In 1990, democratic changes and loss of Soviet economic subsidies led to enormous social upheaval in Mongolia. The objective of this study is to map sexually transmitted disease (STD) trends in Mongolia from 1983-1995 and review human immunodeficiency virus (HIV) surveillance data since 1987. Data for syphilis show a decreasing trend from 1983-1993 with a decline in cases 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 group. Data for gonorrhoea show an upward trend in the rate of cases, from 51/100,000 population in 1983 to 142/100,000 in 1995. The majority of 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 155/100,000 cases in 1995. Like gonorrhoea the majority of cases are in the 15-44 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 reaching 53 and 48/100,000 respectively. Since 1987, more than 176,000 HIV tests have been done with only one confirmed positive result. Rises in STD rates coincide with deterioration in STD services and reduced active surveillance, suggesting that these data reflect a minimum estimation of the problem. Changes in business and social circumstances may have resulted in increasing HIV and STD risk behaviour.
PIP: Democratic change and the loss of Soviet economic subsidies in 1990 led to major social upheaval in Mongolia. Changes in business and social circumstances appear to have resulted in a higher level of HIV and sexually transmitted disease (STD) risk behavior. The prevalence of syphilis cases declined over the period 1983-93 from 70/100,000 population to 18/100,000, then increased to 32/100,000 in 1995. The data indicate a 1.5-3.0-fold higher rate of syphilis for ages 15-24 years than for any other group. The prevalence of infection with gonorrhea increased from 51/100,000 population in 1983 to 142/100,000 in 1995, with the majority of cases aged 15-44 years, while the level of trichomonas infection also increased, from 47/100,000 population in 1983 to 155/100,000 in 1995. The majority of trichomonas cases were also among people aged 15-44 years. For children aged 0-14 years, the level of trichomonas infection remained below 4.5/100,000 during 1983-93, but increased in 1994 and 1995 to 53/100,000 and 48/100,000, respectively. The more than 176,000 HIV tests conducted since 1987 have identified only one confirmed positive case of infection.