newly revealed truth is that although housewives are in
the low-risk category, "good" housewives are vulnerable to
sexually transmitted diseases and reproductive tract infections
-- which are being increasingly recognized as a serious global
health problem with impact for individual women and men, their
families and communities.

The infections can have severe consequences, including
infertility, abnormal pregnancy, chronic pelvic pain,
miscarriages and increased risk of HIV transmission.

The conclusion was drawn during a recent media discussion
forum, the third such discussion, on reproductive tract
infections in low-risk women.

A recent study on the issue in North Jakarta by Population
Council -- an international nongovernmental research organization
that seeks to improve the reproductive health and wellbeing of
current and future generations -- which was presented at the
discussion, confirmed the conclusion.

Laboratory tests of 486 women with comprehensive data (mainly
housewives) visiting two family planning clinics in the area
showed 38.9 percent, or 189 women, had one or more reproductive
tract infections and 14.4 percent, or 70 people, had one or more
sexually transmitted infections.

"This number is worrying, since reproductive tract infections
can cause many adverse pregnancy implications, including
spontaneous abortion, premature rupture of membranes, premature
delivery and consequent low birth weight and still births," said
Sjaiful Fahmi Daili of the sexually transmitted diseases study
group.

According to the study, the majority, or 75 percent of the
total 628 participants (housewives), experienced adverse
reproductive tract symptoms within the past three months, such as
abnormal vaginal discharge, ulcers or sores, pain when urinating,
lower abdominal pain and bleeding after intercourse, while 5.7
percent of the total number of housewives reported symptoms in
their partners.

"Some sexually transmitted infections cause no symptoms at
all, and some can easily be cured. Others result in severe long-
term consequences and cannot be cured," Sjaiful said.

The study was conducted by Population Council for 28 weeks in
the low-income neighborhood at Koja District Hospital, with the
other at Cilincing Community Health Center with support from the
Ministry of Health HIV/AIDS Prevention Project under USAID
funding. The main authors of the report were Meiwita Budiharsana,
Jane H. Patten, Siti Nurul Qomariyah, Catherine Vickers and
Subadra Indrawati Molyneaux, with support from experts, including
Sjaiful.

The study also discovered that 79.4 percent of the women with
sexually transmitted infections returned for and received
treatment according to their final diagnosis, while 75.5 percent
of the husbands of women with sexually transmitted infections
received treatment.

"In the second stage of our data collection, 25 partners of
women with confirmed sexually transmitted infections came in for
counseling. The partners who came in were asked if they had
recently had intercourse with someone other than their wives.
Seventeen of 25 admitted that they had another partner," Nurul
said.

The study concluded that the low number of partners coming to
the clinic might be a result of the participants' fear of
informing their partners about the infections.

"Gender inequality in informing partners is an obstacle to
being free from sexually transmitted diseases. In fact, the
impacts of these chronic diseases are more harsh for women than
men," the report said, urging men to improve awareness and
attention in preventing reproductive tract infections or sexually
transmitted infections while improving available medical
treatments for positively infected people.

Global

Worldwide, the World Health Organization estimates that each
year, there are over 333 million new cases of curable sexually
transmitted infections. In addition, UNAIDS calculates that in
1997 alone, 5.8 million people became infected with HIV.
Reproductive tract infections that are not sexually transmitted
are considered even commoner.

Reproductive tract infections result in numerous serious
consequences, particularly in women. Pregnancy-related
complications, as well as congenital infections, can result from
these infections. Pelvic inflammatory disease can develop and can
cause infertility, ectopic pregnancy and chronic pain.

According to Population Council's fact sheets, reproductive
tract infections, which can affect the external genital region
and the reproductive organs, refer to three different types of
infections which affect the reproductive tract.

Endogenous infections -- resulting from an overgrowth of
organisms normally present in the vagina -- are probably the most
common infections. Common symptoms include vulvo-vaginitis
(itching and pain in the external genital region and vagina),
painful or uncomfortable sexual intercourse and the presence of
an abnormal discharge. Endogenous infections, which include
bacterial vaginosis and candidiasis, can easily be treated and
cured. If they are not treated, they can cause problems ranging
from localized irritation to more serious consequences, such as
pelvic inflammatory disease.

Iatrogenic infections occur when the cause of infection (a
bacterium or other microorganism) is introduced into the
reproductive tract through a medical procedure such as menstrual
regulation, induced abortion, the insertion of an IUD or during
childbirth. This can happen if surgical instruments used during
the procedure have not been properly sterilized, or if an
infection that was already present in the lower reproductive
tract is pushed through the cervix into the upper reproductive
tract.

Sexually transmitted infections are caused by viruses,
bacteria or parasitic microorganisms that are transmitted through
sexual activity with an infected partner. About 30 different
sexually transmitted infections have been identified, some of
which are easily treatable, many of which are not. HIV, the virus
that causes AIDS, is perhaps the most serious sexually
transmitted infection as it eventually leads to death. Sexually
transmitted infections affect both men and women, and can also be
transmitted from mothers to children during pregnancy and
childbirth.

The organization recommends several behavioral changes, such
as reducing the number of partners, being in a mutually
monogamous relationship, substituting nonpenetrative sex for
intercourse, use of barrier contraception, such as male or female
condoms, delaying marriage/first intercourse, treating the
infections in individuals and partners and prompt and appropriate
care. (ste)