Effects of Sex Work on the Prevalence of Syphilis Among Injection Drug Users in Three Russian Cities

The researchers examined risk factors for syphilis infection among injection drug users (IDUs) in three cities in Russia, placing particular emphasis on the potential roles of gender and sex work.

A cross-sectional survey of IDUs in Moscow, Volgograd, and Barnaul was conducted, including the collection of behavioral data and testing for antibodies to Treponema pallidum. Associations between presence of antibodies to T pallidum, and covariates were examined.

Overall prevalence of T pallidum antibodies was 11 percent (95 percent confidence interval=9.7 percent, 13.1 percent). In Moscow and Barnaul, syphilis was associated with involvement in sex work and with gender; this was not the case in Volgograd. Female IDUs not involved in sex work were more likely than men to be younger and to have recently started injecting; female IDUs involved in sex work were more likely than those not involved in sex work to inject daily.

"Syphilis transmission dynamics varied by region," concluded the authors. "Sex work can increase syphilis risk among [IDUs], potentially feeding the momentum of sexually transmitted HIV and syphilis among noninjectors. Targeted interventions are needed to reduce both sexual and injection risk behaviors among [IDUs]."

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