Dr Ganesh
Many young people, according to Hospital Canselor Tuanku Muhriz Universiti Kebangsaan Malaysia (HCTM UKM) infectious diseases physician Assoc Prof Dr Petrick Periyasamy, mistakenly believe that if someone shows no symptoms, they do not have an STD.
“They often assume that only those who experience obvious signs, such as vaginal or penile discharge, are infected, which leads to misunderstandings about the true risks of STDs, especially in new or multiple-partner relationships.
“There needs to be more public health messaging about STDs, particularly within universities.
“Most STDs, such as genital herpes or warts, can initially be asymptomatic for some time.
“Asymptomatic infections can persist undetected for the duration of an individual’s lifetime,” he said, adding that regular testing should be encouraged, even if someone feels healthy.
Dr Petrick said students need clear, honest and accurate information about STD prevention, and the only way to provide this is to invest in sexual health education and community outreach programmes that target young people.
Dr Ganesh
He emphasised that information about STD prevention needs to be easily accessible everywhere.
Additionally, he said improving access to comprehensive prevention services – such as education and condoms – is crucial for young people who are sexually active.
“Cultural barriers and misinformation often undermine prevention campaigns, so we need to address these challenges to reach young people,” he said.
Dr Petrick also called for the development of newer, more sensitive tests for STDs, such as polymerase chain reaction (PCR) tests for chlamydia and gonorrhoea, and immunofluorescent tests for herpes simplex virus (HSV), to be made more widely available in hospitals and primary health clinics.
“We also need to improve laboratory capacity to identify antimicrobial-resistant strains of STDs, especially in cases of gonorrhoea,” he said, adding that shortages in healthcare personnel and diagnostic tools in some areas hinder effective treatment.
Taylor’s University School of Medicine head at the Faculty of Health and Medical Sciences Assoc Prof Dr Ganesh Ramachandran said it is important to understand how STDs spread, especially among adolescents, and what differential interventions are needed to help control STDs within this group.
He said young people may have limited access to healthcare services and may be less inclined to seek treatment due to ignorance of services available, fear of being judged, fear of recrimination from parents and society, and lack of assurance regarding confidentiality, thus further exacerbating the issue.
To effectively control STDs among the younger demographic, Dr Ganesh said a multifaceted approach is necessary, with key interventions consisting of comprehensive sexual education and access to confidential testing and non-judgmental counselling to create a safe and supportive environment.
This, he said, would encourage youth to get tested and seek treatment.
“Self-testing kits must also be made available to promote regular screening, diagnosis and treatment,” he said.
Dr Petrick
Dangers of STDs
STDs encompass a broad range of infectious diseases such as HIV and HPV, explained Taylor’s University Digital Health and Medical Advancement Impact Lab director and School of Biosciences lecturer Prof Dr Chong Pei Pei.
She said STD pathogens can be classified into four main categories: bacteria, viruses, fungi and parasites (see infographic).
The STDs caused by bacteria, fungi and parasites, including syphilis, gonorrhoea, chlamydia, thrush and trichomoniasis, are relatively easily curable.
For viral infections like Hepatitis B, HSV, HIV and HPV, antiviral medications are now available that can slow or stop viral replication.
Although these medications generally cannot eliminate the viruses completely from the body, they can stop the progression of the disease and improve the quality of life for the infected individual. However, patients would have to take these antiviral medications for the rest of their lives in most cases, she said.
“HPV vaccines, however, can protect against HPV infections.
“There are 14 high-risk HPV types characterised to date that can cause cervical cancer, and today we have the 9-valent HPV vaccine, which protects against seven major high-risk HPV types that cause cervical cancer.
“These include HPV types 16 and 18, which cause about 66% of cervical cancer and other HPV-attributable cancers, and types 31, 33, 45, 52 and 58, which account for about 15% of cervical cancer,” Prof Chong said, adding that these vaccines, however, do not cover other oncogenic HPV types that can also cause cervical cancer.
While HPV is commonly transmitted through direct sexual contact involving the genital area, mouth or throat, the virus can also spread through direct skin-to-skin contact, the hands or fomites, she said.
“Some STIs can also be transmitted from mother to child during pregnancy, childbirth or breastfeeding.
“Certain strains of HPV may also spread through touching surfaces or objects that have the virus on them, which is why it’s important to tell young children not to touch objects like doorknobs, handrails and countertops in public places and to maintain good hand hygiene,” she said.
“Girls with HIV are more prone to persistent HPV infections, which increase their risk of developing cervical cancer,” she said, adding that this is due to the lower immunity in HIV positive women.
While lauding the government’s pilot programme to provide public access to Pre-Exposure Prophylaxis (PrEP) – which reduces the chances of contracting HIV from sex by over 90% – Prof Chong said university students may not be aware of the initiative launched in January last year.
Currently, free PrEP prescriptions are available at 21 public clinics nationwide, with 10 more expected by the end of the year.
“Before the programme was introduced, PrEP was only available in private clinics which was too expensive for most students,” she said, adding that more PrEP outreach initiatives must be made accessible to the student population.
