Syphilis and other sexually transmitted infections in the Russian Federation.

The countries of the former Soviet Union are currently experiencing major epidemics of sexually transmitted infections (STIs). By 1997 rates of syphilis notification in the Russian Federation had risen to 277 per 100,000 total population, a 43-fold increase over 1989 levels, with rises proportionally larger among young women. Epidemics of gonorrhoea occurred earlier in Russia with official notification rates rising from 105 per 100,000 in 1987 to 232 per 100,000 in 1993; and exceeded one per 100 among both young men and young women in that year. The true incidence of gonorrhoea is certainly much higher. These STI epidemics cause direct suffering and may be important in significantly enhancing the transmission of human immunodeficiency virus (HIV), in the context of liberalization of sexual behaviour, and epidemics of injecting drug use and related HIV transmission. This paper reviews recent epidemiological trends in syphilis and other STIs in Russia against the background of existing mechanisms for the control of these infections.