Important note: Information in this article was accurate in 1996. The state of the art may have changed since the publication date.

Reuters NewMedia, Inc. - 10 July 1996
Sarah Edmonds / Reuters

Syphilis and several other sexually transmitted diseases (STDs) are raging through many of the former Soviet republics, and experts fear HIV -- now at a very low level relative to the rest of the world -- will mirror this trend soon.

"This is (a) very open gate to the HIV. That kind of unlimited sexual relations, unsafe sex, high prostitution, early age of sexual relations, is also a determinant for HIV," Alex Gromyko, adviser on HIV and AIDS for the region at the World Health Organisation, told reporters after a session this week at the 11th International Conference on AIDS.

"With that kind of STD epidemic, if sustained for two to three years, I am quite sure that with huge prostitution ... inevitably there would be big rise in HIV," he added.

The danger is worsened by a lack of co-ordinated health education programmes aimed at high-risk groups in the former Soviet Bloc countries, said the Lithuanian National AIDS Co-ordinator Dr. Saulius Caplinskas.

"We have ... a trend of drug abusers. Generally drug abuse is growing, they are becoming younger, and we don't have practice in how to work with them," Caplinskas said, adding that drug users often shared needles and seldom wore condoms.

"Then we have another trend with (the epidemic of) sexually transmitted diseases, a tremendous one. And then we have (a) third problem ... we don't have any health promotion, health education programmes and experience.

Furthermore, condoms are expensive, often poorly made and not given out free by government agencies to high-risk groups such as homosexuals and drug users.

Gromyko told reporters STDs were a big problem in many of the countries of the former Soviet Union while neighbours like Hungary or the Czech Republic have STD rates similar to Western Europe -- less than two per 100,000 population.

In Russia, the rate of syphilis has shot up to 172 cases for every 100,000 people from roughly five for every 100,000 in 1990. HIV infection levels are low in contrast -- just five per 100,000 versus Western Europe's 50-100 for every 100,000.

Because HIV takes longer to appear than less-lethal STDs and because until a few years ago the Iron Curtain shielded Eastern Europe from many of the Western ills, it may take a few more years before the extent of the damage is known.

More easily treated gonorrhea has decreased, but Gromyko said this was probably due to private, unregistered doctors prescribing antibiotics for sufferers. This black-market medicine may also mean the rest of the STDs are under-reported.

A Swedish doctor who has studied the region said HIV was likely to increase dramatically in just a couple of years.

"When you find this increase in syphilis, that means that people must make love in an enormous way and spread diseases," said Dr. Thomas Linglof of the department of infectious diseases at the Uppsala University Hospital in Sweden.

"When it gets into the population of prostitutes, it will be a catastrophe if nothing gets done," he added.

Drug use will likely be a major contributor to the crisis. In the Ukraine, the rate of HIV-infected drug users has leapt from nearly zero in 1994 to 2,300 in April. In 1995, 1,021 new drug users infected with HIV were identified and in the first four months of 1996, another 1,805 were found.

Condoms are expensive and those manufactured domestically are often poorly made. They cost from 280 to 2,900 roubles while an average monthly salary in Moscow of 300,000 to 500,000 roubles. Students earn up to 100,000 roubles per month.

In addition, barrier protection is not given out free to high-risk groups by any government agency, said Vadim Pokrovsky, director of the federal centre for AIDS control in Russia. Just 30 percent of Russian homosexuals and 15 to 20 percent of heterosexuals use condoms on a regular basis.

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