Infections due to a sexually transmitted infection (STI) among young people have skyrocketed exponentially in recent years. This is indicated by the latest report on the Epidemiological Surveillance of Sexually Transmitted Infections in Spain, published in 2021 by the Ministry of Health.
That year, 15,338 cases of gonorrhea were diagnosed in Spain, 5,055 more infected than in 2020. Gonorrhea mainly affects men with 12,729 infected, while women number 2,548. The age group with the highest incidence, both in men and women, is between 25 and 34 years of age. There has also been an increase in syphilis infections, with 6,613 cases diagnosed, of which 5,729 were men and 598 were women. Until now, the incidences were higher for men than for women, but in the case of chlamydia, the number of infected men and women is equal, 10,220 and 10,286, respectively. In both sexes, the highest rates occurred between 20 and 24 years of age and 25 and 34 years of age.
“These figures are explained by the fact that there is an increase in the number of sexual partners, there are dating applications to have sexual encounters and there is even much more mobility during periods such as vacations and people have more casual sexual encounters,” explains Dr. Jesica. Obercie, gynecologist at Dexeus Mujer.
The director of the Andrology Unit at Dexeus Mujer and head of the STI unit at the Puigvert Foundation, Álvaro Vives, indicates that “men do not go to the andrologist but women do go to the gynecologist because they have it much more internalized.” Likewise, the doctor points out that men have considered that using condoms is uncomfortable because they have less sensitivity and therefore do not use them.
Three young people have offered to share their experiences with sexually transmitted diseases, each marked by a different STI. These testimonies not only reveal the process they have followed to eradicate it, but also the circumstances that led them to become infected, told by themselves.
Marta, fictitious name to preserve anonymity as with the rest of the testimonies in this report, is 24 years old and had vaginal trichomonas. In February 2021, she noticed small changes in her vaginal discharge, such as a greenish-yellowish color and a strange odor. She also had pain when having sexual relations and a lot of itching.
Marta urgently went to the medical center closest to her home. She explained to the nurse the problem she was having lately with vaginal discharge and immediately told her that it was possibly trichomonas.
Even so, they told her that she had to have a vaginal autocytology done. Marta assures that her treatment with the nurse was very cold, because she had to go to the bathroom and do everything herself. “I am a nursing student and I know more or less what I had to do but it was a little aggressive. It looks like a PCR that we did with Covid,” she says. She was then prescribed an antibiotic for 10 days and, during that period of time, she was unable to have sexual relations. Days later, they called Marta to go to the CAP. It was thought that they were going to give her the results of the cytology, but that was not the case. Once she arrived at the medical center, they told her that they had to do tests. “I freaked out. I didn't know that when there is a possible suspicion that you have a sexually transmitted disease, an analysis is done to find out if you have HIV or a more serious disease. I was really scared. “I came to think that she could have HIV,” Marta explains. Weeks went by and no one called Marta to tell her about the results of both the cytology and the analysis.
Four months later, Marta called. “I got edged. I wanted to know the results and they kept telling me off all the time,” she explains. The secretary who attended to her told her that she did not have HIV, but, nevertheless, they had lost the cytology.
In June 2021, once Marta finished her university exams, she went to her family doctor. At the gynecologist, she had a cytology done again. Everything was negative, but Marta continued to have discomfort when urinating. From the gynecologist she was referred to the urologist. There, she was told that “trichomonas had been detected late and this disease could have side effects.” In her case, she was found to have overactive bladder, which causes a sudden and frequent need to urinate, which can be difficult to control.
During the two years, Marta has had sexual relations. While she had vaginal trichomonas, she used protection, but, later, she stopped using condoms. Marta assures that she is responsible for each of her actions: “I have a stable partner and we both take tests to be sure that we do not have any STIs. Right now I know that I can't infect him with anything and neither can he infect me. Furthermore, there is no possibility of getting pregnant because I take birth control pills and that is why I do not use a condom,” she explains. However, Marta has not felt any coercion on the part of her partner. On the contrary, she explains that "she does not use a condom because the latex irritates her vagina and creates an uncomfortable situation."
Marta does not know who was the person who transmitted trichomonas to her. She “Before she was single and she had a lot of unprotected sexual relations.” Before contracting the STI, Marta was not aware of the impact that not using a condom had on her and she saw the possibility of suffering from an infection as very distant. Even so, she is clear that if she had to have relationships with others, she would use a condom to avoid suffering the same situation.
Albert, 21, was diagnosed with possible gonorrhea in May 2023. When Albert went to the bathroom, he felt discomfort when urinating and had a white discharge coming out of his foreskin. Therefore, he immediately went to CAP. The nurse did not hesitate to prescribe azithromycin, an antibiotic used to treat or prevent infection, in this case, possible gonorrhea. At the same time, the nurse performed an analysis to confirm the suspicions.
After four days, the discharge and burning during urination decreased and the results came back negative. Albert was not afraid at any time because he knew that gonorrhea could be eradicated with an antibiotic and the moment he had symptoms he went to the CAP to detect the infection in time. “I am a nursing student, I know what the symptoms are and I know that it is an infection that can be treated,” adds Albert.
Although in his case the duration of the illness was very short and it was not as long a process as in Marta's case, Albert assures that gonorrhea and chlamydia are very common sexually transmitted diseases among men because there are more sexual practices. risky. Albert had an open relationship with his ex-partner; they did not use condoms between them, but when they both had sexual relations with each other, they did use them to prevent. He himself explains that "in the case of a closed relationship, he believes that if you do prior tests, it is not necessary to use a condom."
Bruna is 21 years old and suffered from human papilloma for 2 years. Bruna had had sexual relations with several boys for a year and her mother advised her to go to the gynecologist for a check-up. Therefore, in the summer of 2021, she went to Dexeus Mujer, in Manresa, a private gynecological center. At her consultation, the gynecologist told her that her uterus was inflamed and that she would proceed to do a culture to determine if she had any sexually transmitted disease.
Once the clinic knew the results of the culture, Bruna was on vacation with her friends in Mallorca, and could not take the call. “If they called you on the phone it meant that you had something, but I didn't know what,” adds Bruna. It wasn't until when she returned from her vacation that she went to the consultation. “You have the human papillomavirus, but we are not going to give you any treatment. Now you have to be responsible, use a condom and not practice oral sex,” the gynecologist told her. In her case, they did not explain anything to her about this sexually transmitted disease and she did not know the process she had to carry out. "I was really scared. They didn't explain anything to me and I didn't know what it was. I am not a gynecology or medical student and there is knowledge that I do not have. There is a lot of misinformation and gynecologists should get involved in explaining in detail to patients what they are suffering from,” she adds. At no time did Bruna have the main symptoms of HPV, such as genital warts, so she, on the one hand, did not expect to have been infected with any disease. But she, on the other hand, assured that “it was strange that she didn't have anything, because she didn't use a condom.”
In the second consultation, once the results were known, the gynecologist did not give her any treatment, since it was a low-injury inflammation and she only had to go to the clinic once every six months. At the end of 2021, Bruna still had the papilloma. Subsequently, the gynecologist decided to start treatment because the disease did not subside. “I had to take a pill once a month and apply a vaginal gel to my intimate area every day except during menstruation,” she explains.
At that time, Bruna had two sexual partners: one frequently and the other sporadically. When she told them both that she had HPV, neither of them found it a problem to continue having sex. However, they didn't even give her the importance she deserved, and she didn't give it to her either. Ella Bruna continued the treatment for many months, but she still had the papilloma. There was something that wasn't working. She did not follow the gynecologist's advice and she had sexual relations without using precautionary measures, which is why the papilloma was difficult to eradicate.
Before the summer, he decided to lower the intensity of sexual relations for two months. It was not until July of this year 2023 that Bruna went to the consultation to have a culture done after two years with the papilloma. She was on vacation with her friends in Granada when, suddenly, her gynecologist called her to give her the most anticipated news about her. “You are clean. You no longer have the papilloma, Bruna,” said the gynecologist. Bruna jumped for joy and “says it was one of the happiest days for her.” “When I found out that I no longer had the papilloma, I cried with emotion,” explains Bruna.
Bruna believes that it was during that period that the papilloma was cured, and that stopping having sex was one of the factors that helped the virus disappear. However, other factors that are not taken into account as much and that help cure HPV are a healthy diet, tobacco and alcohol. Bruna stopped smoking and didn't drink much alcohol. Once her blood was clean, the papilloma disappeared.
For Bruna, having the papilloma was very difficult. "I watched when I went out partying because I had a sexually transmitted disease and I couldn't act like nothing happened," he says. In addition, he doesn't know who the person was who transmitted the virus to him, but he has a theory. "Until then, he just kept sexual relations with a person, but one day, I met a boy and I had sex without caution,” he admits.
Today, Bruna does not use a condom because she has a stable partner and knows that they are both clean. “Surely people will judge me after everything I've been through. I know perfectly well that I should use a condom, but I don't. My partner and I have been tested and we do not have any STIs,” she explains.
It is clear that adolescents do not prioritize the use of condoms, as it is more comfortable for them and they do not take into account the side effects that can arise from an STI. Furthermore, knowing that there are curable infections makes them relax and not take appropriate preventive measures. However, Obercie emphasizes that "one should not take care of oneself out of fear, but out of conscience and that there has to be a sexual-emotional link, that is, worrying about yourself and the other person."
Young people do not take into account the side effects that an STI can cause if it is not detected in time. “Women can suffer quite serious consequences for their health. Chlamydia and gonorrhea can lead to fertility problems and other infections can even be associated with different types of cancer. For example, the human papillomavirus can cause cervical cancer,” says Obercie.