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. Last Updated: 07/27/2016

Frank Talk on Safe Sex

The sharp rise in sexually transmitted diseases in Russia can be seen as a reflection of the upheavals society has suffered these past few years. Today, there is more information than ever about sexuality. But the issue is still not included in most school programs. Rather, it tends to be featured in many popular magazines that are aimed at relatively well-off women between the ages of 30 and 40. And the articles on sexuality are drawn mostly from the Western press, covering a range of topics from pregnancy among older women to the effect of hormonal cosmetics. Given the news media's penchant for scoops and sensationalism, there is a tendency to select those subjects that are most likely to interest the public, to the detriment of providing realistic and necessary information, particularly for the young.


The coverage of this subject on television also has had very little impact on the younger generation. Moreover, the discussions in the media are often pseudoscientific, and the many questions that are raised only mask the persistence of a strong taboo on sexuality.


A recent survey published by Moskovsky Komsomolets is revealing. The survey, involving about 3,000 young people between the ages of 16 and 19, showed that 50 percent of the young women polled did not rule out having an affair with a married man; 27 percent were willing to have several partners; and 22 percent were prepared to make love for money. Whatever the merits or accuracy of the poll, the nature of the questions displays a lack of responsible consideration of issues of sexuality and a tendency toward provocation. In reality, this emerging focus on freedom conceals a profound misunderstanding of sexuality.


Protection against sexually transmitted diseases through the use of condoms is still a side issue. Condoms are used, but are mainly associated with the idea of contraception, a topic that the media are more willing to discuss. Despite family planning programs that have developed in the past few years, resulting in wider availability of birth control methods, contraception has not made much progress.


According to Russian Health Ministry statistics, from 1991 to 1995 only 10 percent of the population used condoms, although the percentage is higher in Moscow. About 16 percent of students polled had any confidence in this method. Although the number of abortions has dropped from 4.2 to 2.5 million in 10 years, the figure of 300,000 abortions a year for girls between 15 and 19 has not changed. In Moscow, nearly one girl out of 10 under the age of 19 resorts to abortion, and having as many as 12 abortions by the age of 26 is not exceptional.


Three-quarters of teenagers are unaware that a condom should not be used more than once, and many of them do not understand how sexual diseases are transmitted. The consequences of such ignorance are predictable. More and more Russians, as well as foreigners, are being infected by sexually transmitted diseases. Although syphilis is now rare in the West, the rate of infection in Russia is doubling annually.


The Russian population persists in not feeling anxious about sexually transmitted diseases and imputing them to foreigners or national minorities. But what is crucial is the ignorance of symptoms. Many carriers without symptoms can unknowingly transmit their diseases


Many people are also often unaware that their pathologies can be chronic. One example of this was a complaint filed by a patient rejecting the diagnosis of herpes after a blood test because there were no visible symptoms. Some benign viruses stay in the organism for life and only manifest themselves intermittently. Equally unknown are the consequences of these pathologies. The increasingly frequent hepatitis B, which is also sexually transmittable, can develop into cirrhosis of the liver. Other viruses cause warts or inflammations in the cervix that can become cancerous. Mycoplasma and chlamydia trachomatous infections are often inadequately treated, and can slowly and permanently change the fallopian tubes so that they may lead to infertility or extra-uterine pregnancies that can endanger the parent's life. HIV is also not very well understood and certain teenagers even wonder whether AIDS is really so dangerous.


But the major problem remains the difficulty in breaking up the chains through which diseases are sexually transmitted, including the human immunodeficiency virus. One woman, for example, accused her doctor of ineffective treatment because of a recurring sexually transmitted disease. Although her husband was treated at the same time, he had an extramarital relationship that resulted in his being reinfected.


With the emergence of AIDS, insufficient efforts have been made by the health community to search for ways to break these infection chains. Condoms are generally used only for contraceptive purposes and therefore only occasionally. Any effort to prevent sexually transmitted diseases that fails to take such attitudes into account is bound to fail. During the communist era, syphilis patients were quarantined in hospitals. Such measures have become inadequate with the emergence of AIDS, the carriers of which cannot be isolated.





Alexandre Fuzeau, a medical doctor at a Western clinic in Moscow, specializes in the psychological and social aspects of AIDS prevention. He contributed this comment to The Moscow Times.