Young people under the age of 25 years are among those most affected by sexually transmitted infections in Fiji, with a FRESH Pilot study finding high rates of chlamydia and gonorrhoea among pregnant women and communities in Viti Levu.
The findings were presented during the Pacific Islands Health Research Symposium at the Fiji National University in Nasinu highlighting concerns over undetected infections and the need for stronger prevention, testing and treatment.
Ministry of Health official and PhD student with the University of New South Wales, Dr Rachel Devi says a pilot study involving women attending antenatal clinics and communities across Viti Levu found a chlamydia prevalence of 30.3 percent among antenatal clinic participants, while the prevalence among community participants was close to 24 percent.
She says the study also found that 86.7 percent of participants were asymptomatic, meaning they had an STI but showed no signs or symptoms.
Dr Devi says this is a major concern because people may unknowingly transmit infections to their partners, while untreated STIs can lead to complications including ectopic pregnancy and pelvic inflammatory disease.
She says STIs during pregnancy can also pose risks to babies.
Dr Devi says the findings provide important data from the Western and Central Division will contribute to the larger FRESH trial in Fiji, which will examine community-wide intervention and treatment using azithromycin.
Dr Devi is urging sexually active people to practise safe sexual behaviour, including using condoms and being faithful to one partner, as well as getting tested where services are available.
She says people experiencing symptoms such as discharge, pain while passing urine, itchiness or ulcers should seek medical attention and receive treatment.
Dr Devi stresses that symptoms subsiding does not necessarily mean the infection has gone.
The study also looked at stakeholders perception where FRESH Research Coordinator with the Fiji Institute of Pacific Health Research and FNU researcher Kelera Tuisova Naivalu says the lack of testing for chlamydia and gonorrhoea in Fiji means many people with these infections may go undetected.
Naivalu says the high prevalence of chlamydia and gonorrhoea among pregnant women under 25 is a major concern for Fiji.
She says Fiji currently relies on syndromic management, where people who present with signs and symptoms of an STI are treated.
Naivalu says this approach can miss around 80 percent of people who are infected but do not show signs or symptoms.
She says her study examined factors influencing access to and treatment for chlamydia and gonorrhoea, as well as the acceptability and feasibility of community-wide treatment in Fiji.
Naivalu says another concern is that some young people confuse other STIs with HIV, which can affect their understanding of the seriousness of these infections and whether they seek treatment.
She says the research found that STIs are predominantly common among young people, with unprotected sex, alcohol use and drug use identified as risk factors.
She says people may not realise that untreated chlamydia and gonorrhoea can lead to reproductive health complications, including complications during pregnancy and risks to unborn babies.
Naivalu says she spoke with key stakeholders, healthcare providers, government organisations and faith-based organisations to understand the situation surrounding STIs and possible community-wide interventions.
Naivalu says testing for chlamydia and gonorrhoea is expensive and is not currently a feasible widespread solution, which is why researchers are considering a broader public health approach to reduce STI prevalence at the population level.
