“Chlamydia is a major problem in Samoa with a high prevalence in pregnant women, who are supposed to be low risk for the disease.”
This is according to the Ministry of Health’s sixth annual report to UNAIDS. Obtained by the Samoa Observer, the report is evidence of Samoa’s commitment to the global response to HIV, AIDS, and Sexual Transmitted Infection’s.
According to the Health’s report of 2,025 individuals tested at hospitals and health clinics in 2015, 26% had Chlamydia.
“This rate is made up of predominantly antenatal women. “The prevalence may be higher in rural areas with one study with women age 18-29 estimating a prevalence of 36.7%,” the report reads.
“Chlamydia also has a low testing rate for the general population (only 1% in 2015).” Furthermore the Health’s report says that Sexual Transmitted Disease’s generally have low voluntary testing rates.
“Chlamydia, has the highest prevalence, yet it also has the low testing rate. “Testing stopped in 2016, due to stock-outs of testing kits. “This is a particular concern considering that a high prevalence of 26% is detected in only 1% of the population.
Testing coverage is also decreasing,” said the Health’s report. Aside from chlamydia, Samoa also faces challenges in sexual health regarding Gonorrhea, Syphilis, and Hepatitis B&C.
“Chlamydia is more prevalent in men (31% compared to 25% in females in 2014)."
“Ages 15-24 represented 26.3% of all Chlamydia infections in 2015, which suggests youth are at particular risk. “Chlamydia if left untreated can lead to sterility and blindness (for infants born to mothers with Chlamydia).”
The Health’s report says that Syphilis, though lower in prevalence than Chlamydia, is increasing from 0.3% detected infections from NHS testing in 2014 and 2015 to 0.9% in 2016.
“Hepatitis B is the second highest STI prevalence to Chlamydia, and remains as such despite a slight decrease in cases from 2013-2015 (2.5% to 2.0% respectively).
“This rate has increased to 2.4% in 2016.”
The Health report indicates that “multiple factors, including stigma around sexual health, low access to condoms, confidentiality concerns, and stigma around the prevention and treatment of STI’s all pose challenges to addressing STI prevalence and encouraging regular testing.”
The Health’s report also points out that gender violence may also play a role in exacerbating the health burden of STI’s.
“Many women in Samoa feel domestic violence is justified with 70% stating it is permissible for a husband to beat his wife if she is unfaithful to him, doesn’t do housework, or disobeys him (State of Human Rights Report 2015).
“A multi-country study conducted by WHO(World Health Organization) from 2000-2003 found that in Samoa that 10% of all women who had ever been pregnant were beaten during at least one pregnancy. “Among women that were ever physically abused in their lifetime, 24% reported the abuse occurred during pregnancy.
“In 96% of those cases, the perpetrator was the father of the child.
“In terms of the health of these women, abused women who had ever been pregnant were significantly more likely to have had stillborn children (16% versus 10%) and miscarriages (15% versus 8%).”
The report notes that 26% of ANC women tested positive for chlamydia in 2015. “There is likely related to the high prevalence of domestic violence, as women in abusive relationships are not able to demand condom use for fear of further violence.
“Accessing treatment is also met with stigma. Despite the high prevalence of Chlamydia, the actual figure is likely higher, as only 2,822 out of an estimated 9616 (29.3%) pregnant women reported for ANC visits and were screened for STI’s in 2015.
“This rate increased to 46.9% of ANC females being screened for STI’s in 2016, but this progress needs to be sustained and expanded.”