North Macedonia is facing a rise in cases of sexually transmitted diseases. In July alone, 25 new cases were registered, of which 11 were HIV/AIDS, 7 syphilis, 4 viral hepatitis B, and one case each of gonorrhea, chlamydia and viral hepatitis C. These are the latest figures from the Institute for Public Health.
Since 1987, a total of 765 HIV/AIDS cases have been registered in North Macedonia. Of these, 141 have died, 508 are currently living with HIV/AIDS, while 116 are considered lost to follow-up, having relocated.
We recall that exactly two years ago, the country registered its first HIV epidemic.
What are sexually transmitted infections?
Sexually transmitted infections are infections transmitted mainly through unprotected sexual contact, whether vaginal, anal or oral. They are caused by bacteria, viruses or other microorganisms.
Some show clear symptoms, while others can go unnoticed for a long time. Even a person without symptoms can transmit the infection to their partner.
When left untreated, these infections can cause serious health consequences. These include inflammation of the reproductive organs, fertility problems, complications during pregnancy, and an increased risk of certain types of cancer.
They can affect anyone, regardless of age or lifestyle. Early detection, proper treatment and prevention remain the best ways to protect your health, and that of your partners.
Below, we look at some of the most common sexually transmitted diseases, what they are, how they spread and how you can protect yourself against them. The information is based on data from the Institute for Public Health of North Macedonia
HPV (Human Papillomavirus)
Human papillomavirus (HPV) is one of the most common sexually transmitted infections. There are more than 100 different types of HPV. Some cause genital warts, while certain high-risk types can cause cellular changes that, if not monitored and treated, may lead to cancer.
HPV is most commonly associated with cervical cancer, but it can also be associated with other cancers, including cancers of the anus, penis, and mouth and throat.
HPV is most commonly transmitted through: sexual contact with an infected person; skin-to-skin contact in the genital area; less commonly, through other intimate contact.
The infection can also be transmitted when the infected person has no visible symptoms.
Most often, there are no symptoms. Some people may develop genital warts, or changes detected during a gynecological examination or Pap test.
Prevention: HPV vaccination; regular gynecological examinations and cervical cancer screening; condom use (reduces the risk but does not provide complete protection); awareness and responsible sexual behavior.
Chlamydia
Chlamydia is a bacterial sexually transmitted infection caused by the bacterium Chlamydia trachomatis. It is one of the most common bacterial STIs, particularly among young people. It is often referred to as a "silent infection" because many infected people have no symptoms.
It is transmitted through: unprotected sexual intercourse; contact with infected genital secretions; transmission from mother to newborn during childbirth.
In women, it may cause increased vaginal discharge, pain when urinating, lower abdominal pain, bleeding between menstrual periods.
In men, it may cause discharge from the penis, burning when urinating, pain or swelling in the testicular area.
Infeksioni i patrajtuar mund të çojë në: inflamacion të organeve të legenit; infertilitet; rritje të rrezikut për shtatzëni jashtë mitre.
Prevention: condom use; testing for people at risk; timely treatment; treatment of sexual partners to prevent reinfection.
Gonorrhea
Gonorrhea is a bacterial infection caused by Neisseria gonorrhoeae. It can affect the genitals, rectum, and throat.
In recent years, increasing antibiotic resistance has become a concern, making it particularly important that treatment be provided according to a doctor's recommendation.
It is transmitted through unprotected sexual contact; through contact with infected secretions; from mother to child during childbirth.
Symptoms may include pus-like or yellowish discharge, burning when urinating, lower abdominal pain, pain or inflammation in the testicular area. In many people, the infection may cause no symptoms.
Without treatment, gonorrhea can cause inflammation of the reproductive organs, fertility problems, spread of the infection to other parts of the body.
Prevention: condom use; testing; timely treatment; avoiding self-medication with antibiotics.
Syphilis
Syphilis is a bacterial sexually transmitted infection caused by the bacterium Treponema pallidum. The disease can develop through several stages and, if not detected and treated in time, can cause serious health consequences.
Syphilis can be successfully treated with appropriate antibiotic therapy, particularly when detected in its early stages.
Syphilis is most commonly transmitted through unprotected sexual contact; direct contact with skin or mucosal lesions of an infected person; transmission from mother to child during pregnancy (congenital syphilis).
Symptoms depend on the stage of the disease.
Primary stage: appearance of a painless sore or lesion at the site where the infection entered the body, swollen lymph nodes.
Secondary stage: skin rash, often including the palms of the hands and soles of the feet, fatigue, fever, swollen lymph nodes.
Later stages: if left untreated, the infection can damage the nervous system, heart, and other organs.
Prevention: condom use during sexual intercourse; regular testing for people at increased risk; early detection and treatment; testing during pregnancy according to the recommendations of healthcare professionals; treatment of sexual partners when necessary.
HIV (Human Immunodeficiency Virus)
HIV (Human Immunodeficiency Virus) is a virus that attacks the immune system, the body's natural defense against infections.
Without treatment, HIV can gradually weaken the immune system and lead to the development of AIDS (Acquired Immunodeficiency Syndrome). Today, thanks to modern antiretroviral therapy, people living with HIV can have long and healthy lives. Early detection and initiation of treatment are very important.
HIV can be transmitted through unprotected sexual contact with an infected person; contact with infected blood; sharing needles or other equipment among people who inject drugs; transmission from mother to child during pregnancy, childbirth, or breastfeeding if appropriate preventive measures are not taken.
HIV is NOT transmitted through shaking hands, hugging, or everyday contact; sharing eating utensils; coughing or sneezing; being in the same room with a person living with HIV.
During the early stage, flu-like symptoms may occur: fever, fatigue, muscle aches, swollen lymph nodes, rash. The infection may then remain without symptoms for a long time.
Prevention: condom use; regular HIV testing; use of sterile equipment during medical and other procedures; use of screened blood for transfusions; preventive and therapeutic measures according to healthcare professionals' recommendations.
Genital Herpes
Genital herpes is a viral infection most commonly caused by herpes simplex virus type 2 (HSV-2), but it can also be caused by HSV-1.
The virus remains in the body and may become active again. Treatment can help reduce symptoms and shorten the duration of active episodes.
It is transmitted through direct contact with the skin or mucous membranes of an infected person; sexual contact, including when there are no visible lesions; contact with active lesions caused by the virus.
Some people have no symptoms. Others may develop painful lesions or blisters in the genital area, itching or burning, pain when urinating, discomfort in the genital area, general weakness and fever during the first infection.
Prevention: condom use (reduces the risk); avoiding sexual contact when active lesions are present; informing your partner; consulting a doctor for appropriate treatment.
Hepatitis B
Hepatitis B is a viral infection caused by the hepatitis B virus (HBV), which affects the liver. The infection can be short-term (acute) or become chronic. Some people with chronic hepatitis B may develop serious liver disease.
The virus is transmitted through sexual contact with an infected person; contact with infected blood; sharing needles or equipment that may be contaminated; transmission from an infected mother to her newborn.
Many people have no symptoms. When symptoms occur, they may include fatigue, loss of appetite, nausea, abdominal pain, dark urine, yellowing of the skin and eyes.
Chronic hepatitis B can lead to liver cirrhosis, reduced liver function, an increased risk of liver cancer.
Prevention: hepatitis B vaccination (the most effective preventive measure); condom use; use of sterile medical equipment; avoiding sharing personal items that may be contaminated with blood, such as razors.
Where can you get tested?
Early testing remains the safest way to protect your health and that of your partners.
Centers for Public Health
Centers for Public Health in various cities across the country, including Skopje, Bitola, Kumanovo, Prilep, Kočani and Tetovo, offer voluntary HIV testing, in most cases free of charge and anonymous. For information and referral to the center nearest to where you live, you can contact the Institute for Public Health.
HERA, Youth Center "Sakam da znam"
Free and confidential testing for HIV and other sexually transmitted infections, with the option to book online as well. The physical service is located in Skopje, in Vodno.
HIV Center, "Zaedno Posilni"
Free testing every working day, no appointment needed. The only self-organized group of people living with HIV in the country, offering peer counseling.
- 7:30 to 13:00, every working day
- zp.mk
Early detection could save your life. If you've had risky contact or simply want peace of mind, don't hesitate to get tested. It is free, fast and, in most cases, anonymous.
General recommendations for preventing sexually transmitted infections
To reduce the risk of these infections, it is recommended to use condoms during sexual intercourse and to get tested regularly, especially for people with new or multiple sexual partners, as well as those who suspect they may have been exposed to an infection.
If symptoms appear, such as unusual discharge, burning during urination, pain in the genital area, or changes on the skin or mucous membranes, it is important to see a doctor as soon as possible. Antibiotics and other medications should not be taken without a doctor's recommendation.
Vaccination against HPV and hepatitis B remains one of the most effective preventive tools, while open communication with your partner and responsible sexual behavior remain just as important as physical protection itself.
This publication was produced within the framework of the project Queer and Present: Media, Rights and Safety for LGBTIQ+ persons in Pollog, which is implemented as part of the broader regional project Together for LGBTQI+ Equality, implemented by the Centre for Civic Education (CCE) in partnership with ERA – LGBTI Equal Rights Association for the Western Balkans and Turkey, Queer Montenegro, Queer Center Skopje, Tuzla Open Center, Open Mind Spectrum Albania (OMSA), and the Center for Social Group Development from Kosovo. The programme is funded by the European Union.
The contents of this publication are the sole responsibility of the Center for Equal Opportunities “Mollekuqja” and do not necessarily reflect the views of the European Union, CCE, or the project partners.
