RISE IN SEXUALLY-TRANSMITTED DISEASES DURING DEMOCRATIZATION AND ECONOMIC-CRISIS IN MONGOLIA

In 1990, democratic changes and loss of Soviet economic subsidies led to enormous social upheaval in Mongolia. The objective of this study i s to map sexually transmitted disease (STD) trends in Mongolia from 19 83-1995 and review human immunodeficiency virus (HIV) surveillance dat a since 1987. Data for syphilis show a decreasing trend from 1983-1993 with a decline in eases from 70 to 18/100,000 population, followed by a rise in cases to 32/100,000 population in 1995. Data suggest a 1.5- 3.0 fold higher rate of syphilis for ages 15-24 than for any other gro up. Data for gonorrhoea show an upward trend in the rate of cases, fro m 51/100,000 population in 1983 to 142/100,000 in 1995. The majority o f cases are aged 15-44. Trichomonas rates also show an upward trend in the number of cases, from 47/100,000 population in 1983 to 155/100,00 0 cases in 1995. Like gonorrhoea the majority of cases are in the 15-4 4 year age range. For children aged 0-14, the 1983-1993 rate remained below 4.5/100,000; however, in 1994 and 1995 the rate increased reachi ng 53 and 48/100,000 respectively. Since 1987, more than 176,000 HIV t ests have been done with only one confirmed positive result. Rises in STD rates coincide with deterioration in STD services and reduced acti ve surveillance, suggesting that these data reflect a minimum estimati on of the problem. Changes in business and social circumstances may ha ve resulted in increasing HIV and STD risk behaviour.