Syphilis as a social disease: experience from the post-communist transition period in Estonia.

Increased incidence of sexually transmitted diseases (STD) and radical social changes have taken place at the same time in Estonia. Our aim was to study the trends in syphilis incidence, selected sociodemographic factors and health status indicators during the economic transition. Associations were estimated by the ordinary least square regression method for change in and actual values of syphilis and tuberculosis incidence rate (IR), percentage of non-ethnic Estonians and urban population, homicides rate, unemployment rate and, birth rate. The analysis was performed by counties at three different time periods. Syphilis IR significantly correlated with the proportion of non-ethnic Estonians, urban population, tuberculosis IR and birth rate. Change of syphilis IR correlated significantly with concurrent changes in unemployment rate and tuberculosis IR. Our findings support the theory that syphilis is a social disease, thus emphasizing the importance of social factors in the occurrence of STDs.