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Mar 20, 2017
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Sexually transmitted diseases and infections (STDs, STIs) are rising at an alarming rate in the Philippines. In a report published in the New Internationalist blog, the Department of Health's Epidemiology Bureau bared that “the number of individuals with HIV newly diagnosed per day rose to 22 in 2015, from just one in 2008, four in 2010, nine in 2012, and 17 in 2014.” 

Unfortunately, it's not only the growing threat of HIV-AIDS that needs to be addressed. Gonorrhea or tulo still remains one of the most common STDs that affects Pinoys.

Cause

Gonorrhea is caused by Neisseria gonorrhoeae, a bacterium notorious for multiplying easily in the body's mucus membranes. It spreads through sexual contact with the penis, vagina, anus, or even the mouth of someone who already has contracted it. And you can keep getting it, even if you’ve been treated before.

Symptoms

Common symptoms of men with gonorrhea include yellowish discharge from the penis, a burning sensation when you pee, swollen testicles, anal itching, and a sore throat. What’s scary about gonorrhea is, a lot of people—mostly women—are asymptomatic, which means they never show symptoms. If left untreated, you risk complications like eye infections, skin sores, arthritis, and inflammation of the heart valves. In rare cases, it might lead to infertility.

According to urologist Dr. Perry Lantin, the incubation period of the virus—between exposure and the appearance of symptoms—ranges from three to 14 days. Luckily for men, they can seek treatment as soon as the symptoms appear. Having gonorrhea can also increase the risk of contracting and transmitting HIV. 

Misconceptions

One of the most common misconceptions about gonorrhea is that it can’t be transmitted through oral sex. “The notion is false because the purulent discharges on the mucus membrane surface of the urethra, once deposited [orally], may cause oropharyngeal gonorrhea,” Dr. Lantin says.

Another misconception is that gonorrhea will just go away on its own, something Alex, 30, learned the hard way. Alex contracted gonorrhea through an oral sexual encounter. “When I found out I had gonorrhea, I was ashamed," he says. "I felt the need to hide it because it was the first time I had an STD. I thought it was okay to let it be and if I just avoid having sex, it’ll heal after a couple of days. I tried wrapping it with tissue and socks so my penis wouldn’t stain my underwear, but it just got worse.” 

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Treatment

Alex eventually sought a doctor to get treated, and it was a quick process. “After I was examined, the doctor prescribed some medication. Although the meds were expensive, I knew they were necessary. It disappeared after a couple of weeks.”

Though treatable, gonorrhea is spreading and evolving at an astonishing speed. The Centers of Disease Control and Prevention’s (CDC) recommended course of treatment involves two antibiotics—an oral dose of azithromycin and a single shot of ceftriaxone, which was confirmed by Dr. Lantin.

However, it’s been reported that “the percentage of gonorrhea isolates with decreased susceptibility to azithromycin, an indicator of emerging resistance, increased more than 400 percent between 2013 and 2014.”

This means that azithromycin might be the next antibiotic to kick the bucket. Penicillin was the go-to drug treatment for gonorrhea until it stopped working in 1976. It wasn’t until 2007 that medical professionals found one class of drug—cephalo-sporins—that consistently worked. 

Dr. Lantin gave us an overview of the kind of treatment you need if you have gonorrhea:

  • 1g vial of ceftriaxone (P1,000 to P1,300) + azithromycin 500mg/tablet (P130 to P150)
  • Or, cefixime 200mg/tablet (P150 to P250)

All of which require prescriptions. For exact doses, consult your doctor.

Other prevalent STDs in the Philippines

But gonorrhea isn’t our only problem. The number of Filipinos infected with Human Immunodeficiency Virus (HIV) has been steadily rising. The first case was reported in 1984, and last year, the Department of Health (DOH) recorded 841 newly diagnosed HIV cases just for the month of June.

Private testing centers have also reported that there are at least 26 new infections every day, which comes out to at least one person diagnosed every hour. And if you think about it, not everyone with HIV gets tested, so the numbers could be much higher. What’s worse is, the victims are getting younger and younger, with millennials—aged 15 to 24—at the center of it all.

While HIV is perceived as the “scariest” one, there are other common STDs we need to be aware of:

Chlamydia

Half of the men infected by chlamydia don’t show any symptoms. It might be interesting to know that chlamydia and gonorrhea often occur at the same time; they also have similar symptoms—swelling around the testicles, painful urination, and penile discharge. Doctors usually prescribe oral antibiotics, but for serious cases, you may require hospitalization and pain medication.

Syphilis

Syphilis is highly contagious as it can be spread through kissing or even prolonged body contact. Dermatologist Dr. Joyce Castillo shares that syphilis has been dubbed as “the great impostor” because its symptoms—like sores—are similar to those of skin conditions. That’s usually the first stage of the STD. During the second stage, you might experience flu-like symptoms like sore throat, rashes, and fever, Dr. Ivan Singzon adds. At the most dangerous stage, the disease affects your vital organs, which may lead to dementia, paralysis, impotence, and death.

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Hepatitis B 

Hepatitis B is spread through infected bodily fluids like blood, semen, and open sores. The DOH found that “10 to 16 percent of adult Filipinos suffer from chronic hepatitis B infection.” Hepatitis B causes liver disease, which can lead to liver cancer.

An article in Medical Observer estimated the cost of the STD: “Hepatitis B profile costs P1,800; ultrasound, P450; hepatitis B viral load, P4,500; and genotyping, P14,350...Hepatitis B medication costs P135 a day or P49,000 a year that (may possibly run) for the rest of our lives.”

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