In a BTA interview, obstetrician and gynaecologist Aleksandar Kobakov said that whether one will fall into a risk group for sexually transmitted infections (STI) depends solely on their behaviour and not on their age, gender or religion. Kobakov took part in a sexual and reproductive health prevention project within Sofia Municipality’s Europe Programme. Together with psychotherapist Elena Dimitrova, he discussed topics such as sexual and reproductive health, emotional maturity, sustainable relationships, contraception and unintended pregnancy with students from two schools in Sofia.
Kobakov said that the children had some knowledge of STIs thanks to their biology and health education classes and were curious to learn more about the human papillomavirus, which causes cervical cancer and is quite common among young people of reproductive age.
Human Papillomavirus Research and Vaccination
“Testing for human papillomavirus and other STIs is not accessible to young people because it is not free,” Kobakov said. “Only a small portion of biology classes are devoted to discussing some ways of prevention, there is almost no prophylaxis, and there are no mechanisms in the health care system that make it possible to get free testing for these infections,” he added. The gynaecologist found out that after his discussion with the students only one girl had gotten the jab. Kobakov noted that the 70% vaccination goal and low rates of cervical cancer morbidity and mortality can only be achieved through a good public awareness campaign. “Data was presented at the Bulgarian Association of Gynaecological Oncology’s congress, according to which the vaccination coverage against human papillomavirus in our country is 5-7%,” he added.
Sharing with Parents
Kobakov said that the boys appeared to be less intimidated to talk with them in front of their classmates than the girls, who approached them after the discussions. He stressed that there is a lack of parent-child communication on STIs, adding that children are often embarrassed to talk with their parents about having had sexual relations for fear of letting them down or being judged or ridiculed by their classmates.
Reproductive Health
“Over 145,000 couples in Bulgaria have reproductive issues. In half of those cases, when a couple cannot have a child, it is because of the man,” Kobakov said.
He also noted that as women reach the age of 35, their ovarian reserve decreases. He added that they tend to resort to in vitro fertilization as they are prone to chronic diseases and poor egg quality, which in turn can result in a damaged fetus.
Risk Factors for Reproductive Problems
Risk factors for reproductive problems include STIs, smoking, drug use, and any factors leading to an increase in testicular temperature in men or cooling of the lower back and abdomen in women. Occupations that involve sitting in a chair for long periods of time, behind a steering wheel, or working in a very warm environment and wearing very tight clothes pose a risk for altering spermatogenesis, the doctor added.
HIV Data
Health Ministry data for the first ten months of 2023 show that 277,759 people tested for HIV anonymously and free of charge. Since the beginning of the year, 228 people have been found to be HIV seropositive. The number of newly diagnosed HIV-positive men is many times greater than the number of women infected – a steady tendency in recent years. The ratio of infected men to infected women in 2023 is 4:1 (185 men and 43 women).
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