Epidemics of syphilis in the Russian Federation

Abstract

Tichonova and colleagues' report on the epidemic of syphilis in the Russian Federation (July 19, p 210)1Tichonova L Borisenko K Ward H Meheus A Gromyko A Renton A Epidemics of syphilis in the Russian Federation: trends, origins, and priorities for control.Lancet. 1997; 350: 210-213Summary Full Text Full Text PDF PubMed Scopus (175) Google Scholar is admirable. In the past 5 years I have been invited to Russia on two occasions by the Russian Association Against STD (SANAM) and have visited Poland, Hungary, and the former East Germany to view facilities for sexually transmitted diseases (STDs). Other factors not mentioned by Tichonova and co-workers are important in the increase of STDs.In these countries there was no free flow of information so the climate did not exist for the discussion of healthy sexuality which would enable young people, prostitutes, and homosexual men to liaise with health professionals. Condoms have not been easily available. Although some specialists in Russia are highly motivated, most are poorly skilled by western standards, often in dead-end jobs and using ancient techniques. Many scientific advances have not been disseminated. Although the use of benzathine penicillin is mentioned, I have seen outmoded penicillin regimens administered that require patients to be admitted and incarcerated for weeks on end.Difficult political times have also meant that senior specialists and opinion makers have been cautious about what they are willing to say about the epidemics. The epidemic is not only in Russia, my personal observation in Eastern Poland in September, 1996, suggests that it is spreading rapidly, together with HIV, into neighbouring countries. The community of health professions in the west need to respond urgently to this crisis and co-operate in essential help. Tichonova and colleagues' report on the epidemic of syphilis in the Russian Federation (July 19, p 210)1Tichonova L Borisenko K Ward H Meheus A Gromyko A Renton A Epidemics of syphilis in the Russian Federation: trends, origins, and priorities for control.Lancet. 1997; 350: 210-213Summary Full Text Full Text PDF PubMed Scopus (175) Google Scholar is admirable. In the past 5 years I have been invited to Russia on two occasions by the Russian Association Against STD (SANAM) and have visited Poland, Hungary, and the former East Germany to view facilities for sexually transmitted diseases (STDs). Other factors not mentioned by Tichonova and co-workers are important in the increase of STDs. In these countries there was no free flow of information so the climate did not exist for the discussion of healthy sexuality which would enable young people, prostitutes, and homosexual men to liaise with health professionals. Condoms have not been easily available. Although some specialists in Russia are highly motivated, most are poorly skilled by western standards, often in dead-end jobs and using ancient techniques. Many scientific advances have not been disseminated. Although the use of benzathine penicillin is mentioned, I have seen outmoded penicillin regimens administered that require patients to be admitted and incarcerated for weeks on end. Difficult political times have also meant that senior specialists and opinion makers have been cautious about what they are willing to say about the epidemics. The epidemic is not only in Russia, my personal observation in Eastern Poland in September, 1996, suggests that it is spreading rapidly, together with HIV, into neighbouring countries. The community of health professions in the west need to respond urgently to this crisis and co-operate in essential help.