September 28, 2026
Sexually transmitted infections are everywhere in South Africa, and most people carrying one have no clue.
"The infections doing the most damage are usually the ones nobody knows about," says Dr Mark Faesen, a specialist gynaecologist at the Clinical Health Research Unit."HPV, chlamydia, gonorrhoea, trichomoniasis, herpes, even HIV in its early stages, all of these can be present with zero symptoms, especially in women."
HPV alone infects more South Africans than any other STI. It’s driving cervical, vulvar, vaginal,anal, penile and throat cancers. HIV still affects around 8 million South Africans, though new infections have dropped sharply over the past two decades.And chlamydia, says Faesen, is probably the biggest curable threat to youngwomen's fertility. If left untreated, it can damage the fallopian tubes and cause infertility, all without warning.
That absence of symptoms is problematic. It means an infection can pass between partners for months,even years, before anyone finds out, which is also why a positive test is not proof of cheating. "A new diagnosis can't tell you when an infection arrived or who it came from," Faesen says. "It might have been there before the relationship started, picked up early on and only just noticed, or a virus like HPV or herpes reactivating after lying low for years."
Faesen explains that two myths about STIs persist. That you can catch an STI from a toilet seat, and that washing immediately after sex keeps you safe. Neither is true."Almost all STIs need direct sexual contact, which includes mucous membranes, fluids, skin-on-skin," he says. "The message isn't 'cleanup afterwards,' it's 'protect yourself beforehand.'"
Then there's oral sex,widely assumed to be risk-free. "For a lot of people, 'sex' only means intercourse, so oral sex never makes it into safe-sex conversations at all," Faesen explains. HPV is the clearest casualty of this thinking due to decades of messaging that tied it to cervical cancer and Pap smears, while its growing role in throat cancer barely gets mentioned.
Doctors increasingly favour "STI" over the older "STD," and it's not justpolitical correctness. "Disease implies you're visibly sick. Infection doesn't," says Faesen. "Most STIs cause no illness at all. Getting that distinction right takes some of the shame out of testing."
His advice for anyone who suspects they've picked up something: don't wait, and don't try home remedies first. Public clinics and private GPs or sexual health services can both help.Public healthcare usually treats by symptom pattern, while private testing can pinpoint the exact organism.
And if a result comes back positive, telling a partner doesn't have to be a confrontation. "Keep it calm and factual: you've been diagnosed, they may have been exposed, they should get tested," Faesen says. "This isn't about blame. It's about two people protecting their health."
This September, marking World Sexual and Reproductive Health Month, that's the message CHRU wants South Africans to hear: an STI is simply a medical diagnosis, not a verdict on your character. Get tested if you have any concerns; don’t wait.