A survey on the sexually transmitted disease (STD) incidence in the rural region of Chatlon was conducted by the Republican Reproductive Health Center as part of the agreement between the Government of Tajikistan and WHO for the implementation of the United Nations Population Fund (UNFPA) project "Improving Reproductive Health Services and Access to Family Planning." Some 1034 women answered the questionnaire on all aspects of STDs; 400 women were physically examined, and 200 blood specimens were tested for syphilis, hepatitis B and C, and HIV. 75.7% of the examined cases revealed a variety of STDs: trichomoniasis (25.3%), candidosis (17.9%), chlamydia trachomatis (14.9%), syphilis (5.6%), gonorrhea (.2%), and hepatitis B virus (.2%). STDs were most commonly found in the 21-39 age group; the lowest rate (1.89% of the cases) was found among women with a high educational level. Investigations also showed a low awareness of STDs among the population: 72% of those questioned knew nothing about STDs, while 62.8% of all housewives in the survey group knew nothing to prevent STDs. Furthermore, STD screening of the 17-20 age group revealed that 30% had genital skin changes, while 77.7% of the 19-20 age group had vaginal discharges. The results confirmed that there was a high prevalence of STDs in Tajikistan, suggesting that there was a need to promote urgent social and medical remedies. Three main goals for combating STDs are outlined: 1) to improve quality of life, 2) to decrease the risk of infection through primary prevention, and 3) to diagnose and provide early treatment to people who are infected with curable forms of STDs.
This article outlines the measures undertaken by the Government of Kyrgyz Republic to combat the STD epidemic, particularly syphilis, which has plagued the country since 1991. A decree entitled "Emergency Situation Due to the STD Epidemic" was adopted on June 30, 1997. The policies encompassed and encouraged by the decree are enumerated as follows: widespread implementation of the outpatient approach for syphilis treatment, which has already increased the percentage of patients treated as outpatients from 9.2% in 1995 to 49.4% in 1997, the expansion of the anonymous examination and treatment that has been provided in all Dermatology and STD clinics since 1996, Broad use of mass media for popularization of safe sex principles (so far this has included a hot line service for consultation on STD and AIDS issues and the distribution of 50,000 leaflets, brochures and booklets), and increased financing for STD services. The article closes by mentioning the opening of the Center on STD Care for Sex Workers at the Dermatology and STD Clinic. At the Center sex workers will be treated to prevent the spread of STDs and trained on the principles of safe commercial sex.
The alarming increase of STDs, particularly syphilis (from 378 cases in 1990 to 2520 cases in 1997), has been identified as a high priority area in Bulgaria, where Doctors Without Borders has been working since 1997. In July 1998, DWB Switzerland set up a pilot project that supported the implementation of an innovative treatment procedure and encouraged the Bulgarian Minister of Health to adopt a new ordinance on syphilis treatment. The treatment procedure is recommended by WHO and is based on delayed-release penicillin; it is less expensive and requires no hospitalization, which makes it more acceptable to patients. An assessment conducted in January 1999 to evaluate the evolution of the project showed that of the total 274 patients treated, approximately half of them were in the primary stage, which indicates a high incidence of primo-infections. An increase in the cost of treatment was noted due to the different treatment procedures used. Lack of understanding of the criteria on the part of the physician and resistance to adopting a new treatment procedure were among the problems encountered. Thus, an appeal to annul the old ordinance of 1978 regarding syphilis treatment, which requires hospitalization, was made in order to ensure the rapid implementation of the new procedures. Furthermore, DWB is planning to implement a program that will give emphasis to the training of Bulgarian professionals to respect the patients and their rights to confidentiality, reinforce therapeutic services and health education, distribution of condoms, and access to HIV testing and counseling.
This article discusses the importance of men's participation in sexual and reproductive health programs. In examining the context and the problematic framework of services organized for men, it was noted that initiatives claiming to involve men are established but have poor quality of service. Thus, involving men in reproductive programs is relevant for reasons that men lack the information on where to turn for treatment and to obtain advice with regard to their sexual health. Furthermore, men's sexual behavior affects the sexual and reproductive health of women, and it contributes to improving man-woman communication. Hence, the challenge to implement effective programs for men should be met. Four principles focusing on gender approach and respecting the principles of equity and equality are cited in developing such services. Some of the specified objectives for suitable services include improving the sexual and reproductive health of women and men, addressing fully the problems of men's sexual and reproductive health, and improving communication between men and women on the subject of sexuality.
This article reviews the video film "Let us talk" and the book "Preventing FGM", the Danish response to the challenge of FGM (female genital mutilation). The video film, produced in Somali in 1998, presents different Somali views on the harmfulness of FGM. Also included are the opinions of Somali men, a religious leader and professionals in the fields of psychology and medicine. The main points against FGM cited in the video include the physical and mental impact of FGM, religious aspects of FGM, and violation of human rights. This is meant to raise consciousness, induce discussions and sway common opinion on the subject. Meanwhile, the book published by the Danish National Board of Health in 1999 aims at the professionals working in the public sector. It deals with the prevention of FGM and supplies the reader with important background information, statistics and diagrams. Guidelines on how to address specific situations involving FGM are offered.
