⚡ Key Highlights & Quick Takeaways
- HIV is no longer a word that frightens young people.
- However, these figures do not capture the full picture, as Keralam does not have routine STI surveillance across public and private hospitals.
- STIs also rarely figure in formal public health conversations.
HIV is no longer a word that frightens young people. For a generation that has grown up seeing HIV transformed from a feared death sentence into a manageable chronic condition, the virus no longer carries the deterrent power it once did.
But the fading fear of HIV is confronting Keralam with a new public-health challenge. Changing sexual behaviour, gaps in information and awareness, and growing substance use are increasingly putting young people at risk of sexually transmitted infections (STIs).
The numbers seeking care at the 23 District STI/RTI Centres (DSRCs) under the Kerala State AIDS Control Society (KSACS) have been rising steadily. However, these figures do not capture the full picture, as Keralam does not have routine STI surveillance across public and private hospitals. STIs also rarely figure in formal public health conversations.
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World Sexual Health Day
On World Sexual Health Day (September 4), experts say Keralam needs more open conversations with young people about sexual health, safe sexual practices, consent and healthy relationships. Equally important is ensuring that youngsters know where they can seek confidential testing, advice and treatment without fear of judgement.
KSACS data compiled up to December 2025 show that attendance at DSRCs rose from 41,417 in 2023-24 to 63,129 in 2024-25. Another 51,243 people visited the clinics during April-November 2025 alone.
New HIV infections going up steadily in 15-24 year group in Kerala
The proportion of DSRC clients undergoing RPR screening for syphilis also increased—from 55% in 2023-24 to 70% in 2024-25 and 79% during April-November 2025. The increase in screening means more infections are being detected, and the figures cannot by themselves be taken as evidence of a corresponding rise in prevalence.
Of particular concern is the increase among younger clients. Among those aged up to 19, clinic attendance rose from 1,547 in 2023-24 to 2,255 in 2024-25; another 1,910 had been recorded during April-November 2025. The proportion of newly detected HIV infections among those aged 15-24 also rose from 10% in 2022-23 to 15% during April-October 2025.
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Change in societal attitudes
“There is a change in societal attitudes towards casual sex and today, the earlier message of abstinence that we used to give youngsters no longer works. Many youngsters are sexually active today and our only message to them is to remain safe, because their health is at stake,” a senior Health Department official said.
Being safe goes beyond HIV prevention. Condoms significantly reduce the risk of many STIs, including HIV, gonorrhoea and chlamydia, but do not eliminate the risk of infections such as syphilis, HPV and genital herpes, which can spread through skin-to-skin contact. HPV and hepatitis B vaccination, regular testing, timely treatment and reducing exposure to multiple or unknown partners are also important.
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Consent and communication also need to be part of sexual-health messaging. Being safe means being able to say no, respecting a partner’s decision and discussing protection before sex.
Substance use among young people is another concern for sexual-health professionals, who say intoxication can increase risky sexual behaviour and impair the ability to make informed decisions.
Testing is crucial
“One of the most important messages we can give youth today is that testing matters, even without symptoms. Many STIs cause no symptoms, so someone can have and transmit an infection without knowing it. Testing becomes particularly important after a potential exposure or when starting a new sexual relationship,” said V. Sam Prasad, who heads AHF India Cares, an NGO working in HIV.
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Keralam’s STI clinics are seeing a range of infections, with syphilis emerging as a particular concern. Doctors also report a resurgence of gonorrhoea, which they say is increasingly being encountered in clinical practice.
KSACS data show that clients found reactive for syphilis on screening increased from 1,206 in 2023-24 to 1,455 in 2024-25, with another 1,121 recorded during the first seven months of 2025-26.
Complicated infections
“We are quite concerned that some STIs are now presenting differently and with serious complications. We have had reports of neurosyphilis, ocular syphilis and cardiovascular syphilis, which are complicated and require long and intensive treatment,” a Health official said.
At STI clinics, young people diagnosed with an infection are encouraged to bring their partners for testing to prevent reinfection. They are also advised to complete treatment and undergo HIV testing, given the close relationship between HIV and other STIs.
Self-assessment tool
To encourage confidential testing, KSACS has launched a digital self-assessment tool through which users can privately assess their sexual-health risk. By scanning a QR code and answering questions about lifestyle and behavioural practices, users receive guidance on whether testing may be advisable, along with information on the next steps and the nearest STI clinic.