The Infections That Strike Silently
Sexually transmitted infections are among the most common infections in Nigeria, yet they are among the least discussed — because of stigma, because symptoms are often absent, and because seeking help for a sexual health concern requires navigating significant social barriers. This silence has consequences. In Nigerian women, STIs cause pelvic inflammatory disease that leads to infertility. They cause ectopic pregnancies that kill. They drive cervical cancer, the second most common cancer killer in Nigerian women. And HIV — still highly prevalent in Nigeria — continues to take a disproportionate toll on young Nigerian women. None of this is inevitable. Every STI discussed here is either preventable, curable, or manageable — but only if it is known about.
The Four Most Important STIs to Understand
HIV (Human Immunodeficiency Virus) attacks the immune system over years, leaving the body progressively unable to fight off infections and certain cancers. Without treatment, it progresses to AIDS. With modern antiretroviral treatment (ART), people with HIV now live long, essentially normal lives. In Nigeria, approximately 1.9 million people are living with HIV — young women aged 15 to 24 are the group acquiring new infections most rapidly. HPV (Human Papillomavirus) is the most common STI in the world. Most infections clear without causing problems, but high-risk strains cause cervical cancer, as well as cancers of the vulva and throat. Low-risk strains cause genital warts. Chlamydia is caused by the bacterium Chlamydia trachomatis and is the most common bacterial STI. It infects the urethra, cervix, fallopian tubes, and rectum. It is almost always completely silent — no discharge, no pain, no fever — while quietly damaging the reproductive tract. A woman may discover she has untreated chlamydia only when she cannot conceive. Syphilis is caused by the bacterium Treponema pallidum and is re-emerging in Nigeria after years of decline. It begins with a painless sore (chancre) that heals on its own — many people think they are fine. In reality the infection has entered the body and, without treatment, progresses through stages that eventually damage the heart and brain. In pregnancy, untreated syphilis causes miscarriage, stillbirth, and severe congenital illness in the newborn.
Common Symptoms — But Remember, Many STIs Have None
- A sore, ulcer, blister, or wart on or near the genitals, anus, or mouth
- Unusual vaginal discharge — change in colour (yellow, green, grey), consistency, or a strong odour
- Burning or pain when urinating
- Pain during sex
- Pelvic pain or lower abdominal pain (sign that infection has spread to the reproductive organs)
- A rash — particularly on the palms of the hands and soles of the feet (a classic sign of secondary syphilis)
- Flu-like illness — fever, swollen glands, fatigue — shortly after a new sexual encounter (can be acute HIV)
- The most important message: the absence of symptoms does NOT mean the absence of infection. Testing is the only reliable way to know.
Who Should Get Tested?
- Anyone who has had unprotected sex with a new partner
- Anyone who has noticed any of the symptoms above
- All pregnant women — HIV and syphilis testing in pregnancy is essential and should be part of every antenatal visit
- Women who are HIV-positive — to screen for co-infections
- Women with unexplained pelvic pain, infertility, or recurrent miscarriages
- Anyone whose partner has been diagnosed with an STI
- Testing regularly is a responsible, normal part of being sexually active — it is not an indication of promiscuity
Prevention — Practical Steps
- Consistent, correct use of condoms significantly reduces the risk of all STIs including HIV
- Know your status and that of your partner — both of you should test before deciding to stop using condoms in a relationship
- HPV vaccine for girls aged 9 to 14, before sexual activity begins — this prevents the virus that causes cervical cancer
- PrEP (pre-exposure prophylaxis) — a daily tablet that prevents HIV — is available in Nigeria and highly effective for women at high risk
- Attend antenatal care where HIV and syphilis testing are routinely offered
- Treat partners — if you test positive for an STI, your partner(s) need to be tested and treated too, otherwise reinfection will occur
How Doc on Wheels Can Help
Doc on Wheels offers private, confidential STI testing arranged at your home — including HIV rapid tests, syphilis serology, and chlamydia screening. Our doctors can discuss your results with you, advise on next steps, and answer questions without judgement. If you are concerned about exposure, if you have symptoms, or if you simply want to know your status, reach out through the app. Your sexual health is your health.