DEVELOPMENT BULLETIN-CIS: Sexually Transmitted Disease Sweeps Ex- Soviet Union

By IPS Correspondents Reprint | | Print |

Andrei Ivanov

MOSCOW, May 30 1998 (IPS) - While the rapidly rising incidence of HIV infection and AIDS in the former Soviet Union causes much concern, it is only one of a range of sexually transmitted diseases (STDs) which are currently engulfing the region.

A dramatic increase in the number of syphilis cases in Russia, for example, is posing problems for lawmakers and health officials. According to the Russian Health Ministry, around 450,000 cases were registered in 1997 alone, almost 200,000 more than in 1 995. This compares with just 7,900 new cases in 1990.

“This could become a problem for the whole of Russia,” says Aleftina Aparina, of the Committee for Children and Family Affairs in the State Duma (parliament). She points out that the official figures to not reflect the real situation “because many peo ple do not even know they are infected”.

The problem is particularly acute in northern Russia. Even more disturbing is the fact that those affected are getting younger. “Each year we register more and more cases where children under 14 are suffering from this disease,” she says.

Eduard Sarkisov, a member of the Russian Academy of Medical Sciences says the rate of spread is “frightening”. Over the past 10 years the number of cases reported annually has increased 40- fold.

Health officials blame economic hardship for the spread of the disease. Boris Andreyev, a doctor at Moscow’s Botkinskaya hospital, explains that for most Russians financial problems take precedence over health considerations.Ad the government has no fu nds to combat the problem.

In the early days of the Soviet era the state had programmes targeting syphilis. “With the help of police, we could force an infected person to be treated, but now all we can do is tell them they have it,” Andreyev says.

While syphilis is not always life-threatening, it is extremely dangerous. It can produce small genital sores, but often goes unnoticed in women.

If left untreated, it can lapse into a latent stage that can persist for years. But secondary syphilis can then develop in the form of severe damage to the central nervous system, lesions of the heart, skin or bones and eventually death, usually owing to brain damage.

In Ukraine, the spread of STDs is an epidemic of the young. The syphilis rate among the over-30s now stands at around 180 cases per 100,000, according to the Ministry of Health. For girls under 1, however, the rate is 600 cases per 100,000, while for 15 – to 16-year-old girls it ranges between 1,550 and 2,000 pe00,000. Tis is largely the result of teenage prostitution.

About 2,000 girls work as prostitutes in Odessa in the winter, according to psychologist Valeri Kiunov, who has investigated the sex trade for UNAIDS and Odessa State University. But in the summer, the prostitute population more than doubles.

Kiunov has identified six categories of prostitutes. The youngest girls, aged 11 to 17, mainly work by flagging down customers on the streets after school two or three times a week. They typically earn 40 to 50 dollars a week and use condoms.

A second group, averaging 26 years of age, works through female pimps and tends to have steady customers. Kiunov says two-thirds of these women have had at least one STD in the past three years.

Members of the poorest groups congregate around factories and large workplaces, and take on 20 to 40 clients a week. The mean age of the group is 19, and they account for more than half of Odessa’s sex workers.

“The can’t afford condoms (which cost 25 cents each),” says Kiunov “and when you talk to them about ‘safe sex’ they think it means avoiding getting beaten up”.

In the Republic of Moldova, it is estimated that more than a third of the growing population of homeless children in Chisinau city are infected with syphilis. The number of new cases in the Republic rose from under 700 in 1990 to almost 9,000 in 1996.

AWell Woman’s Clinic opened in Chisinau last year to creen women for STDs, and testing for syphilis is now mandatory by law, which may lead to a ight decrease in number of cases this year, according to the clinic’s director, Boris Gilca.

But STDs still carry a stigma which deters people from seeking help. “Sometimes they don’t contact a doctor for treatment and use self-treatment which may have serious consequences,” Gilca says.

Throughout the former Soviet states, prostitution has become the industry of last resort in face of economic colapse and unemployment. For some in Moscow and Odessa, Tbilisi, Novosibirsk and Irkutsk, it means survival. For others it has become big busin ess.

Multinational crime syndicates regularly bring thousands of girls (and sometimes boys) from the poorest areas in the former Communist world to areas that share borders with western European and Middle Eastern countries, explains Marco Gramegna of the Int ernational Organisation of Migration.

He estimates that half a million women from theformer Soviet Union had been smuggled into western Europe and forced into prostitution by 1995. “The scale of the operation has escalated since ten, with up to 300,000 more women trafficked into western E urope annually, mostly from Russia and Ukraine,” he says.

In the Baltic states young women are recruited to service customers from Finland, Norway and Sweden. Health officials estimate that 2,000 Estonians work as prostitutes in Helsinki.

The Deaconess Institute of Helsinki, a government-financed medical research facility, says syphilis rates among Estonian prostitutes increased 16-fold from 1990 to 95, when the rate reached 852 cases per 100,000. And the gonorrhoea rate doubled, to mor e than 3,000 cases per 100,000.

Efforts are being made to stem the tide of infection, however. In Moscow, Saviour’s Hospital for Peace and Charity has launched various programmes aimed at young women at risk.

The 2,300 adolescents who visit the centre each year are screened for a number of STDs and given condoms. Educators from Saviour’s also travel to Moscow schools to teach teenagers about safe sex and reproductive health.

Melissa Zahniser, programme co-ordinator for Magee Womancare International, which works closely with the centre, says that though a strong network of women’s health centres may slow the spread of STDs, men also have to get involved if the problem is to b e tackled effectively.

“Often they want to keep the problem under wraps. And services have not been as planned out as they have been for women,” she says.

“But if you want to make sure the same people aren’t getting reinfected, you’ve got to make sure that both partners are diagnosed and treated, and that they learn about precautions.”