Out of 66,377 pregnant women who came to the hospital for first-time antenatal care from April to December, 2023, some 1,255 tested positive for syphilis, according to the province’s health ministry.
The proportion of men being treated for Male Urethritis Syndrome (MUS, an inflammation usually caused by gonorrhoea or chlamydia) has jumped from 12 per cent to 15 per cent in only three years.
“We believe that the high uptake of PrEP among women (in Gauteng) has led this group to have unprotected sex resulting in a high incidence of MUS,” said Nomantu Nkomo Ralehoko, the province’s health minister.
PrEP and PEP medications were first rolled out in South Africa in 2016 to vulnerable groups, including sex workers, men having sex with men and intravenous drug users.
The medications are now more widely available, with more than 500,000 sexually active South Africans enrolled on oral PrEP and PEP to date, according to a 2023 study.
‘PrEP has freed them to discard condoms’
Dr Ndiviwe Mphothulo, president of the Southern African HIV Clinicians Society who also doubles as the TB/HIV manager for the City of Johannesburg’s Anova Health Institute said the syphilis rate in the province, at around two percent, was “problematic”.
“We should be worried about the rising numbers of STIs, it tells us that people are not using condoms. It’s a threat,” he warns.
Ms Nale’s experience as a sexual health counsellor in places like Soweto mean she is not surprised by the rising figures, she says.
“They confide to me that PrEP has freed them to discard condoms. It’s mind-boggling,” she says.
Gauteng’s manufacturing, townships, technical colleges and universities all give the province a youthful population.
“That makes Gauteng a perfect hotspot for casual, and transactional sex especially in the key 17 to 30 population band,” she says.
