Syphilis among intravenous drug-using population: Epidemiological situation in St Petersburg, Russia

Introduction. An epidemic of syphilis and other sexually transmitted infections (STI) in the Russian Federation is believed to be related to the rise in injection drug use. A study was carried out in collaboration with a non-governmental organization, Foundation 'Vozvrastcheniye'. Methods: Nine hundred and ten injection drug users participating in the programme were tested for syphilis, HIV, hepatitis C virus (HCV) and hepatitis B virus (HBV); 65 participants who had laboratory markers for syphilis and 45 syphilis-negative serosurvey subjects agreed to participate in a questionnaire study. Results: Syphilis, HIV, HBV and HCV were diagnosed in 12%, 0%, 48% and 79% of drug users, respectively. Prevalence of syphilis seromarkers was nine times higher in females than in males, and strongly associated with sex work. Conclusions: The results of the study indicate that resources to treat and prevent further infections including HIV should be prioritized toward risk reduction in drug injectors and sex workers in St Petersburg.