One night, on his 19th birthday, a young man went to Devil Street in Lilongwe. He was in the company of mischievous boys who knew every corner of the city. They coaxed him into joining them at a popular nightclub.
Nineteen-year-old Dave walked into the dimly lit club, where women in revealing clothes moved between tables, flirting with men. A popular tune was playing. People were playing pool. From the top floor, the lights of the city could be seen below.
It was Dave's birthday, and he was having a good time.
His friends started teasing him about being a virgin.
Then a girl about his age walked past. She smiled at him. A few moments later, she came back and said hello. They hit it off. She took him by the hand into a room behind the club.
But Dave had been drinking Malawi gin and tonic. He was laughing, swaying to the music and, without thinking about the consequences, had unprotected sex with her while the music continued to play in the nightclub outside.
Five days later, Dave found himself in my clinic.
His mother had brought him in. She was angry.
“Iwe fotokoza!” she demanded.
For the past five days, he had been experiencing severe pain when urinating and had noticed pus-like discharge from his penis.
I asked his mother to leave us. That was when Dave told me the whole story.
We sat for some time as I listened. We talked about condoms, HIV, PrEP and sexually transmitted infections. His HIV test was negative. He repeated the test months later and remained negative.
But he had acquired an STI.
We treated him, and after a couple of follow-up visits, the symptoms eventually disappeared.
I remembered this story today because Dave recently texted me and asked, “Why don't you share my story?”
So I thought, why not?
In the era of PrEP, when people understandably feel more protected against HIV, it is important to remember something simple: PrEP protects against HIV. It does not protect you against most other sexually transmitted infections.
Condoms still matter.
Having fewer sexual partners reduces your risk. Regular STI testing matters. And, perhaps most importantly, alcohol can impair judgement. When you are drunk, you may make decisions that sober you would never make.
So, if you find yourself in a nightclub, celebrating your birthday, surrounded by friends encouraging you to do something foolish, remember Dave.
Enjoy yourself.
But protect yourself too.
Goodnight.