Society
MoD Proposal to Send Men with STIs to Ukraine Could Have Devastating Consequences for Public Health
March 13, 2025
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Rustam Alexander
Melbourne University and author of Red Closet: The Hidden History of Gay Oppression in the USSR
Historian Rustam Alexander writes about what is wrong with the Russian Ministry of Defense’s recent proposal to draft men with syphilis and traces the highs and lows of Russia’s fight against the disease and STIs in general.
Men at the conscription office. Fall 2022. Source: Wiki Commons
Valery Panyshkin was one of the few journalists who sharply criticized the idea of drafting soldiers with syphilis:
One may think the Ministry of Defense is filled with idiots who do not understand the catastrophic consequences of such a proposal… It is also possible the officials in the Ministry of Defense think that a chancre on the penis or a rash on the body does not interfere with waging war. They do not understand that syphilis has grave consequences, and children conceived by syphilitics (since the state is so eager to boost birth rates) are likely to develop severe psychoses… Perhaps, they are just idiots who fail to understand that the spread of syphilis cripples the nation.
Panyshkin’s anger is understandable.
One may think the Ministry of Defense is filled with idiots who do not understand the catastrophic consequences of such a proposal… It is also possible the officials in the Ministry of Defense think that a chancre on the penis or a rash on the body does not interfere with waging war. They do not understand that syphilis has grave consequences, and children conceived by syphilitics (since the state is so eager to boost birth rates) are likely to develop severe psychoses… Perhaps, they are just idiots who fail to understand that the spread of syphilis cripples the nation.
Panyshkin’s anger is understandable.
“The syphilis situation in Russia was relatively stable during the first two decades of the 21st century, but now the Ministry of Defense’s proposal threatens to undo this hard-won progress, particularly in the context of the gradually rising syphilis rates in the country since 2022.”
How the Soviet Union dealt with STIs
The proposal is even more striking given that the Soviet government had always struggled with the issue of STIs. The epidemic of syphilis in the USSR worsened after World War II. The return of Soviet soldiers, combined with the ravages of the war, provided fertile ground for the epidemic.
In August 1945, the Council of People’s Commissars issued a directive that urged authorities across the country to double down on the struggle with STIs. Fortunately, a gradual improvement in living conditions was accompanied by increasing availability of penicillin, which allowed the Soviet government to curb the epidemic by the mid-1950s.
In 1963, the problem of STIs resurfaced, and the USSR Ministry of Health issued an order criticizing regional and republican authorities for the sharp increase in venereal diseases. It also instructed doctors to collaborate with the police to apprehend people with STIs and take them, against their will if necessary, to STI hospitals for examinations.
During the Brezhnev era, the push toward criminalization of STI transmission intensified. In 1971, despite the anti-VD laws already on the books, the Soviet authorities toughened criminal liability for men and women who spread STIs. The evasion of compulsory STI treatment became a criminal offense punishable by one year in prison.
For Soviet citizens diagnosed with STIs, medical treatment in state hospitals was a deeply humiliating experience. It involved intrusive interrogations about their sexual contacts (particularly embarrassing and distressing events in a country where sex was taboo). Patients had to deal with the police and with the fear that their diagnosis would be made known to others, at home or at work, or both. Given the frequent breaches of medical confidentiality in the USSR, these fears were not unfounded.
After the collapse of the Soviet Union, the problem of STIs and syphilis in particular persisted. Sexual permissiveness exploded alongside the old Soviet puritanism, and many Russians still believed that syphilis, just like any other venereal disease, was shameful and revolting.
Soviet venerology – coercive, punitive and simply frightening – left a lasting and extremely negative imprint in the minds of Russians, fostering deep mistrust of seeking medical help for STIs. As a result, in the early 1990s Russian venerologists faced the formidable challenge of undoing this Soviet legacy.
The decades-old stigma surrounding STI diagnosis in Russia led to the emergence of a whole system of underground treatment. Upon learning they had syphilis, many Russians avoided treatment, paid bribes to doctors and consulted faith healers, with some simply masking their symptoms without seeking proper treatment, which inevitably had dreadful consequences.
As Russia was embracing democracy, anonymous testing and treatment for syphilis gradually became more accessible, however. The 1971 law that imposed criminal and civil sanctions on STI patients was repealed. Yet the positive effects of these developments were not immediately apparent, and the number of reported syphilis cases continued to grow. For example, in 1997 they had risen to around 270 per 100,000 people.
A temporary turnaround
Progress was happening. A 2017 report on syphilis in Russia in 2006-16, prepared by the Ministry of Health’s State Research Center for Dermatovenerology and Cosmetology, revealed that “currently, in Russia, as a result of the implementation of various specific federal programs and anti-epidemic measures, a favorable epidemiologic situation with syphilis has been established.” According to the report, by 2016 the incidence of syphilis had reached 21.3 cases per 100,000 people – a 92% drop versus 1997 (277.3 per 100,000). Meanwhile, from 2006 to 2016 the incidence of syphilis decreased from 65.4 to 21.3 cases per 100,000 people.
However, 2021 marked a significant increase in syphilis infections again, with reported cases rising 39.4% year over year to 14.5 per 100,000 people. In 2022, the trend continued, and 25,695 cases of syphilis were reported (a 33.7% year-over-year increase). Some regions saw a doubling in syphilis infections. Russian venerologists linked the resurgence of syphilis with a restart to migration after the lifting of Covid-19 restrictions, particularly from “neighboring countries” and regions with armed conflicts taking place. These included the so-called DNR and LNR, as well as Kherson and Zaporizhzhia, where, as they noted, “adequate venereological care for the population and proper disease reporting have been absent for many years.”
In 2023, Russian venereologists observed: “these alarming figures likely indicate the onset of a new, fourth wave of syphilis and other STIs in Russia since the end of the Great Patriotic War. The amplitude and duration of this wave remain uncertain.” Interestingly, STI infections, especially syphilis and gonorrhea are also on the rise in Europe, reportedly due to decreasing condom use among young adults.
If the Ministry of Defense’s proposal is accepted and soldiers with syphilis are drafted into the army, the impact on public health in Russia will be long-lasting and devastating, reversing decades of progress in managing and curbing the disease. Moreover, the damage will not be limited to Russia.
The proposal is even more striking given that the Soviet government had always struggled with the issue of STIs. The epidemic of syphilis in the USSR worsened after World War II. The return of Soviet soldiers, combined with the ravages of the war, provided fertile ground for the epidemic.
In August 1945, the Council of People’s Commissars issued a directive that urged authorities across the country to double down on the struggle with STIs. Fortunately, a gradual improvement in living conditions was accompanied by increasing availability of penicillin, which allowed the Soviet government to curb the epidemic by the mid-1950s.
In 1963, the problem of STIs resurfaced, and the USSR Ministry of Health issued an order criticizing regional and republican authorities for the sharp increase in venereal diseases. It also instructed doctors to collaborate with the police to apprehend people with STIs and take them, against their will if necessary, to STI hospitals for examinations.
During the Brezhnev era, the push toward criminalization of STI transmission intensified. In 1971, despite the anti-VD laws already on the books, the Soviet authorities toughened criminal liability for men and women who spread STIs. The evasion of compulsory STI treatment became a criminal offense punishable by one year in prison.
For Soviet citizens diagnosed with STIs, medical treatment in state hospitals was a deeply humiliating experience. It involved intrusive interrogations about their sexual contacts (particularly embarrassing and distressing events in a country where sex was taboo). Patients had to deal with the police and with the fear that their diagnosis would be made known to others, at home or at work, or both. Given the frequent breaches of medical confidentiality in the USSR, these fears were not unfounded.
After the collapse of the Soviet Union, the problem of STIs and syphilis in particular persisted. Sexual permissiveness exploded alongside the old Soviet puritanism, and many Russians still believed that syphilis, just like any other venereal disease, was shameful and revolting.
Soviet venerology – coercive, punitive and simply frightening – left a lasting and extremely negative imprint in the minds of Russians, fostering deep mistrust of seeking medical help for STIs. As a result, in the early 1990s Russian venerologists faced the formidable challenge of undoing this Soviet legacy.
The decades-old stigma surrounding STI diagnosis in Russia led to the emergence of a whole system of underground treatment. Upon learning they had syphilis, many Russians avoided treatment, paid bribes to doctors and consulted faith healers, with some simply masking their symptoms without seeking proper treatment, which inevitably had dreadful consequences.
As Russia was embracing democracy, anonymous testing and treatment for syphilis gradually became more accessible, however. The 1971 law that imposed criminal and civil sanctions on STI patients was repealed. Yet the positive effects of these developments were not immediately apparent, and the number of reported syphilis cases continued to grow. For example, in 1997 they had risen to around 270 per 100,000 people.
A temporary turnaround
Progress was happening. A 2017 report on syphilis in Russia in 2006-16, prepared by the Ministry of Health’s State Research Center for Dermatovenerology and Cosmetology, revealed that “currently, in Russia, as a result of the implementation of various specific federal programs and anti-epidemic measures, a favorable epidemiologic situation with syphilis has been established.” According to the report, by 2016 the incidence of syphilis had reached 21.3 cases per 100,000 people – a 92% drop versus 1997 (277.3 per 100,000). Meanwhile, from 2006 to 2016 the incidence of syphilis decreased from 65.4 to 21.3 cases per 100,000 people.
However, 2021 marked a significant increase in syphilis infections again, with reported cases rising 39.4% year over year to 14.5 per 100,000 people. In 2022, the trend continued, and 25,695 cases of syphilis were reported (a 33.7% year-over-year increase). Some regions saw a doubling in syphilis infections. Russian venerologists linked the resurgence of syphilis with a restart to migration after the lifting of Covid-19 restrictions, particularly from “neighboring countries” and regions with armed conflicts taking place. These included the so-called DNR and LNR, as well as Kherson and Zaporizhzhia, where, as they noted, “adequate venereological care for the population and proper disease reporting have been absent for many years.”
In 2023, Russian venereologists observed: “these alarming figures likely indicate the onset of a new, fourth wave of syphilis and other STIs in Russia since the end of the Great Patriotic War. The amplitude and duration of this wave remain uncertain.” Interestingly, STI infections, especially syphilis and gonorrhea are also on the rise in Europe, reportedly due to decreasing condom use among young adults.
If the Ministry of Defense’s proposal is accepted and soldiers with syphilis are drafted into the army, the impact on public health in Russia will be long-lasting and devastating, reversing decades of progress in managing and curbing the disease. Moreover, the damage will not be limited to Russia.
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