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Episode 3 - Herpes and Sexual Networks

The third episode of the new series of Siyayinqoba Beat It! deals with herpes and its role in the spread of HIV/AIDS
A segment from Khayelitsha shows the lack of understanding of the disease in our communities. What becomes apparent is that some of us clearly have a vague idea about herpes and know it is contracted sexually, but it also becomes apparent that not many South Africans are willing to take responsibility for their actions. It shows how when we place blame elsewhere instead of taking responsibility, we merely compound the problem of HIV and sexually transmitted diseases.

Shalom Ncala: Sanibonani siyanamukela nonke ehlelweni iSiyayinqoba Beat It!, lolu hlelo elawo wonke umuntu wase Ningizim Afrika othintekayo esifeni sesandulela ngculaza kanye ne ngculaza. Ngiya jabula ukunibona guys ninjani? Ndithanda ukwamkela no Doctor Nkuli, Unjani? Siyaphila sijabula ukuba nawe namhlanje. (IsiZulu) (SeSotho) Hello and welcome everyone to Siyayinqoba Beat It!, the programme for everyone in South Africa affected by HIV and AIDS. In the Siyayinqoba support group we are all living openly and positive with HIV. Nice to see you again guys, how are you?

Support Group: Siphilile Shalom, wena unjani? (IsiZulu) Very well thank you Shalom.

Shalom: I would also like to welcome Dr. Nkuli, how are you doctor? We're happy to have you joining us.

Dr Nkuli: Ngiyaphila, Unjani wena sisi? Ngiyajabula nam ukuba nani apha eKapa. (IsiZulu) I'm very well thank you. I'm happy to be with you guys here in Cape Town.

Shalom: (SeSotho) This week on Siyayinqoba we are talking about Herpes and sexual networks. Herpes is one of the most common sexually transmitted infections. However, there is also a very effective treatment for Herpes. Herpes is closely linked to HIV because it is also passed through sex. So if people are getting Herpes by having unsafe sex, they could very well be getting HIV too. To get an idea why Herpes spreads so fast, Let's watch this story from Khayelitsha.

Sexual Networks

KTC, Western Cape

Luvuyo Nibe: Molo, namhlanje sise KTC, sithetha nabafana nge Herpes. Sithetha nge Herpes apha. Sifuna ukwazi ukuba yintoni na iHerpes? Umntu nje oyaziyo mhlambe owakhe wanayo okanye itshomi yakhe yanayo. Sazi ntoni nge Herpes? (IsiXhosa) Hi, today we're in KTC , talking to a group of guys about Herpes. Let's talk about this Herpes. We want to know, what is this herpes? Maybe you've had it or you know someone who has it. What do we know about Herpes?

Xolani Mdoyi: iHerpes ndiyazi ngkubana uske uphume amaqhakuva yabo. Iqale iphume uyibona xa uqhiba ukuchama, uve ibihlungu iyatsisa xa uchama iway ezinjalo. (IsiXhosa) Herpes are blisters or pimples and you get a burning sensation when you urinate.

Guy 2 : Ndingathi iHerpes yenziwa ligazi elimdaka, like kukungazi cleani. (IsiXhosa) I think it's caused by unclean blood.

Guy 3: Isamething yafostana isabu drop wise uyafestana.(IsiXhosa) I know it's like Gonorrhea.

Vuyo: Eza way ziya spreada esapecially apha apha ekasi. Yenzwa yintoni laway? Yintoni lena yenza thina ukuthi kube lula ukuba siyifumane? (IsiXhosa) These infections spread quite fast in our communities. Why is that so? Why are we such easy target?

Mzwanele Mahla: Leway yoba kubalula ukuyifumana kunga condomizi. Like ulale necherry emdaka. Abantwana bangahlambiyo okanye udibane nawe esimokolweni uthi no maloving masibe kule tamshi. Ufumaniseke uyanqumla naye awuyisebenzisi iplastic xakulapho. (IsiXhosa) It's because we have unprotected sex with dirty girls. Like you meet a girl at a shebeen and you take her home, you don't even think about a condom.

Vuyo: Mangaphi xa ewonke awakho? (IsiXhosa) How many girlfriends do you have?

Mzwanele: Noko andima cherry mangako kodwa mna ndiyayi hlohla. Apho ndibine  khona nenkazana sivane, hayi noko ndiyayinqumlisa ndiyihlinje logusha leyo.( Ibawesi xa uthe watya nerhanqa) Hayi ke mtakwwethu andazi ke apho. (IsiXhosa) Not so many. I just have sex with however, just so long as it's consensual. (It's even worse when you're drunk.) I don't even want to go there !

Lusanda Kuta: Ngihlobo endi understanda ngalo, it seems kum lendaba yinqokelela xa umana ubabusy kwezizinto umane utuna kwezindawo uzituna kuzo. So lendaba mna andinokuthi ibasically yindaba edibana namamedi. Which means nathi ikhona icontribution esiyenzayo towards ukuba ibekhona isamething. (IsiXhosa) The way I see it, this is a collection of different things from all the sleeping around. So we can't just blame it on dirty girls. We also play a part in pushing these infections.

Vuyo: Akutsiwo ukuba sisifo samacherry esi. Amacherry akwazi ukusifumana namajita ayasifumana. So if icherry yakho inoyo which means nawe uzakuyifumana. But kodwa if wena unawo uzakuyinika imedi.(IsiXhosa) Herpes is not an infections for women olny, we all get it. If you have it, you can pass it on to your girlfriend and vice-versa.

Lusanda: Xa ufume umntan iwes umntana omtsha, ubanenqondo yokuthi uvile ukuba ikhona lewayikhoyo yangaphandle apha. Okay iqangala lokuqala mandimbethe nge plastic. Okwesibini uqonde hayisuka ( kuyahlekwa) iya unyanisile inoba iphelile, okanye akanayo isamething umntu loo uyafestana. (IsiXhosa) When you get a new girlfriend, you think about these things. So you don't use a condom, for the first round. For the second round you think, it's gone, Yes that's right. You think whatever she had, it's gone.

Xolani: Ehayi jonga ugrand usameone, usibhethe kakhuhle, soloko estrict kokwabo soloko engena ngexesha okay akahambi phandle nje ngabanye abantwana aba adakase. Uqonde ukuba haysuka uzakuyinxibelani leway?. Lontana ugrand, zange wambona emene awuthi estratweni.So uqonde haysuka akanayo leway ugrand uclean. (IsiXhosa) She's nice, she's beautiful, she's well- behaved and she's never out on the street at night, like the others. Why should you condomise? You've never seen her with a man, so she's 'clean'.

Lusanda: Apho inxaki abakhona kuxana nokuba ingangazi male nesi okany abafazi uya understanda. Mara apho indaba ibakhona yi approch yabo uyanderstanda xabe dealishana nendaba uya understanda. Because aba banntu ukuba mna ndiyele indaba edibanisele nale grootesi, bafuna ukunditsala igazi, ngame nditsale igazi lakho ndibone ukuba uwunayo na enye into. So yi fear yokuba ndiyazi ukuba ndinaleya mandiqale ndiqhibe lena. Ukuba nje ndinga ngena nje apha kwaBawo uJwarha endimaziyo ukuba lixhwele elithile. Ndiyayzi ukuba yindaba yam nojwarha and ibonwa ngabantu baninzi xa ndiphuma pha ndiphethe lamxhube ndiwufake eplastikini. Kodwa ukuba ndingene kwaMasincedane ndithi xa ndingena pha oh naku uThitho uzele iTB. And then ndingela kwelacandelo labantu aba ne samething yabo. Ndithi ndifika ekasi nakanjani usemnandi. (IsiXhosa) The problem lies with the nurses, whether it's female nurses or male nurses. It's their approach when dealing with these things. It's not right because if I go to a clinic for Herpes, they want to take my blood for series of other tests. I don't want to know about that. I came here just for this! If I go to a traditional healer, that stays between the two of us. Nobody else sees me walking in and out with my medication. But if I go to Masincedane Clinic, a friend is there for a TB check up, and he sees me going to the STI side. Then by the time I get home everyone knows about my visit to the clinic.

Vuyo: Thina nje sihleli apha, sixoxa ezizinto sibone esiyazi nesingayaziyo. Siyeni thina ngokwethu pha konesi sibuse pha kubo thina sizokwazi ukufunama mandithi inyani. Ingathi ngesihmba siya ekliniki. (IsiXhosa) We're sitting here talking about these things. Now how about we go to the clinic and ask the nurses. So we can get all these facts. Let's go to the clinic.

Support Group

Shalom: Kahle kahle iHerpes le iyinto enjani, ibukeka kanjani? Sizokwazi ukuthi sohlukanise njengokubana into endiyendayiboni kula insert ingathi kukhona iconfushin ngendaba ye Herpes ne Drop. Sizakucela uDoctor Nkule asicacisele? (IsiZulu) How does Herpes look exactly, what are the signs? What I noticed from the insert is the confusion between Herpes and Gonorrhea. Can you please make things clear to us?

Dr Nkule: Iherpes yenziwa ligciwane esithi yi Herpes Simplex Virus. Now there are two types yala magciwane : kunale kutrhiwa HSV 1 or uHSV2. UHSV1 ngulona wenza izilonda zonkhuhlane lana kuwena ngasemlonyeni uye uzithole mawuzakuqala yiflu. UHSV2 nguyena loo uzakwenzela izilonda zangaphantsi kwisifo sanga sese. Indlela eye ibonakale ngayo iherpes uma unayo iyafana noma yilee yomkhuhlane okanye le yesifo sakugcantsi. Kuyekuqale ubenala mashasazi ana manzi ngaphakathi esithi phecelezi ngamablisters. And then with time bese ayaqambuka kwenze iyilonda lokho. Now iproblem izakubakhona kuphi ngoba uneyilonda especially langaphantsi ngoba loko kungeza ubeselungciphekweni lokuthola izifo ezifana ne HIV. (IsiZulu) Herpes is caused by a virus called the Herpes Simplex Virus(HSV). There are two types of this virus: HSV 1 and HSV 2. HSV 1 is the one that causes cold sores around your mouth. HVS 2 is the one that causes sores on your genital area. Now the symptoms of Herpes, whether it's cold sores or on your genitals, first appear as small blisters with fluid-like substance inside. And then with time they burst and cause sores. Now it's a problem when you have sores on your genitals, because that puts you at risk of getting other infections such as HIV.

Luckyboy Mkhonzwane: Abantu they still need information eningi because masibabona labafana labaya omunye wabo uthi yena uyayibheka icherry ukuthi injani because uyafumanisa ukuthi izifu zaku ncantsi sitolakala kamantombazana alosi ahambahambayo. Soyena abo cherry bakhe noba baningi abahamba hambi . And lonto leyo iyawandisa ukuthi like amaSTI's abamaningi emphakhathini. And also as udoctor eshilo iyawakhuphula namatsansis eHIV because if you are presenting ngama STI's especially iHerpes the chances of you getting HIV from one of your partners are very high. (IsiZulu) People still need information, because one of the guys in the insert said that STIs most affect dirty girls that sleep around. So even if he has a lot of girls, as long as they don't sleep around. And I think that's the part of the reasons STIs are so widespread in our communities. And also, like Dr Nkuli mentioned, it increases the chances of getting HIV because you are presenting with an STI, especially Herpes the changes of getting HIV from one of your partners are very high.

Shalom: Nina nichabangani is there a link between STI's nama sexual partner amaningi? (IsiZulu) What do you guys think, is there a link between STIs and multiple sexual partners?

Luckyboy: Mina into endiyicabangayo is ukuthi if ngikwirelationship nomuntu, and then I partner yam inama partner ayi four kuyafana ingathi ngilala nabo bonke abobantu, kahle kahle kuyafana ingathi ngilala nomuntu oyedwa ngilala nabantu abayifive. So whatever illness or infections ibanayo ndizobanayo mani because inderectly silala sisonke. (IsiZulu) I think that if I'm in a loving relationship with someone, and then my partner has four other sexual partners, it's almost as if I'm not sleeping with my partner only, but only with five people. So whatever illness or infection they may have, I will have as well because indirectly, we're all sleeping together.

Dr Nkule: Yilento sisithi yindlela yama sexual networks, instead of nina nginomuntu omnye endiya naye echatsini oyiwedwa at the time. Ngizo overlapa nomunye umuntu mhlaweubhe babeyi two noba bayi three. And ofcourse nabo boyi two or three abaphelele kumina, angithi nabo bazanabanye abantu. That way ziyaspreader siyathelelana nge sifo (IsiZulu) That is what we call sexual networks, whereby instead of me having one sexual partner at a time, I overlap and have two or three other sexual partners. And of course those two or three also have other sexual partners on the side. In that way we are infecting each other and spreading these infections.

Shalom: (SeSotho) Siyayinqoba will be back, stay with us.

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Shalom: (SeSotho) Welcome back, for the treatment of Herpes to work, you need to start with it as soon as possible.

Sexual Networks

Kuyasa Clinic, Khayelitsha, Western Cape

Vuyo: Molweni namhlanje sise Kuyasa Kliniki eKhayelitsha, ndihamba nabafana bezokuzi qhondela nge Herpes konesi masiyeni. (IsiXhosa) Hi, today we're at Kuyasa Clinic in Khayelitsha with these guys where they ask the nurses about herpes, let's go inside.

Thobile Mfuleni: Sorry man sisi bendicela nje ukubuza umbuzo nje omncinci, bendicela ukukwazi ukuba zintona isymptoms ze herpes ? (IsiXhosa) Can you please explain to me about the symptoms of herpes?

Sista Gxowa : Besithe iba lityunguza lisenoba liyi one okanye abe manninzi kwi genitals zakho. Isenoba painful in some other cases umntu athi xa um-examina uthi alikho buhlungu but most of the time its painful blisters ezibakho kwi genitals zakho. Sometimes they go away xa ungazi treatanga but they come back. (IsiXhosa) It's small blisters, one or more, on your genitals. It is painful, but in some cases the blisters are not painful. Most of the time it's painful blisters on your genitals. If not treated, the blisters go away and come back again later.

Sinethemba Matyobeni: Into endifuna ukuyazi mna ingaba iHerpes ne HIV zinxulumana njani, like irelationship wazo iphi? (IsiXhosa) Can you please explain the relationship between HIV and herpes?

Sister Ndileka Mbobosi: Iherpes ne HIV zisexual transmitted disease zombini. Into eyenzekayo xa une herpes iba ibayo-blister emva kweblister emva kwalablister isenoqekeka iskin esi sophuke. And then xa si breakhile then uza kwenza isex nomntu oHIV positive. Kubalula ngolohlobo ukuba mayingene. (IsiXhosa) Herpes and HIV are both sexually transmitted infections. Herpes starts out as blisters and then your skin breaks. Once your skin is broken and you have unprotected sex with someone with HIV, it is easy for you to get infected with HIV.

Sibusiso Maka: If unazo iHerpes so ukuze ukhawuleze uyitreate ungazinceda njani ukuze ufumane itreatment mhlambi ndenzela ukuba abanye abantu elokishini abayazi loweyi ukuba uncedo bangalifumana njani uncedo phi? (IsiXhosa) If you have herpes, where can you get quick and effective treatment?

Sister Ndileka : Okokuqala xa uzakuyi treater yona iHerpes kufanele ukuba uza apha ekliniki. And then xa uze apha akuboni usister ukuba lento unayo yi Herpes nyani na. Xa ethe wayifumanisa ukuthi yiyo nyani zikhona itreatment esithi siyisebenzise ukunyanga yona. (IsiXhosa) If you want to treat herpes you must come to the clinic. When you come here, the nurse will examine you and make sure it's herpes. If it really is herpes, we will use the appropriate treatment to treat it.

Sister Gxowa: So ke sinayo itreatment apha ekliniki esiyisebenzisayo that works very well kwi Herpes kuthiwa yi Acyclovir, unesi ukubonayo kudepender kwi degree iseverity le ye Herpes yakho ithini na okanye ingakanani na, so ke abanye abantu banikwa ipilisi ibe yi 1 kathathu nge mini. Abanye bayinikwe ibeyi one kabini nge mini but you should take this for for five to seven days depending on ugqirha okanye unesi wakho uthe uyitye kangaphi. (IsiXhosa) The treatment we have at the clinic for herpes is Acyclovir. Depending on the severity of the herpes infection at the time, some people have to take one pill three times a day. And others take one pill two times for five or seven days, depending on your doctor's instruction.

Simnikiwe Mjika : Mna ndifuna ukubuza ndingenza njani ukwazi ukupreventer ukungayifumani iHerpes? (IsiXhosa) What can I do to prevent myself from getting herpes?

Sister Ndileka: Indlela yoku preventa okokubana ungayi fumani iHerpes kukuthi usebenzise icondom ngalo lonke ixesha ozakufumana isex. So if ubusebenzisa icondom awuzukwazi ukosuleleka because yona iyakwazi ukupreventer ukuthi ungasuleleki. (IsiXhosa) One way is to use a condom every time you have sex. If you use a condom all the time, then you will be protected.

Sista Gxowa: Eyona nto ibalulekiyo yi information kufuneka ubene full information so that uzoyazi uzazi isigns ne sympoms ze STIs especially iherpes lena nifuna ukuwazi ngayo. Then ukwazi ukuyi treater as soon as possible. And the other thing esiyi encourageyo among abantu aba young kukuba maba tester for HIV because iHerpes is one of the opportunistic infections. Not that I affecta abantu aba positive only but it's more common among abantu aba HIV positive. (IsiXhosa) The most important thing is to have all the information so that you can know the signs and symptoms of all STIs, especially herpes we're talking about today. And be able to seek treatment as soon as possible. Another thing we encourage the youth to do is to get tested for HIV because herpes is one of the opportunistic infections. Not that it only affects people living with HIV; it's just more common among people living with HIV.

Sibusiso Mantini: Kutheni iHerpes isazazeka lula apha kwi Community? (IsiXhosa) Why does Herpes spread so easily in our communities?

Sister Ndileka: Abantu abangamadoda njengoko benitsilo bathatha ixesha ukuza ekliniki. Because iherpes xa iqala ukuphuma ingathi yinyebethu and then xa itshoyo umntu ukaqabe bnezinye izinto angezi ekliniki. Athi xa esiza ekliniki kube seku late and ngelaxesha seke lele nabantu abaninzi ukubosulela ngeloxesha. Yenye yezinto ebangela ukubana ikhawulezise ukusasazeka.( IsiXhosa) Like you said, men tend to be reluctant when they have to come to the clinic. The thing is, Herpes appears as fever blisters and so people use other ointments. And only come to the clinic at a later stage, after sleeping around and passing it on to other people. That's one of the reasons why Herpes is spreading around so fast.

Sinethemba: Singenza njani as thina bantu batsha sihleli apha ukuze singa feely embrassed xa sisiya ezikliniki umzekelo sine herpes okanye iSTI yabo? Yintoni like enokwenziwa ukwenzela abantu abatsha bakwazi xa athi azibone enezonto kubelula ukuba makaze ekliniki azo treater ezonto okanye afumane i-information abaout ezo zinto? (IsiXhosa) What can be done to help us, the youth, not to feel embarrassed when we go to the clinic for Herpes or other STIs? What can be done to make it easier for the youth to come to the clinic for treatment or even information?

Sister Ndileka: Kuxhomekeka xa usiza ekliniki kuxhomekeka kuwe ukuba ungumntu onjani uyabona. Uba ungumntu ongaqhelanga ukuba phakathi kwabantu nakanjani uzakufeelisha u-embarrased. But ke ngoku kufuneka into ibenye kuwe ichachayo yokuba wena ufuna uncedo, and akhukho nenye indawo ozakufumana kuyo uncedo ngaphandle kwalapha ekliniki. So xa uzixelela lonto usasuka endlini uzafunamisa ukuba yonke enye into iza ilula ngoba wena into ojonge kuyo qa luncedo olufumana apha ekliniki. (IsiXhosa) I'd say it depends on the kind of person you are. If you're naturally reserved person, then you might be embarrassed. The one thing you must tell yourself is that you want help and you're not going to get it anywhere else but from the clinic. If you tell yourself that, everything else will be easier. Because now you'll only be focusing on getting help from the clinic.

Support Group

Shalom: (SeSotho) That was some useful information.. Guys nichabangani nini abantu besilisa bayazimisela ngephela na ukuthi ba hambe bayokubheka indaba zeHerpes ukubangabe beziva ukuthi uyavela? (IsiZulu) Are you guys really prepared to go to the clinic with their Herpes symptoms?

Simphiwe Ngongoshe: Ukubangabe umuntu wesilisa ento ekuye ngakwisito sakhe a ngajwayelekile uzakwesaba ukuthi aphume lubala kuqala kwi partner yakhe. Into ezofika ukuyena emqondweni wakhe ngeyokuthi makaye kumuntu omgumelaphi wendabuko okanye inyanga noba yisangoma. So ke thina bantu besilisa kwiskathi esininzi siyesaba ngezi nto esinazo ukuthi masiye emthola mpilo. (IsiZulu) If a guy has something funny on his genitals, he won't tell his female partner. The first thing on his mind his mind will be to go to a traditional healer. So most guys shy away from going to the clinic for anything down there.

Dr. Nkuli: Out of ten HIV negative people, eight will have Herpes even more so xa abantu be HIV positive. One of the reason eyenza iHerpes ibe common kangaka yilentu ba abantu abaninzi abanayo do not know ukuba banayo iHerpes. They can confuse impawu zayo with other things. Acinge umntu ukuba yi yeast infections so iyi ignore angayi treati. Umntu acinge ukuthi une allergic reaction maybe to the kinda of detergents the kinds of isepha esizi sebenzisayo or even isoftern esizisebenzisayo. (IsiZulu) Out of ten HIV negative people, eight will have Herpes even more so if they're HIV positive. One of the reasons Herpes is so common is that most people that have it don't know that they have Herpes. They can confuse the symptoms with other things. They may think that it's a yeast infection and ignore it. Some may say it's an allergic reaction to the detergents or softeners we use on our clothes.

Busi Maqungo: Omnye athi yi peyiti lena ayinxibayo. (IsiXhosa) Some say it's the fabric of the underwear.

Dr Nkuli: Exactly and that is because ayipheleli iHerpes normally ayikho restricted only kule ndawo bekukho iclose contact kuyo the time uyifumana. You can have it apha ezimphundwini around your buttocks ubenayo around apha kwindawo lena yokuzithuma. And more importantly ayibi zizilonda ezibonakalayo. Uyabona nje sithatha nge blisters ukuba ubana matyutyuza anamanzi or ubanezilonda. It's not always like that what heppens is you can get little cuts or ubenezinto esithi zivishers ezi crestekileyo. (IsiZulu) And that is because Herpes is normally not restricted only to the area that came into close contact at the time of the infection. You can have it all around your buttocks or around the anus. And more important, it's not always sores or the blisters we keep talking about. It's not always like that what happens is you can get little cuts or little crusted incisions.

Simphiwe: Abantu abathandanayo okubalulekileyo mazi umuntu wakho. Suku banamahloni ukuthi ubonwe ngu muntu wakho enaked. Ukuba uzabanamahloni kwenziwe izinto ebunyameni. Awumazi upartner lo wakho lo noba ucwele izilonda na, okanye kwenzeka ntoni kuyena so ke mazi upartner wakho. Again umuntu wesifazane maka kwazi ukuthi icondom ayifake ku partner wakhe makakwazi. (IsiZulu) If you're in a relationship know your partner. Don't be shy to see your partner butt naked. If you're going to be shy and do things in the dark, you don't know if your is coved in sores or something, know your partner!And females mustn't be afraid to help her partner put a condom on.

Busi: And xa ebona into angayiqhelanga abuze ukuba yintoni le.(IsiXhosa) And ask questions if she notices anything funny while she is at it.

Dr Nkuli: Enye into ebalulekileyo ngayo is that xa i-reactivator ivuselela from i-nerve lakade ingene khona it can cause impawu in which case uzozazi ok ndine herpes its either ndine tyunguza or ndinesilonda. But you can also have lento siyibiza ukuba yiAsymptomatic Reactivation, iyaphuma from the nerve iyodlala and as idlala iya multiplya andithi so ke uzaba ne virus enintsi kwi discharges zakho from the vigina if ungumuntu wesifazane or from the semen xa ungumntu ongutata. And you can have i-virus apha kwi skin where it normally will appear xa ubanayo uzoba nephawu but ufumanise awunazo imphawu. So une virus elapha kwi skin elapha kwi fele lakho but wena akuyi boni ivurus because awunazi londa. In that way when you have sex undibana ne partner wakho uzakuyidlulisela ke nge Herpes. In fact izi studies iresearch ezininzi sezibonisa ukuba most of us siyifumana ngale ndlela esithi yi Asymtomatic Shedding. So you're got it unayo i-virus kwi discharges zakho and on the skin but awunazo impawu ezibonisayo ukuthi unazo. So ke kubalulekile ukusebenza njengoko sibonile kwi insert ukuba umntu asebenzise icondom at all times. But more especially xa zikhona imphawu zayo the best thing is to ba u avoider altogether ungabinayo isexual intercourse until zide ziphole izilonda zakho. (IsiZulu) Another important thing is that when Herpes reactivates from the nerves, it can cause clear signs like those blisters or sores. But you can also have what we call Asymptomatic Reactivation, whereby Herpes comes out of the nerves to multiply. So you will have a lot of virus in your discharges, from the vagina if you're a female or from the semen if you're male. And you can even have the virus on your skin, where the signs would appear but now you don't have the signs. So you have the virus on your skin but your skins but you don't have sore as a sign. In a way, you can pass Herpes on to your partner during sex . In fact, many studies show that most of us get Herpes through this Asymptomatic Shedding. So you've got it in your discharges and on the skin, but don't have the signs. So, like we saw in the insert, we must use condom at all the times. But when you have the sores, the best thing is to avoid sex altogether, until the sores heal.

Shalom: (SeSotho) Let's take a short break, we'll be right back.

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Shalom: Siyakwamkela futhi (SeSotho) Welcome back, we've been talking about Herpes and myths about STIs. Let's go to Gauteng for another story.

Herpes

Hillbrow, Gauteng

Mxolisi Mgobhoza: Molweni namhlanje sise Hillbrow Esselen Clinic sizothetha no Nandi. U-Nandi uphile ne HIV/AIDS and wakhe wane herpes ngaphambili. Sisi Nandi sicela usixelele nge experience nge Herpes? (IsiXhosa) Hello, today we are in Hillbrow at Esselen clinic to speak to Nandi. Nandi is living with HIV/AIDS and has once suffered from Herpes. Nandi, can you please tell us about your experience having Herpes?

Nandi Ngcobo: i-Herpes bengingazi ukuthi nginayo. But bengihlala ngihlale ngibe neyilonda, sometimes ngibe nama craks langaphantsi esitweni sam sangasese. Then mangiya kudoctor ebelibe engi treater. But ngaza Esselen Clinic. I had to come to the Esselen Clinic ngezwa ngayo. So ngezwa ngayo ukuthi batreater bafuna abantu aba HIV positive ukuthi kune Study.(IsiZulu) I didn't know I had Herpes, but I had sores in my genitals area. I went to the doctor and got treatment, then decided to come to Esselen clinic because I heard they work with HIV positive people.

Dr Nkuli: Yake Nandi ndiyajabula ukuthi sowu buyile ke sisi ukuthi sizokubheka sekunjani langaphantsi njekade ngikunike itreatment yazo iyilonda lebeyiphume ngasese. (IsiZulu)I'm happy that you came back so we can see how you're doing now since I've given you treatment for the sores.

Nandi: Ukubangabe njengoba sengisazi ukuthi ngi ne Herpes, kumele ngize ekliniki ngoba sekuveli iyilonda okanye nje maqala nje ukuzwa amasigns ukuthi izovela ngoba sengiyazi mayizovela kewnzekalani mele ngize ngesozikhathi ngizothola itreatment?(IsiZulu) As I know that I have Herpes, should I come to the clinic when I have sores or should I come for treatment immediately when I feel the symptoms?

Dr Nkuli: Kahle kahle ukuze itreatment ibe effective for ukuyi treater iHerpes kufuneka iqalwe ngale sikhathi uzwa imphawu zokuthi izoqala iherpes even before uzubone iyilonda nawo lamashashazi.(IsiZulu) For the treatment of Herpes to be effective, it has to be started as soon as you feel the symptoms even before the sores appear.

Nandi: Kuno mehluko yini ukuthi ubone amasign eHerpes kumuntu wesilisa nowesifazane nje o kuyafana nje?(IsiZulu) Are the symptoms of Herpes the same in both males and females?

Dr Nkuli: Amasigns indlela avela ngayo ziyafana basically into engaske itsintshe ngukuthi vele kobaba yonke into inga phandle iyabonakala so yena u more likely ukuthi abone xa evela lamashashazi la eHerpes or evela iyilonda. Where as kuthina bomama zifihlekile izinto eziningi especially if iyilonda or amashashazi azovela emlonyeni wesibeletho phecelezi icervix or abelapha inside the vigina angekhe uzibone. Enye indlela engavela ngazo especially uma ilapha emlonyeni wesibeletho ngoba unayo leyi londa uzolokhu uzibona une discharge eheavy nje ngalo eso sikhathi sama outbreaks. (IsiZulu) The way symptoms show is the same basically, the only difference is that in males everything shows on the outside so it's easy for him to see when there are sores. Where as with females everything is hidden, especially if the sores are on the cervix or inside the vagina. The other way to recognize that it's on the cervix is you'll experience heavy discharge during the outbreaks.

Nandi: Kubalulekile yini ukuthi mangabe ngihamba ikliniki yokukhulelwa ngiba tsele ukuthi ngi ne Herpes, Kungenzeka yini ukuthi iphazamise umntwana? (IsiZulu) Is it important, If I am pregnant to tell the antenatal clinic that I have Herpes. Will it affect the baby?

Dr Nkuli: Kubalulekile ukuthi usho kanjalo ngoba iyakwazi ukuthi indluliseke emntwaneni like most of izifo zochantsi. So if uyazazi ukubana wakhe waba nayo especially with i-HIV ubo discloser uthi une Herpes. (IsiZulu) That's very important because it can be transmitted to the baby like STIs. Especially with HIV, you have to disclose that you have had Herpes.

Support Group

Shalom: (SeSotho) The good news about Herpes is that there is a very effective treatment for it called Acyclovir. Nandi seems to have her Herpes well under control.

Dr Nkuli: Njengokubana ngikade ngitsilo once yabanayo iHerpes unayo for life. It's one of those chronic STIs. Iye ivele iphinde iphele vuthi. Some people are lucky ibavela once ibangene but bangabi nazo imphawu later on in life. So ke the best time ukuthi uthathe itreatment yakho le esithi yi episodic treatment ngaleso sikhathi meaning that si treater kuphela leyo episode onayo uyabona and iba yi course ye 5 days. But kubantu especially abathola ama outbreak la aphuma kayingi iyilonda it's always best ukuthi uba adviser ukuthi no indlela onga controla ngayo iHerpes kukuthatha ipilisi everyday you'd control ushukela o u controle uBP. And you can use it for iminyaka eminingi ayizokunika iresistance for instance and also its well tolerated. (IsiZulu) Like I have said, once you have Herpes, you will have it for life. It's one of those chronic STIs. It will come back and then disappear again. Some people are lucky, it only shows up once but they don't get flair ups later on in life. So that is the best time for you to take the episodic treatment, meaning that we will only treat that particular episode of flair ups, and it's a five day course of treatment. But for the people that get most frequent outbreaks, it's always best to advise them to take a pill everyday to control Herpes, just you'd do to control Diabetes and Blood pressure. You can use it for so many years and you won't develop resistance, and Acyclovir is well tolerated.

Luckyboy: Mina into engithanda ukuyazi doctor njengomuntu obanawo ama outbreaks alandelelanayo weHerpes. La ngihlala khona umangiya ekliniki to report it I get written referral letter because it's not available ekliniki so that kufuneka ngiye esibhedlela. Is it universally available kuma kliniki or vele ku necessary uyoyithola esibhedlela Acyclovir? (IsiZulu) As someone who gets more frequent outbreaks of Herpes, when I go to the clinic to report it, they write me a referral letter because Acyclovir is not available at the clinic, it's only in hospitals. So is it universally available from our clinics, or do I have to go to the hospitals?

Dr Nkuli: Iyinkinga yona i-availability wayo i-Acyclovir kwi public sector yethu. But into engiyaziyo khona manje nje is that kwi province efana ne Western Cape ingathi i-avaliable and it's been available for isikhathi eside kuma kliniki ase lokishini you know laku lula khona ukuthi umuntu aye khona. But even na then ezoba available yile ye five day course le yokuthi utreater ngesikhathi une yilonda. And what happens is if uyithole sekulate kuyafana. Uzotselwa futhi ngabantu abasebenza emthola mpilo ukuthi asizunika ngoba uyi presenter late because it won't work If sowuyitholee late. Some kliniki eGauteng uyakwazi ukuthi uyithole i-episodic one lee ye five days. But generally le ye prophylactic le ekufuneka uyithole for isikhathi eside it's a problem nationwide. (IsiZulu) The availability of Acyclovir is a problem in our public sector. But in a province like the Western Cape I think it's been available for quite some time from your easily accessible local clinics. But even then, it's only the five day course of episodic treatment and if you get it very late, it's useless. Even the nurses will tell you that they won't give it you, if you present with symptoms later because it won't work. Some clinics in Gauteng do provide the episodic (5day) treatment. But availability of the prophylactic everyday pill is a problem nationwide.

Shalom: (SeSotho) So we can see that Herpes is one of the common STIs. Luckily it's also very easily treated at your local clinic or doctor. Should you get any symptoms especially relating to you genitals, get it checked out straight away! We love receiving your letters and e-mails. Please contact us at the details on your screen now. Check out our new website at www.beatit.co.za!(IsiZulu) Sizophinde futhi sibuye ngokuzayo. We will be back same time, same place next week. Until then, protect yourself, protect others. Bye bye.