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Siyayinqoba Beat It! 2004 Episode 2 – STIs

In this episode of Siyayinqoba Beat It! the team discussed sexually transmitted infections (STIs). The inserts focused on the prevalence of STIs amongst the youth which in turn got the support group to discuss how prevention messaging can be improved to bring about behaviour change in the youth when it comes to sex.

Jason Wessenaar: Sanibonani, dumelang, siyanamukela kuSiyayinqoba Beat It! Support Group. Igama lam ngu-Jason. {IsiZulu} [Greetings welcome to the Siyayinqoba Beat It! Support Group. My name is Jason.] I am living with HIV. Each week I get together with other people living with HIV to talk about issues that affect us, our partners, our family members and friends. So if you’re living with HIV or know someone who is living with HIV, Siyayinqoba is for you. This week we are focusing on STIs - Isifo socantsi {IsiZulu} [Sexually Transmitted Infections.] We all know that HIV is transmitted sexually, but, did you know that any STI increases your chances of being infected with HIV?

Sexually Transmited Infections

Khayelitsha, Cape Town

Narrator: The Siyayinqoba team visited Welcome Khozo, a healthcare professional treating STIs at a loveLife youth clinic in Khayelitsha.

Wandile Mtikrakra: My name is Wandile Mtikrakra I am staying in Delta, I am one of TAC volunteers and also in project Ulwazi where we go around communities and churches and other places to educate people about what is HIV and AIDS.

Wandile Mtikrakra: Some girls, each and every Friday and Saturday, they go to sleep with a different guy. Why do we think is it necessary to do that?

Young woman: Here in Delft, it’s true girls are changing their boyfriends because they think they’re clever, but actually they’re stupid. You can go to the shebeen, thinking you’ll exploit the man for his money, whereas you’re the one who ends up being exploited. And you end up going with that person, as the girl.

Wandile Mtikrakra: Okay, Nonkosi, what’s your response to that?

Nonkosi: Of this changing of boyfriends. Well, if your boyfriend does not have money, and you see another guy who has money, you’ll follow him. That is what happens with most of the girls.

Mamoisile Welcome Qhosho (Healthcare Worker): The S stands for sexual,
the T stands for transmitted, the D stands for Disease. If a woman has sex with a man who has a discharge, she’ll be able to see the disease after fourteen days. Why fourteen days? It first goes into her womb and then it spreads from there. That’s why it takes fourteen days.

Young male participant: What causes one to get this STD?

Mamoisile Welcome Qhosho: You can get it from someone who has it, who’s not using a condom.

Young woman participant: Those who don’t get treatment for their STDs can they become HIV positive?

Mamoisile Welcome Qhosho: The possibility of getting HIV is very high when you have STDs, when you have STDs. If you have STDs, it tells us that you have little tears in your body. Those little tears make it easy to get HIV when you sleep with someone who has HIV.

Bulelwa Vakala (Young woman participant): I think it’s mostly people of my age who get STDs and HIV. People should control themselves and not sleep around. But whether there is trust or not, people should use a condom. The reason why I didn’t want to use a condom is because I didn’t really believe that STDs existed. I didn’t even trust using a condom because I wasn’t going to get exactly what I wanted. When I didn’t want to use a condom, I wanted to taste the original thing. I didn’t want to get it in the plastic. I wanted to feel those sperms go inside me.

Support group

Support Group members Prudence Mabele: It is so obvious that many people still believe in the older way of making love, or of having sex. And how do we really put across the messages that really the HIV spread through unprotected sex. So, I want to know from the Support Group: What can we do to reach out to the youth to say, really this thing is here?

Busisiwe Maqungo: This lady, I think she said she used to not believe in condoms and wanting to have sex without a condom, and feeling the sperms going in. I think now that she started to develop STIs did she say that? Now, after that, she realised that she was doing the wrong thing.

Jason Wessenaar: But I think the issue is, don’t wait till that happens to you. Rather prevent it than have experience STIs. It just could have been an STI it could have been HIV, which would have changed her life completely.

Lihle Dlamini: It’s very hard to convince the youth… because she wanted to feel the sense of belonging…And wena as umuntu omudala if ubakuza they just say ag! sasingeko ebusheni bakho uyabona leyento and they feel ukuthi you are interfering in their lives. It’s not until umuntu into iyenzeke kuyena xobolwake kuze abone ngemphela ukuthi its happening. [And you as an adult, when you reprimand them, they just say: “Ag, we were not around in your young days.” And they feel you are interfering into their lives. It’s not until this thing happens to a person that they see this thing happening.]

Prudence Mabele: I called my safer sex workshop; Love Party. And it goes with: “Turn on your lights, not off – I want to see your thing.” Okay, because if your thing, it’s been hidden, it means it has something. What’s wrong with you to just sneak in? Let’s see it!

Jason Wessenaar: When you go for treatment for STIs, should you bring your partner with?

Lihle Dlamini: If a boy goes to a clinic for STI treatment, he doesn’t take his partner with, and he’ll take the antibiotics and they’ll help him, but then he didn’t take his partner there. And then he goes back to that partner, who still has that STI, and he gets re-infected. I think it is very important ukuthi umuntu mangabe uya eclinic ahambe no partner wakhe. If you ama-partners ayi-two take them both if you, if bawu three take them all with you, so that nonke nizokwazi ukusizakala. Because it doesn’t help seriously ukuthi uzosaba abonesi ukuthi bazothi kusho ukuthi uyafeba or uyisoka lama nyala. You must take them, if ungafuni ukuhamba nobo bonke kuze bazane lo umunye iya naye namhlanje omunye uye naye kusasa, omunye ngelanga elilandeyalo. {IsiZulu} [that when a person goes to the clinic, they take their partner along. If you have two partners, take them both with you. If you have three, take them all with you. So that seriously, so that you can all be helped. Because it doesn’t help seriously to say you are afraid of the nurses thinking that you are sleeping around or womanizing. If you don’t want to take them all at once, fearing that they’ll know about each other, take the one today and the other the next day.]

Busisiwe Maqungo: I think zikhona ezinye i-factors ezi-contibutayo kulento ye-youth. Abazi nto nge HIV okanye STI’s and abazi nto nge prevention uuba kuhamba kanjani bayazi. {IsiXhosa} [I think there are other factors contributing to this thing of the youth. It’s not that they know nothing about HIV and STIs, and nothing about prevention]

Anthony Fernandes: It has to be where people say: “Listen, it’s cool to go around and have a condom.” “I’ve got it in my back pocket. I’ve got it in my purse.” In all the gay clubs, and all the gay bars that I’ve been to, overseas and here in South Africa, there is condoms everywhere so the guys can’t come up to me and say: “Listen, I don’t really feel like using it, or it’s not really my thing.” You tell them: “Bugger off”. That is just not the attitude. You make them feel embarrassed and ashamed if you’re ignorant, if you’re stupid. You make it trendy, you make people feel proud about yourself: Condom is the way I do it. If it’s not on, it’s not in. I’m not interested in playing with, having sex with you. You have to get that same dignity, that same confidence, to young people.

Jason Wessenaar: There’s this certain barriers in using safer sex, even though we know it’s safe, so I think those are some of the issues that people need to be talking about. Say, you know it kills the mood, it wastes time. I’m on right now, now I have to get a condom and put it on. And some times it takes more than a minute to put it on for some people who don’t know how to put it on properly. So I think once people get used to using it, and loving it, they’ll actually get to use it all the time. It won’t be a problem. But I think the first sexual experience that most of us had, at thirteen or twelve, was not with a condom. We got used to that. And I mean, some of the condoms didn’t even fit some of us at that age.

Anthony Fernandes: I can take a condom and take it out of its wrap and put it onto a penis in less than ten seconds. If you give it to my right now, I’ll show you. It’s that quick.

Jason Wessenaar: You’ve learnt that. That’s my point, you’ve practiced that. A lot of times I understand your point about having condoms everywhere in shebeens. That’s just what it is. The condoms are there, but who gets to teach people how to use them properly? You can use it in ten second yes because you have learnt that.

Anthony Fernandes: It’s the boys who teach the girls that it feels good to do it without a condom. It’s the same boys who have to start teaching these people it feels good with a condom, that’s the way it should feel like.

Busisiwe Maqungo: Old as I am, if I want to take something out of my wallet, let me first take the condom and put it there, then look for the money, and then take the condom and put it back. Then people will be like, oh, it’s cool.

Jason Wessenar: Hlala nathi {IsiZulu} [Stay with us,] we will be right back.

Jason Wessenar: [We are back welcoming you back to Siyayinqoba Support group.] {SeSotho} The programme for everyone affected and infected by HIV. The Siyayinqoba teams spend some time with Thobela Mhlubulwana, a Health Care Worker proifessional providing treatment for for you people with STI’s. He expalians the link between STI’s and HIV.

loveLife Youth Clinic

Khayelitsha, Western Cape

Thobela Mhlubulwana (Healthcare worker): I’m working here as a health service provider to the community of Khayelitsha, particularly the youth because this is a youth centre. Anybody can have sexually transmittable infections, but young people are more vulnerable to STIs because they are in a stage of identity formation, and therefore they explore and experiment with sex. And hence we give them priority here at the youth centre, to give them counselling, treatment and care.

Benjamin Dyonase: Igama lami ndingu Benjami Dyonase, ndine minyaka engu 24 ndihlala apha eKhayelitsha, ndize apha eclinic ndizo checker isofo sokosulela sangaphantsi. Nami ndifudula ndingayisebenzisi i-condom ngaphambili ndilala nje ndithi inyama enyameni. Kodwa ke ngoku yandibeka engxakinike leyonto. Ndabona ukuthi ngoku kamva ukuthi hayi kuyigozi ukulala nje uthi inyama enyameni. Nxa ufuna ukulala nentombazana sebenzisa i-condom. Ngiye ngabona ukuthi yigozi enkulu kakhulu ngoba ndingasebenzisi i-condom indibangele ingxaki ezinintsi endiyendadibana nazo.{isiXhosa} [My name is Benjamin Dyonase. I’m 24 years old. I live in Khayelitsha. I’m coming to the clinic to check out my problems down below. I used to have sex without a condom, flesh to flesh. Now I use a condom because of the STI I got. I used to boast about having sex without a condom, flesh to flesh. Now, when I sleep with a woman, I use a condom. I’ve realised that not using a condom is very dangerous and it’s given me many problems to deal with afterwards.]

Thobela Mhlubulwana: Bhuti unegxaki ngesifo esingaphantsi [You’ve come because of an STI?]

Benjamin Dyonase: Ewe [Yeah.]

Thobela Mhlubulwana: Izibona njani? [How do you know?]

Benjamin Dyonase: Into endiyendayiva abakum ne ndive ukushisa ekubeni ndive lento ndaphuma imadyungudyundu. {IsiXhosa} [It burns when I urinate and I have pimples.]

Thobela Mhlubulwana: The diagnosis is made based on the side-effects. Therefore, if one, whether male or female, have got any of the signs: a discharge, sores on the genital parts, or the warts, all those are the signs of STIs. If you’ve got a sign of STIs, it is important to come to the clinic as soon as you have seen it. Because that time that one does not come to the clinic, you are infectious. You are infecting any body that you are coming into contact with through sex.

Thobela Mhlubulwana: That area where there was an ulcer or a blister, that becomes a weak area, therefore that becomes an exit point for the virus. There is a high incidence of people getting HIV because we get the HIV; it’s in the blood stream. And therefore, with the hole bleeding, and the hole’s fluids, which are blood-related, from the ulcers and the sores, the spread of HIV is just more common.

Support Group

Support Group Vuyani Jacobs: The way I used to grow up, me and my twin brothers and other people, we walk around and say: “Okay, this is holiday, I’m not going to go out with my ‘known girlfriend’, I’m going to at least need about three partners in the next two, three weeks” and then you have sex without condoms. And then you come back, you go to the nurse, and the nurse actually checks you out, you have a drop. And you tell all your friends: “I have a drop.”

Busisiwe Maqungo: And it’s like you’re cool.

Vuyani Jacobs: Yeah, and it’s cool, and you go back to the clinic. You know what we used to say to the clinic: “No, but I was away this weekend, and that’s where I had this sexual relationship.”

Jason Wessenaar: How should older people talk to younger people about safer sex?

Anthony Fernandes: It’s the big boys that’s hanging around the shebeens that has to speak this language, not the youth. The youth is going to look up to older people who has sexual experience and it’s going to start there, they’re gonna ask questions, they’re gonna make up their own mind, and I think that’s important. It’s the older people who has to be comfortable to discuss this, feel comfortable in their skin to say: “If you don’t want to talk about it it’s fine.” But they need to know, they need to know how it works, the mechanics.

Busisiwe Maqungo: I do the same thing with my son, who is twelve years old. I’m his parent, I’m not comfortable to talk to him about sex, condoms, but I have to do it. We talk about it, yes, I told him the safest sex ever is no sex, but if he can’t wait until he is 21, then at least he must do it with a condom. I’m not going to force him not to have sex if he wants to. Nobody forced me not to have sex at fifteen when I started having sex. I had it at fifteen. I regret that. There’s nothing I can do about it. But, it will be the same thing with him. If he decides to have sex before the right time; when he will be able to take responsible decisions, then if he decides not to wait for that time, then its fine, he can do it with a condom.

Jason Wessenaar: How do we deal with the embarrassment of talking about STIs to health workers?

Vuyani Jacobs: When I started first having herpes, I was very embarrassed, and actually telling to these ladies at the clinic, are very beautiful, you just cannot tell to this lady, beautiful, beautiful lady, so you see that you’ve got this thing on your penis and you show it to them. And most of my doctors have been gorgeous, all the time, and it was not an easy thing to come to. But I want to tell you about the effect of what happened out of that. My herpes was now incurable. It came all the time. Now I had to wait another week with this painful thing, and I’m not going to go to the doctor this week. And my best friend actually took me to the doctor and said: “Check his thing.”

Jason Wessenaar: What embarrasses you? The fact that you have to speak to a female person to you know, show them, or the fact that you have an STD?

Vuyani Jacobs: Two ways. I’ll be very much honest in two ways. Firstly, I didn’t want to show it to a woman and second way was, now I’m HIV positive, now that I am HIV positive, I was embarrassed to tell them that I have an STD, because I might get this whole thing of: “Hey, you don’t use condoms”, and I was afraid because I’m an AIDS activist and I’m openly living with my HIV status, and I didn’t want to compromise that kind of part, because I didn’t want to say to anyone that I had a condom failure or that kind of thing, and at the same time I was using condoms. But now I understand that it was a recurring thing.

Nomandla Yako: Feeling embarrassed to go to the clinic when you have STI is delaying getting the treatment because when you have herpes to be treated with Acyclovir within 72 hours, so nxa wuhleli endlini [when you’re sitting at home,] it happened to me as well in 1998. I think I had herpes, I had herpes, because I had a test for STDs but I had no STD, but herpes comes, even now, when I have stress, because I was shy to go to the clinic and show them I have herpes and people are talking, the nurses are talking there: “You are so young, you have these things, you see.” Ndiya cinga ukuthi yalidishela ukuthi mandifumane i-HIV lula. {siXhosa} [I think that’s why I contracted HIV so easily.]

Jason Wessenaar: Coming up after the break, Dr Nombulelo our resident doctor will be answering our questions about the links between STIs and HIV.

Jason Wessenaar: Welcome back to the Siyayinqoba Support Group and we welcome Doctor Nombulelo. Who will be answering our questions about the link between STI’s and HIV.

Dr Nombulelo Madala: If an HIV positive person you must be aware now that sexually transmitted infections are difficult to treat in HIV positive people, they sometimes take even longer. So imagine now if you come in later in the infection, so it might take even longer to treat, and again, you are at risk for the complications. When the gentleman on the tape said that sexually transmitted infections only show symptoms after 14 days I think what he meant was that they could show symptoms from the first day up to 14 days after the risky sexual behaviour, because people can actually present after the following day with things like the drop and the burning of the urine.

Anthony Fernandes: Doctor, I practice safe sex because I don’t want to pass my HIV on to other people, but would you say that if you use a condom every single time that you will prevent STIs?

Dr Nombulelo Madala: I think everybody is clear about the fact that the safest sex is no sex at all. And everything after that has got a degree, it goes down in degrees. So if you use a condom every time, you’ve got a higher chance of not transmitting infections and not getting infections, compared to someone who doesn’t use a condom at all. But you are still less safe than someone who doesn’t engage in sexual activity at all. I hope that answers your question.

Busisiwe Maqungo: Ndicela ukuthi undicacisele ngeqhagamsheloe ye HIV ne STI’s. Owesibini umubuzo yintoni le abantu abathandwa zi-STD’s because thina sizibiza kakhulu ukuba zi-STD’s. So yintoni into ebangela ukuba abantu abathandwa ziSTD’s fumaniseka ukuthi yibona abasengozini ukubas baganayo i-HIV? {IsiXhosa} Could you please explain the connection between HIV and STIs? Secondly, how is it that people who are prone to STDs, you find that they are the ones at risk of contracting HIV?

Dr Nombulelo Madala: A person who has got a sexually transmitted infection to me as a doctor and to another health professional, is at risk of possibly having HIV right now, or if they continue engaging in the activity that led them to having a sexually transmitted infection, they will soon enough probably get HIV. That’s the first link between the two. So, both of them are sexually transmitted, that’s the bottom line. The second thing is that if you are HIV negative, but have a sexually transmitted infection, and then you have sex with someone who is HIV positive, you are more likely to get the HIV than someone who does not have a sexually transmitted infection; the reason being that the lining of your genital area is not intact while you are having a sexually transmitted infection.

Vuyani Jacobs: In case of two partners engaging in oral sex, in other words, the use of tongues. Let me say partners, when my partner or I don’t have an STD, and maybe we are both HIV positive, when we both start playing with tongues we are more relaxed without using protection until we have penetrative sex. You understand my question. I want to understand the danger of all of those things.

Dr Nombulelo Madala: During oral sex, STIs can be transmitted. So you will not wait until penetrative sex to be at risk. If someone has herpes down there, the other can contract the herpes through the mouth.

Jason Wessenaar: Thanks to Dr Nombulelo, the Siyayinqoba Support Group and viewers at home. Things we should remember are:

Get your STIs treated immediately.
Take your sexual partners with you for treatment.
Untreated STIs greatly increase the risk of contracting HIV as well.

We hope that you have enjoyed the show and that you are feeling the Siyayinqoba Spirit, that, together we can Beat It! Please send us your comments and suggestions for our support group or for Dr Nombulelo, our resident doctor, on the numbers on your screen now. Join us again next week in the Siyayinqoba Beat It! Support Group. Goodbye. Remember, stay healthy, stay positive.