31.2.2  Risk factors for STIs

There are a number of factors that increase the risk of transmission of STIs, including biological, behavioural and socio-cultural factors. In this section we will be discussing the major risk factors that are associated with the transmission of STIs. Understanding these factors will help you in identifying the factors that promote STIs and their relation to the most ‘at risk’ groups of the population affected by STIs. In your daily assessment you will utilise this knowledge to assess patients and give them health education and counselling support in order to prevent STIs.

Biological factors

Biological factors are related to the age, sex and immune status of an individual. Certain age groups of the population are known to have a high prevalence of STIs.

Women in general are at greater risk of HIV transmission than men due to the larger vaginal surface area that comes in contact with the penis during sexual intercourse. In particular, young women between 15 and 24 years old, and women going through the menopause, are at high risk of acquiring STIs. Young women also may not have a comprehensive knowledge of STIs transmission. In addition, the risk of transmission of STIs is high in these groups due to immature or weakened vaginal mucosal lining of young and menopausal women, respectively.

The immune status of an individual also determines the risk of STIs. People with weak immunity have a greater risk of acquiring STIs than individuals who have a healthy immune system.

Behavioural factors

Behavioural factors are associated with actions of individuals towards a certain situation, in this case their sexual behaviour. It is well known that certain risky behaviours expose people to the transmission of STIs. These factors include having more than one sexual partner or having sex with ‘casual’ partners, for instance sex workers or their clients. One of the main risk behaviours that promotes transmission of STIs is unprotected sexual intercourse, that is sex without using a condom. Proper use of condoms effectively prevents the transmission of STIs; hence you should educate your clients at health post level, or in the community, about the proper use of condoms (Study Session 25). Changing sexual partners frequently is also a behavioural risk factor.

The use of alcohol, stimulants like ‘khat’ or illegal drugs may negatively affect the proper use of condoms. They usually affect our ability to weigh up risky situations and may result in involvement in unsafe sexual acts.

Socio-cultural factors

These are factors that indirectly affect the ability of individuals to take an independent responsibility for their behavioural actions. For example, factors like gender bias of a community, women’s economic dependence on men, and young marriage, affect women indirectly to be exposed to the transmission of STIs more than men. Harmful traditional practices like tattoos and unsterile circumcisions are also associated with contracting of STIs directly from the sharp materials that are used for that purpose.

31.2  Transmission and risk factors for STIs

31.2.3  Epidemiology of STIs in Ethiopia