Manzini Region recorded the highest number of sexually transmitted infections (STI) cases in the country last year, accounting for one in every three infections reported nationwide.
This is according to the ministry of health’s annual report. The report shows that a total of 25,604 STI cases were recorded across the country during the year under review. Of these, Manzini accounted for 8,442 cases, representing 33% of the national burden and making it the hardest-hit region.
The surge in infections in Manzini was followed by Hhohho, which recorded 7,028 cases, while Lubombo reported 5,051 cases and Shiselweni registered 5,083 cases.
It was noted that the figures continue to demonstrate that sexually transmitted infections remain a significant public health concern despite ongoing prevention and treatment efforts. The report reveals that young adults continue to carry the greatest burden of infections, with the highest number of STI cases recorded among people aged between 20 and 29 years.
This age group accounted for the largest share of reported infections across both males and females. Data presented during the dissemination meeting showed that women tend to be diagnosed with STIs at younger ages than men, with infections peaking among females aged 20 to 24 years. Among males, the highest number of infections was reported in the 25 to 29 age group.
The trend suggests that young women remain particularly vulnerable to sexual and reproductive health challenges, including early sexual debut, inconsistent condom use, unequal power dynamics in relationships and exposure to multiple sexual partners. The report further indicates that STI cases were recorded across all age groups, including adolescents and older adults, demonstrating that sexual health interventions need to target the entire population and not only young people.
According to the ministry of health, the continued high burden of STIs also increases the risk of HIV transmission, as untreated sexually transmitted infections can make individuals more susceptible to acquiring or transmitting HIV.
The report states that the country’s STI programme continues to provide screening, diagnosis and treatment services through health facilities nationwide. Efforts have also been made to integrate STI services with broader sexual and reproductive health programmes to improve access and encourage early treatment.
Also, the report highlighted the importance of health education, partner notification and treatment adherence in controlling the spread of infections. It states that untreated STIs can result in serious complications, including infertility, chronic pelvic pain, pregnancy complications and adverse birth outcomes.
Despite the high number of cases recorded, health authorities believe increased reporting may also reflect improved access to testing and treatment services, enabling more people to seek care and receive timely diagnosis.
The ministry of health says continued public awareness campaigns, condom promotion, youth-friendly health services and expanded STI screening will remain critical in reducing infections and protecting vulnerable populations. It was also stressed that there was a need for communities, parents, schools and healthcare providers to strengthen sexual health education and encourage responsible health-seeking behaviour among young people.
Reliance on PrEP, no condom use a catalyst – NERCHA
The growing reliance on Pre-Exposure Prophylaxis (PrEP) coupled with declining condom use is contributing to the continued spread of sexually transmitted infections (STIs) in the country, says National Emergency Response Council on HIV/AIDS (NERCHA) Information Centre Manager Sibusiso Ngubane.
Ngubane made the remarks following the Ministry of Health’s 2025 Annual Report Dissemination Meeting, where data showed that more than 25,000 STI cases were recorded across the country during the year under review. He said observations from HIV prevention programmes suggest that people have focused more on preventing HIV infection while paying less attention to other sexually transmitted infections.
“We are seeing reduced condom use because some people are now relying on PrEP. People are more worried about contracting HIV than other diseases, including STIs,” said Ngubane.
PrEP is a medication taken by HIV-negative individuals to reduce their risk of acquiring HIV. While it is highly effective in preventing HIV when taken correctly, it does not protect against other sexually transmitted infections such as syphilis, gonorrhoea and chlamydia.
Ngubane said the rise in STI cases cannot be viewed in isolation as there are underlying social and economic factors that influence people’s ability to negotiate safer sex practices. He pointed to gender-based violence, unequal power dynamics in relationships and poverty as some of the factors that continue to place individuals, particularly women and young girls, at risk.
He stated that there were people who find themselves unable to insist on condom use because of their circumstances. Gender-based violence, economic dependence and poverty can force people to do what pleases the other person in order to receive support in return.
Ngubane stressed that while PrEP remained an important HIV prevention tool, it should not be viewed as a substitute for other prevention methods. He said NERCHA continues to promote comprehensive HIV prevention strategies that combine multiple interventions to provide broader protection against both HIV and other sexually transmitted infections.
“We encourage combination prevention for both HIV and other diseases, including STIs. People should not depend solely on PrEP,” he said.
Ngubane urged the public to continue using condoms consistently and correctly, undergo regular HIV and STI testing and seek treatment early when symptoms develop. He said reducing new infections would require collective effort involving individuals and communities, adding that prevention remains one of the most effective tools in the fight against HIV and sexually transmitted infections
