Sexually Transmitted Diseases in Ukraine.To the Editor: With the political changes in eastern Europe Eastern Europe The countries of eastern Europe, especially those that were allied with the USSR in the Warsaw Pact, which was established in 1955 and dissolved in 1991. in the last 10 years have come social and economic changes (1). Ukraine not only faces almost insurmountable problems as it tries to form a new government, it also faces many serious health issues including sexually transmitted diseases Sexually transmitted diseases Infections that are acquired and transmitted by sexual contact. Although virtually any infection may be transmitted during intimate contact, the term sexually transmitted disease is restricted to conditions that are largely (STDs). Surveillance data from the Ukrainian STD (Subscriber Trunk Dialing) Long distance dialing outside of the U.S. that does not require operator intervention. STD prefix codes are required and billing is based on call units, which are a fixed amount of money in the currency of that country. Center from January 1, 1989, through December 31, 1995, were analyzed on the basis of reports received through 1997. In western Europe, the incidence of syphilis and gonorrhea gonorrhea (gŏnərē`ə), common infectious disease caused by a bacterium (Neisseria gonorrhoeae), involving chiefly the mucous membranes of the genitourinary tract. declined from 1980 to 1991 to less than 2% per 100,000 persons for syphilis and less than 20% per 100,000 persons for gonorrhea. However, in Ukraine, since 1989, the notification rate of syphilis has skyrocketed--from 5 per 100,000 persons in 1990 to 170 in 1995. In some regions, this rate exceeds 220 cases per 100,000 persons. Moreover, cases among children younger than 14 years of age are also increasing. In 1995, the syphilis rate for persons older than 30 years of age was 170 per 100,000; 600 per 100,000 girls younger than 15 years of age; and 1,550 to 2,000 per 100,000 girls 15 to 16 years of age. The large number of girls with the disease is in part due to teenage prostitution (1). Most syphilis and gonorrhea cases are attributed to sexual transmission. Explanations of this phenomenon include the rapid growth of the sex industry, increasing numbers of homeless persons and refugees in Ukrainian cities, poor diagnostic facilities, punitive legislation that reduces the likelihood of going to treatment services, and limited or inadequate treatment (2). The Ukrainian government is reviewing its arrangements for the control of STDs, including HIV/AIDS HIV/AIDS Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome , to identify clear objectives and priorities. Education and treatment would be effective in preventing the spread of STDs in Ukraine, but these measures are inadequately funded (3). Evaluation and risk reduction are also great weapons in preventing the spread of STDs (4). However, the response of the local and world communities has been inadequate in stemming a major STD epidemic in Ukraine. United Nation's Children's Fund (UNICEF UNICEF (y  `nĭsĕf'), the United Nations Children's Fund, an affiliated agency of the United Nations. ) is developing a long-term program in Ukraine with a focus on STDs in adolescents and youth. This comprehensive program will tackle not only STDs but other related issues, such as HIV HIV (Human Immunodeficiency Virus), either of two closely related retroviruses that invade T-helper lymphocytes and are responsible for AIDS. There are two types of HIV: HIV-1 and HIV-2. HIV-1 is responsible for the vast majority of AIDS in the United States. and teenagers' reproductive health (5). Greater coordination of the agencies responsible for STD control in Ukraine will be sought, together with an expansion of health promotion and prevention projects for young persons and groups at high risk (6). An effective strategy for the control of STDs in Ukraine will, therefore, need to find ways to modify current programs and the way they interact to create effective control interventions. References (1.) Dittmann S, Gromyko A, Mikkelsen H, Schaumburg A, Adamian R, Khodakevich L, et al. Epidemic of sexually transmitted diseases in eastern Europe. Geneva Geneva, canton and city, Switzerland Geneva (jənē`və), Fr. Genève, canton (1990 pop. 373,019), 109 sq mi (282 sq km), SW Switzerland, surrounding the southwest tip of the Lake of Geneva. : World Health Organization; 1996. (2.) Kobyshcha Y. HIV risk-related behavior of homo and bisexual men and STD patients in Ukraine. National AIDS Committee and Center 1994;7:290-3. (3.) Normand J, Vlahov D, Moses LE. Preventing HIV transmission: the role of sterile needles and bleach. The effects of needle exchange programs needle exchange program Syringe exchange program Public health Any program intended to slow the spread of AIDS among IV drug users, in which a governmental or charitable agency exchanges sterile needles for dirty, potentially HIV-contaminated needles used by IVDAs . Washington: National Academy Press; 1995. p. 208-55. (4.) Spinhenko Y. Prevention of the spread of AIDS in the Ukrainian SSR. Lik Sprava 1988;9:1-3. (5.) Usenko A, Grazhdanov N, Stepanets V, Neshcheret E, Maksiutenko E. Effective knowledge propaganda in the chief strategy for preventing HIV infection among adolescents. Lik Sprava 1994;9:192-6. (6.) Tichonova L, Borisenko K, Ward H, Meheus A, Gromyko A, Renton A, et al. Epidemics of syphilis in the Russian Federation: trends, origins, and priorities for control. Lancet 1997;350:210-3. Dmitry I. Ivanov University of Alabama at Birmingham UAB began in 1936 as the Birmingham Extension Center of the University of Alabama. Because of the rapid growth of the Birmingham area, it was decided that an extension program for students who had difficulties which prevented them from studying in Tuscaloosa was needed. , Birmingham, Alabama, USA |
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