“It is naive to think about an evil infection and innocent victims. There are no winners or losers in a game called STI, only losers. Men and women must understand, what, protecting others, they protect themselves ".

The last 15 years in Belarus, as in other CIS countries, there is a high incidence of diseases in the population, sexually transmitted (BPPP) and HIV infection, which requires concentration of attention on this problem not only for medical institutions, but the whole society as a whole. Malosymptomatic, and the often asymptomatic course of many of them led to the appearance of the 10th revision in the International Classification of Diseases (Copenhagen, 1990 g.) new term, which more accurately reflects their essence - infections, predominantly sexually transmitted (STIs).

The total absolute number of officially registered patients in 2009 r. exceeded 149000, in 2010 r. – 138000, and in 2011 r. – 121000. but, due to the impossibility of a complete examination of the population with a low-symptom course of STIs, the given official registration data may differ from the real picture of the incidence. According to the epidemiological forecast, the total incidence of STIs in the Republic of Belarus among other infectious diseases is 3 place after ARVI + flu and helminthiasis.

In the last 3 years in the republic, new characteristic trends and features of the incidence of STIs were noted. Against the background of the annual decrease in the incidence of bacterial STIs, there is an increase in viral infections. So, in 2011 r. the incidence of syphilis decreased by 2,5 %, gonococcal infection - on 8,2%, trichomoniasis - on 13,7%, chlamydial infection - on 11,8%. At the same time, the registration of genital herpes increased (on 16,5%), anogenital warts (on 16,4%). Has grown (on 19,7%) identification of patients with infection, caused by Micoplasma genitalium. An important reason for new trends is the improvement of laboratory diagnostics of STIs in the republic. (including, introduction of modern protocols of laboratory diagnostics, purchase of modern equipment, nursing staff training) against the background of high infection of the population. More detailed data for 2011 year displayed in the table (application 2).

The victims of STIs are mainly (to 70%) becomes youth from 15 to 29 years. This requires the concentration of efforts of health care organizations to work with this age group..

The current STI prevention system is mainly based on the identification and treatment of an already ill person. Only about 15-20% sick. In this regard, further active formation of the prevention system is necessary., aimed at preventing diseases and the patient's independent referral to a doctor.

The most important element of this system should be the primary prevention of STIs among young people., which will be primarily attended by educational institutions, non-governmental youth organizations, mass media, as well as medical professionals (valeologists, dermato-venereologists, obstetricians-gynecologists, urologists, pediatricians, paramedical staff of specialized medical and prophylactic institutions).

For adolescents, the most important individual risk factors for contracting STIs are upbringing in a dysfunctional family. (violation of emotional contact between parents and children, parenting in an incomplete family, neglect by parents and aimless time on the street, alcoholization of parents and the presence of mental illness), deformation of moral and ethical attitudes, the presence of character accentuations, consumption of erotic and pornographic video products, early onset of sexual activity without knowledge of the rules of safe sexual behavior and non-use of STI prophylaxis, drinking, drugs, etc..

As one of the factors, actively affecting the incidence rate, advocates the level of awareness, availability of hygienic knowledge and skills of young people about diseases, sexually transmitted. Taking into account the research carried out in the republic, the decisive importance of timely scientific information on the STI problem as one of the conditions for the formation of the personality of a teenager with a stereotype of safe sexual behavior is obvious. In this case, responsible behavior in the field of sexual relations becomes one of the stable characteristics. (heck) human personality, according to which he behaves and subsequently brings up offspring accordingly.

Undoubtedly, that the doctor, due to the workload of medical practice, cannot perform the entire volume of work on the primary prevention of STIs among schoolchildren and college students. Moreover, one-time event (lecture) is a form of health education and cannot have such a profound and lasting effect, how upbringing. In such a situation, the most valuable is the role of the doctor as a methodologist. (consultant, expert), educating teachers, representatives of youth organizations, parents, that is those, who constantly communicates with young people and can carry out educational work for a long time in an educational institution and in an informal setting. As a result, the teenager should form a strong stereotype of safe sexual behavior., which will be the main protection against STIs for a young man or girl for the rest of his life.

Undoubtedly, no one can better describe the suffering of venereal patients, medical and social consequences of these diseases, than a doctor. but, a young man or woman should get key information on this issue from their teacher.

Equally important, than describing the characteristic clinical signs of STIs, is information, aimed at forming convictions among young people, that state treatment and prophylactic institutions are the most acceptable and accessible type of venereal care, a definite alternative to self-medication. This is facilitated by the acquisition of knowledge about a significant change in our republic of a number of principles for the provision of venereal care to the population.. for example, hospitalization for medical reasons only. Most patients are treated on an outpatient basis. Anonymous examination and treatment is possible in paid offices at dermatovenerologic dispensaries. Highly qualified medical staff guarantees a complete cure with early treatment. The legislation provides for free testing for syphilis and AIDS, as well as keeping the patient's diagnosis secret. Syphilis treatment is free, including during outpatient treatment in a day hospital. Closed venereology departments were liquidated, the exit of patients from which was prohibited. Canceled criminal liability for evading examination for "classic" venereal diseases - syphilis and gonorrhea. Ensured compliance with the requirements of the Constitution when conducting compulsory examination and compulsory treatment of venereal diseases. Coercive measures are now applied only in exceptional cases with the approval of the prosecutor or by court order. For other STIs (except syphilis and gonorrhea) they are not provided for by law at all. An alternative network of commercial non-governmental medical institutions has been created, testing for all STIs and their treatment (except syphilis and gonorrhea). Helplines are organized in all large dermatovenous dispensaries, where you can get anonymous advice on STIs.

When carrying out preventive work with youth, it is necessary to adhere to a certain algorithm (given below), which allows you to create a correct understanding of the modern principles of providing venereal care.

1. The concept of infections, sexually transmitted, and their relationship to human behavior.

2. Prevalence of STIs in the world and in Belarus.

3. STI incidence in different age groups, preferential damage to sexually active youth.

4. The relationship between AIDS and various STIs (mutual enhancement of transmission efficiency), the possibility of simultaneous infection with several STIs.

5. General understanding of the negative impact of STIs on the body (infertility, sexual dysfunctions, violation of the menstrual cycle, damage to the nervous system, congenital deformities in offspring, ectopic pregnancy, premature birth, etc.).

6. Causative agent, source of infection and routes of transmission of syphilis, gonorrhea and other STIs (sexual, including during orogenital and anogenital contacts, and household routes of infection, inability to get infected when swimming in a pond, handshake, for colds, etc.).

7. Clinical manifestations of syphilis, gonorrhea, chlamydia and other STIs (the most characteristic visible signs of these diseases, frequent latent course and lack of subjective sensations, high infectivity of sick and infected people around, the similarity of the clinical course of many inflammatory STIs).

8. Principles of STI Diagnosis: obligatory laboratory confirmation of the diagnosis, where you can be examined for STIs - tell about the location of the dermatovenerologic dispensary, anonymous examination rooms, about the possibilities of diagnosis by an obstetrician-gynecologist, urologist.

9. Syphilis treatment principles, gonorrhea, chlamydia and other STIs: complete curability in the early stages without hospitalization, danger of self-medication and treatment by non-specialists, impossibility of choosing the right medicine without laboratory diagnostics due to the clinical similarity of many diseases, the need for dispensary observation of the patient due to the propensity of STIs to recurrence and the risk of human disability, survivor, especially with syphilis, the concept of medical secrecy - keeping secrets from teachers and parents, provided that the doctor's prescriptions are fulfilled.

10. Individual prevention of STIs (adherence to the principles of safe sexual behavior: postponing the onset of sexual activity to a later age, reducing the number of sexual partners to one of the most reliable, exclusion of premarital and casual sex, random sex criterion, rules for the use of means of individual prevention of STIs - condoms, solutions of chlorhexidine bigluconate and miramistin, the contraceptive drug "Pharmatex" with an anti-STD effect, the presence and address of an emergency anti-STD prevention point at dermatovenerologic dispensaries, where help is provided anonymously, free and around the clock).

11. Quoting excerpts from the works of the classics of world and domestic literature depicting the clinical manifestations of syphilis and gonorrhea.

Associate Professor of the Department of Skin and

venereal diseases BSMU A.L. Navrotsky

Incidence of infections, sexually transmitted, and contagious skin diseases
in the Republic of Belarus for 2011 year
Download the table