MANILA—HIV could be the most talked about sexually transmitted disease but the most common STD is still gonorrhea, with genital molluscum contagiosum on the rise, a Filipino dermatologist said.

Dr. Gilbert Yang said it is more challenging to treat female patients because they have "silent infections" or "silent symptoms" since unlike their male counterparts, their genitals are internal.

Women with rashes or irritations on the skin will need to undergo tests to check if these are related to sexually transmitted illnesses.

Yang, a venereologist and male STD specialist, said he is most likely to treat 3 of 10 cases of gonorrhea at his skin and STD clinic in Ortigas.

"The most common (STD) actually is gonorrhea, urethral discharge, genital warts, herpes, syphilis.They rank among the higher... more people get them than HIV. But you see there's a lot of groups advocating HIV. Unfortunately, wala pang group na naga-advocate (tungkol sa) gonorrhea, syphilis and herpes. And these are quite common and they have a stigma," said Yang.

"In a random group of 10, based on my clinical practice, STDs include 3 gonorrhea, 2 genital warts, 2 cases of herpes, 1 case of HIV and 2 cases of other sexually transmitted infection, like Molluscum contagiosum," he added.

Molluscum contagiosum is common in children and is transmitted by incidental contact and the prevalence may be high, particularly in young children.

In adults, it is likely to be a sexually transmitted disease.

According to a World Health Organization (WHO) report in June, more than 1 million people worldwide contract sexually transmitted infections every day, namely chlamydia, gonorrhea, syphilis and trichomoniasis.

The report further revealed more than 290 women have human papillomavirus (HPV) and more than 500 million people are estimated to have genital infection with herpes simplex virus.

In the Philippines, however, the population with STIs other than HIV is unknown.

In 2011, the Philippine Dermatological Society began documenting cases of sexually transmitted infections. Syphilis, HPV, and HIV are found to be the most common infections in the country.

A study found that a total of 665 syphilis patients, 2,053 HPV-infected patients and 977 with herpes have been treated throughout the Philippines from 2011 to 2018.

Those who visit Yang's clinic who are diagnosed with STI or STD range from as young as 15 to 50.

It isn't just the physical visits that keep the skin doctor up around the clock, as he has been actively using social media to connect with patients.

He said there is a growing number of overseas Filipino workers hailing from Visayas and Mindanao who have been making queries.

"The most common concerns first is whether they have STI. Most of them really have STI and they would ask questions. I'd tell them to visit the clinic," Yang said.

"A number are curious. They want to know if they can get HIV through wiping the tears of someone."

"There are more than 30 sexually transmissible infections. HIV is just one of them. HIV is the most well advertised. It's not the most common," he added.

Some patients, however, are considered "anxious well" - they have no illness but have had sexual contact.

"Sometimes they do tests, 2 or 3 times and they still don't believe that they are negative. This is when they've had sexual contact and they just want to be screened," Yang said.

The dermatologist, who specializes in male STD treatments in his field, said he sometimes gets female patients in his clinic.

Yang said he does not turn them down but refers them to ob-gynes and obstetricians if necessary.

"If a male gets an STI, okay, we'll treat. We'll do the tests and treatable na. But for women, number 1, they don't have symptoms. They don't have discharge for gonorrhea. They have silent infections so I tell them let's confirm by doing a test," he said.

The venereologist said vaginal discharge can be due to a change in PH acidity or when the woman patient washes her vagina too much, which alters the odor. But sometimes it's due to infections so it's still best to be vigilant and take tests.

"Sa women kasi there's still something inside, which opens to the cavity and causes the inside of the body much more complication," he said.

Given the complexities surrounding potential infections, the dermatologist also encourages partners to get tested or get treatment. He warned that female patients could become infertile if they fail to treat STDs.

Yang said that while a lot of people come to his clinic, there is still a stigma in society about contracting a sexually transmitted illness.
Discrimination against LGBT community is also a challenge for some patients.

"I want to share to the Filipinos and the patients, huwag na kayong mahiya. A lot of OFWs think they're going to be deported and they actually fly here to get treated. I always tell them it's going to be confidential," he said.