During the 1990s, a striking increase in the notification rate for syphilis has been observed in the Russian Federation and Eastern Europe. Given easier current access to international travel and migration from Eastern Europe, this trend is likely to involve Western Europe as well. To investigate this possibility, 110 foreign-born prostitutes (32 from Albania, 34 from tropical Africa, and 44 from Eastern Europe) presenting to an outpatient clinic in Verona, Italy, over a 19-month period were screened for sexually transmitted diseases (STDs). At their initial visit, HIV infection was detected in 2 prostitutes (both African); 9 women were positive for serologic markers of active syphilis (5 from the former Soviet Union, 1 from Romania, 1 from Croatia, and 2 from Africa). By country of origin, the incidence of active syphilis was highest among immigrants from the former Soviet Union (5/18 or 27.8%). Although 65.9% of Eastern European women compared with 56.1% of women from other regions had been prostitutes for less than 1 year, Eastern European prostitutes were significantly more likely than their counterparts from Africa and Albania to have had more than 30 partners per week (70.5% vs. 51.5%) and to have become pregnant during the study period (40.9% vs. 11.8% of Africans and 18.7% of Albanians). Compared with their other Eastern European counterparts, Russian women had the least past experience in prostitution (77.8% had less than 1 year) and the highest incidence of pregnancy (50%). These findings indicate that Eastern European immigrants, especially those from the former Soviet Union, have little knowledge of STD risks or effective contraceptive use.
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