CHAPTER ONE

INTRODUCTION

1.1 Background

Sexually transmitted infections (STIs) are as old as mankind and epidemics are mentioned already in the Old Testament of the Bible. However, the perception of the conditions has changed over the centuries (Burg et al., 2012). In ancient times they were taken for an individual punishment for a blasphemy conduct of life or because of low sanitation and hygiene (Marks et al., 2021). In the late 19^th and beginning of 20^th century, the many achievements in microbiology and chemistry finally took the frightening threat from the STIs, which had terrorized millions of “normal” and “famous” people of all social classes over centuries and has been linked to many scandals (Elain, 2018). Moreover, the perception of STIs has turned from a “personal stroke of fate” into a collectively important issue of public health.

Sexually transmitted infections (STIs) are infections caused by pathogens and are contracted through sexual activity (intercourse, oral and anal sex). Some of the most common STIs result from bacterial (chlamydia, gonorrhea, and syphilis) and viral infections such as (HIV/AIDS, herpes, hepatitis B, Human papillomavirus) are because of exposure. In addition to bacteria and viruses, protozoa and fungi also cause STIs including those that cause trichomonas vaginitis and jock itch respectively (shim, 2011). Despite the rapid reduction in STIs rates since World War II, STIs still remain a significant health issue in the United States and other developing countries (Shim, 2011). Sexually transmitted infections (STIs) according to some healthcare clinics are interchangeable with STDs; however, others believe that STIs are the precursor to STDs because they are caused by the same pathogens but are at a stage where no symptoms are present in the host (University of Alabama Student Health Centre, and University of Wisconsin (Wire, 2010). In addition, STI is used as a more current term and may be less embarrassing to a patient upon diagnosis compared to using the term disease (Wire, 2021).

STIs impact the cost of healthcare in the United States with over $16b being spent annually to diagnosed and treat those infections. This financial burden is further compounded by a long term effect of STIs on health including pelvic inflammatory disease and infertility, as well as those infections that increased susceptibility to HIV/AIDS(Centers for Disease Control,2012a).Females are at greater risk of contracting STIs and developing complications if infections go untreated, and often times STIs do not present symptoms in males or females, which leads to increased transmission and greater susceptibility to other types of infections (UpChurch et al.,2004). The implications for positive social change of this study are to support the belief that sexual education beyond HIV/AIDS must occur at earlier ages to educate young adults before they initiate sexual activity as well as to provide support in demonstrating the lack of STI, education among this age group even though the age of unset of sexual activity is occurring earlier than expected (Carminis et al., 2007).

The World Health Organization (WHO) estimates that Sub-Saharan Africa bears approximately 40% of the global burden of STIs. This is so because STIs are symptomatic and asymptomatic and are a major cause of mobility in developing countries. In Cameroon, sexually transmitted infections (STIs) including Human Immunodeficiency Virus (HIV), are at the fore front of public health challenges with a high HIV prevalence rate (5.1% in 2010). Cameroon records one of the highest burdens of associated socio-economic impacts of HIV in Sub-Saharan Africa (SSA). This burden therefore rests on the policymakers to provide adequate mechanism for addressing the forces behind.

1.2 Problem Statement

Despite the improvement in the world’s technology and medical science specially in the gynecologist and venereology department associated with the different sensitization programs organized by the government of Cameroon about sexual transmitted infections, many people still suffer from sexual transmitted diseases some of these condition end in disastrous complication such as infertility, ectopic pregnancy, cervical cancer, miscarriage and even death. Most often, complication set in due to lack of necessary knowledge from youths to prevent the disease or to diagnose it early when it occurs. In 2015, about 1.1billion people had STIs other than HIV/AIDS (Allen et al., 2016). About 500 million were infected with either syphilis, gonorrhea, chlamydia or trichomoniasis (WHO, 2013). At least an addition of 530 million people had genital herpes, and 290 million women had human papillomavirus (CDC, 2013). STDs other than HIV resulted in 108.000 deaths in 2015 (Allen et al., 2016). In the United States, there were 19 million new cases of STIs in 2010 (STTs Trends in the United States, 2010). In Cameroon, some sexual transmitted infections like gonorrhea, syphilis, Chlamydia, Trichomoniasis, HIV/AIDS, and Hepatitis B are more common than others (WHO 2015). Also 620000 people have been diagnosed and living with HIV in Cameroon, corresponding to about 4.5% of the adult population 15-49 years (UNAIDS, 2019) added to it a study done in the Southwest Region of Cameroon about the prevalence and risk factors of STIs in health facilities review that prevalence of HIV, gonorrhea and syphilis was 8.1%, 12.9% and 16. 9% respectively (WHO, 2015), which is a call of concern.Hence,this study is based on assessing the factors influencing the reoccurrence of STIs among young adults in the Mutengene Community.   

 1.3 Rational

Sexually transmitted infections are not only a cause of acute morbidity in youth’s but may result in complications such as infertility in both men and women, ectopic pregnancy, cancer, premature mortality, abortions, low birth weight. In other to avoid STIs and unwanted pregnancy, knowledge on STIs prevention and management is of almost importance for youths because youths are more sexually active than adults, they are particularly vulnerable to sexually transmitted infections (STIs). It is also especially important for them to learn about STIs so that they can protect themselves from infections.

1.4 Study Questions

• What knowledge do young adults have about sexually transmitted infections.

   2) What are the factors influencing the reoccurrence of sexually transmitted infections

1.5 Objectives of Study

1.5.1 General Objective

      1) To determine the factors influencing the reoccurrence of sexually transmitted infections among young adults in the mutengene community.

1.5.2 Specific Objectives

  1) To assess young adults’ knowledge on the reoccurrence of sexually transmitted infection.

  2) To determine the factors that influences the reoccurrence of sexually transmitted infection