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A large-amplitude impact-induced like electric field signal is often observed by the Radio and Plasma Wave (RPW) Instrument onboard Solar Orbiter. The signal has a sharp increase followed by an exponential decay, typically observed when spacecraft experiences a dust impact. The amplitude can reach several V/m. The impact dust size can be estimated from the electric field amplitude and is similar to the characteristic dust size near the sun expected from the zodiacal-light observations. On the other hand, the signal's decay time is the order of second, unusually long compared to the dust impact signals previously reported by the other spacecraft. We will show the characteristics of these signals and discuss the origin.

Until recently in Russia the general methodology for the prevention of sexually transmitted infections (STIs) including HIV-infection and blood-borne infections (BBI) has not been developed and targeted preventive interventions aimed at vulnerable populations have not been applied. As a rule, domestic researchers have been confined to detailed analysis of epidemiological data on the prevalence of STIs and other socially significant diseases in general population and their clinical features without offering social prevention technologies. Meanwhile, a large number of scientific researches aimed at improving the prevention strategies for STI/BBI and comprehensive preventive programs combining biomedical and behavioral components are being carried out all over the world. Unfortunately, preventive programs developed abroad cannot be mechanically introduced into the practice of Russian health care system. The programs should be adapted and implemented in the context of the socioeconomic and cultural uniqueness of Russia. The current epidemic situation necessitates switching from secondary and tertiary STI/BBI prevention and traditional biomedical approach to primary prevention and multidisciplinary approach. The multidisciplinary approach to healthy life style promotion and prevention of self-destructive behaviors including alcohol and drug use and risky sexual practices is a new branch of medicine. The presented article is aimed to analyze theoretical, methodological and practical aspects of the development, implementation and effectiveness evaluation of behavioral preventive interventions focused on socially significant infections.

Recently, management of patients co-infected with syphilis and HIV infection is becoming an increasingly important problem. Similarity of circumstances and ways of HIV and syphilis transmission as well as populations at risk of infection suggests that in the coming years the number of cases of co-infection will increase. The .negative synergy. of HIV infection and syphilis has been proven. This means a mutual reinforcement of the negative effect, when each of the diseases in their combination is more unfavorable than the separately existing disease. Syphilis increases the likelihood of HIV acquisition and transmission during unprotected sexual intercourse and contributes to the progression of HIV infection. On the other hand, it is traditionally believed that concomitant HIV infection can significantly change clinical features and course of syphilis and make its diagnosis and treatment more complicated. However, the widespread use of antiretroviral therapy has allowed to significantly reduce this negative effect. The review article is devoted to the problem of the biological and epidemiological .synergy. of these two infections, as well as to the analysis of modern data on the clinical features of syphilis developing against the background of HIV infection.

Context.The Radio and Plasma Waves (RPW) instrument on board Solar Orbiter has been operating nearly continuously since the launch in February 2020. The Time Domain Sampler (TDS) receiver of the RPW instrument is dedicated to waveform measurements of plasma waves and dust impact signatures in an intermediate frequency range from 0.2 to 200 kHz.Aims.This article presents the first data from the RPW-TDS receiver and discusses the in-flight performance of the instrument and, in particular, the on-board wave and dust detection algorithm. We present the TDS data products and its scientific operation. We demonstrate the content of the dataset on several examples. In particular, we study the distribution of solar Langmuir waves in the first year of observations and one Type III burst event.Methods.The on-board detection algorithm is described in detail in this article and classifies the observed waveform snapshots, identifying plasma waves and dust impacts based on the ratio of their maximum amplitude to their median and on the spectral bandwidth. The algorithm allows TDS to downlink the most scientifically relevant waveforms and to perform an on-board statistical characterization of the processed data.Results.The detection algorithm of TDS is shown to perform very well in its detection of plasma waves and dust impacts with a high accuracy. The initial analysis of statistical data returned by TDS shows that sporadic Langmuir waves that are not associated with Type III events are routinely observed in the inner heliosphere, with a clear increase in occurrence rate closer to the Sun. We also present an example of RPW observations during an encounter of the source region of a Type III burst, which exploits the on-board calculated histograms data.

International audience; The Radio and Plasma Waves (RPW) instrument on the ESA Solar Orbiter mission is designed to measure in situ magnetic and electric fields and waves from the continuum up to several hundred kHz. The RPW also observes solar and heliospheric radio emissions up to 16 MHz. It was switched on and its antennae were successfully deployed two days after the launch of Solar Orbiter on February 10, 2020. Since then, the instrument has acquired enough data to make it possible to assess its performance and the electromagnetic disturbances it experiences. In this article, we assess its scientific performance and present the first RPW observations. In particular, we focus on a statistical analysis of the first observations of interplanetary dust by the instrument’s Thermal Noise Receiver. We also review the electro-magnetic disturbances that RPW suffers, especially those which potential users of the instrument data should be aware of before starting their research work.

Context.Solar Orbiter was launched on 10 February 2020 with the purpose of investigating solar and heliospheric physics using a payload of instruments designed for both remote and in situ studies. Similar to the recently launched Parker Solar Probe, and unlike earlier missions, Solar Orbiter carries instruments designed to measure low-frequency DC electric fields.Aims.In this paper, we assess the quality of the low-frequency DC electric field measured by the Radio and Plasma Waves instrument (RPW) on Solar Orbiter. In particular, we investigate the possibility of using Solar Orbiter’s DC electric and magnetic field data to estimate the solar wind speed.Methods.We used a deHoffmann-Teller (HT) analysis, based on measurements of the electric and magnetic fields, to find the velocity of solar wind current sheets, which minimises a single component of the electric field. By comparing the HT velocity to the proton velocity measured by the Proton and Alpha particle Sensor (PAS), we have developed a simple model for the effective antenna length,Leffof the E-field probes. We then used the HT method to estimate the speed of the solar wind.Results.Using the HT method, we find that the observed variations inEyare often in excellent agreement with the variations in the magnetic field. The magnitude ofEy, however, is uncertain due to the fact that theLeffdepends on the plasma environment. Here, we derive an empirical model relatingLeffto the Debye length, which we can use to improve the estimate ofEyand, consequently, the estimated solar wind speed.Conclusions.The low-frequency electric field provided by RPW is of high quality. Using the deHoffmann-Teller analysis, Solar Orbiter’s magnetic and electric field measurements can be used to estimate the solar wind speed when plasma data are unavailable.

Context.The Radio and Plasma Waves (RPW) instrument is one of the four in situ instruments of the ESA/NASA Solar Orbiter mission, which was successfully launched on February 10, 2020. The Low Frequency Receiver (LFR) is one of its subsystems, designed to characterize the low frequency electric (quasi-DC – 10 kHz) and magnetic (∼1 Hz–10 kHz) fields that develop, propagate, interact, and dissipate in the solar wind plasma. Combined with observations of the particles and the DC magnetic field, LFR measurements will help to improve the understanding of the heating and acceleration processes at work during solar wind expansion.Aims.The capability of LFR to observe and analyze a variety of low frequency plasma waves can be demontrated by taking advantage of whistler mode wave observations made just after the near-Earth commissioning phase of Solar Orbiter. In particular, this is related to its capability of measuring the wave normal vector, the phase velocity, and the Poynting vector for determining the propagation characteristics of the waves.Methods.Several case studies of whistler mode waves are presented, using all possible LFR onboard digital processing products, waveforms, spectral matrices, and basic wave parameters.Results.Here, we show that whistler mode waves can be very properly identified and characterized, along with their Doppler-shifted frequency, based on the waveform capture as well as on the LFR onboard spectral analysis.Conclusions.Despite the fact that calibrations of the electric and magnetic data still require some improvement, these first whistler observations show a good overall consistency between the RPW LFR data, indicating that many science results on these waves, as well as on other plasma waves, can be obtained by Solar Orbiter in the solar wind.

All authors: Zouganelis, I.; De Groof, A.; Walsh, A. P.; Williams, D. R.; Müller, D.; St Cyr, O. C.; Auchère, F.; Berghmans, D.; Fludra, A.; Horbury, T. S.; Howard, R. A.; Krucker, S.; Maksimovic, M.; Owen, C. J.; Rodríguez-Pacheco, J.; Romoli, M.; Solanki, S. K.; Watson, C.; Sanchez, L.; Lefort, J.; Osuna, P.; Gilbert, H. R.; Nieves-Chinchilla, T.; Abbo, L.; Alexandrova, O.; Anastasiadis, A.; Andretta, V.; Antonucci, E.; Appourchaux, T.; Aran, A.; Arge, C. N.; Aulanier, G.; Baker, D.; Bale, S. D.; Battaglia, M.; Bellot Rubio, L.; Bemporad, A.; Berthomier, M.; Bocchialini, K.; Bonnin, X.; Brun, A. S.; Bruno, R.; Buchlin, E.; Büchner, J.; Bucik, R.; Carcaboso, F.; Carr, R.; Carrasco-Blázquez, I.; Cecconi, B.; Cernuda Cangas, I.; Chen, C. H. K.; Chitta, L. P.; Chust, T.; Dalmasse, K.; D'Amicis, R.; Da Deppo, V.; De Marco, R.; Dolei, S.; Dolla, L.; Dudok de Wit, T.; van Driel-Gesztelyi, L.; Eastwood, J. P.; Espinosa Lara, F.; Etesi, L.; Fedorov, A.; Félix-Redondo, F.; Fineschi, S.; Fleck, B.; Fontaine, D.; Fox, N. J.; Gandorfer, A.; Génot, V.; Georgoulis, M. K.; Gissot, S.; Giunta, A.; Gizon, L.; Gómez-Herrero, R.; Gontikakis, C.; Graham, G.; Green, L.; Grundy, T.; Haberreiter, M.; Harra, L. K.; Hassler, D. M.; Hirzberger, J.; Ho, G. C.; Hurford, G.; Innes, D.; Issautier, K.; James, A. W.; Janitzek, N.; Janvier, M.; Jeffrey, N.; Jenkins, J.; Khotyaintsev, Y.; Klein, K. -L.; Kontar, E. P.; Kontogiannis, I.; Krafft, C.; Krasnoselskikh, V.; Kretzschmar, M.; Labrosse, N.; Lagg, A.; Landini, F.; Lavraud, B.; Leon, I.; Lepri, S. T.; Lewis, G. R.; Liewer, P.; Linker, J.; Livi, S.; Long, D. M.; Louarn, P.; Malandraki, O.; Maloney, S.; Martinez-Pillet, V.; Martinovic, M.; Masson, A.; Matthews, S.; Matteini, L.; Meyer-Vernet, N.; Moraitis, K.; Morton, R. J.; Musset, S.; Nicolaou, G.; Nindos, A.; O'Brien, H.; Orozco Suarez, D.; Owens, M.; Pancrazzi, M.; Papaioannou, A.; Parenti, S.; Pariat, E.; Patsourakos, S.; Perrone, D.; Peter, H.; Pinto, R. F.; Plainaki, C.; Plettemeier, D.; Plunkett, S. P.; Raines, J. M.; Raouafi, N.; Reid, H.; Retino, A.; Rezeau, L.; Rochus, P.; Rodriguez, L.; Rodriguez-Garcia, L.; Roth, M.; Rouillard, A. P.; Sahraoui, F.; Sasso, C.; Schou, J.; Schühle, U.; Sorriso-Valvo, L.; Soucek, J.; Spadaro, D.; Stangalini, M.; Stansby, D.; Steller, M.; Strugarek, A.; Štverák, Š.; Susino, R.; Telloni, D.; Terasa, C.; Teriaca, L.; Toledo-Redondo, S.; del Toro Iniesta, J. C.; Tsiropoula, G.; Tsounis, A.; Tziotziou, K.; Valentini, F.; Vaivads, A.; Vecchio, A.; Velli, M.; Verbeeck, C.; Verdini, A.; Verscharen, D.; Vilmer, N.; Vourlidas, A.; Wicks, R.; Wimmer-Schweingruber, R. F.; Wiegelmann, T.; Young, P. R.; Zhukov, A. N., Solar Orbiter is the first space mission observing the solar plasma both in situ and remotely, from a close distance, in and out of the ecliptic. The ultimate goal is to understand how the Sun produces and controls the heliosphere, filling the Solar System and driving the planetary environments. With six remote-sensing and four in-situ instrument suites, the coordination and planning of the operations are essential to address the following four top-level science questions: (1) What drives the solar wind and where does the coronal magnetic field originate?; (2) How do solar transients drive heliospheric variability?; (3) How do solar eruptions produce energetic particle radiation that fills the heliosphere?; (4) How does the solar dynamo work and drive connections between the Sun and the heliosphere? Maximising the mission's science return requires considering the characteristics of each orbit, including the relative position of the spacecraft to Earth (affecting downlink rates), trajectory events (such as gravitational assist manoeuvres), and the phase of the solar activity cycle. Furthermore, since each orbit's science telemetry will be downloaded over the course of the following orbit, science operations must be planned at mission level, rather than at the level of individual orbits. It is important to explore the way in which those science questions are translated into an actual plan of observations that fits into the mission, thus ensuring that no opportunities are missed. First, the overarching goals are broken down into specific, answerable questions along with the required observations and the so-called Science Activity Plan (SAP) is developed to achieve this. The SAP groups objectives that require similar observations into Solar Orbiter Observing Plans, resulting in a strategic, top-level view of the optimal opportunities for science observations during the mission lifetime. This allows for all four mission goals to be addressed. In this paper, we introduce Solar Orbiter's SAP through a series of examples and the strategy being followed. © 2020 ESO., Solar Orbiter is a space mission of international collaboration between ESA and NASA with contributions from national agencies of ESA member states. The spacecraft has been developed by Airbus and is being operated by ESA from the European Space Operations Centre (ESOC) in Darmstadt, Germany. Science operations are carried out at ESA's European Space Astronomy Centre (ESAC) in Villafranca del Castillo, Spain. SWA is an international collaboration which has been funded by the UKSA, CNES, ASI, NASA and the Czech contribution to the ESA PRODEX programme. UAH authors want to thanks the Spanish MINECO-FPI-2016 predoctoral grant with FSE, and its project FEDER/MCIU-AEEI/Proyecto ESP2017-88436-R. The Spanish contribution to SO/PHI has been funded by the Spanish Ministry of Science and Innovation through several projects, the last one being RTI2018-096886-B-C5, and by "Centro de Excelencia Severo Ochoa" programme under grant SEV-2017-0709. RAH, RCC, DMM, SPP, and AV acknowledge the support of the NASA Heliophysics Division, Solar Orbiter Collaboration Office under IAT NNG09EK11I. JEP acknowledges grant UKRI/STFC ST/N000692/1. All French involvements are supported by CNES and CNRS. DV is supported by the STFC Ernest Rutherford Fellowship ST/P003826/1 and STFC Consolidated Grant ST/S000240/1. The authors thank the referee for her constructive comments and suggestions, which led to the substantial improvement of this paper.

A review article highlights the practical issues of design, implementation and effectiveness estimation of STI prevention programs aimed to correct the behavior leading to infection. the importance of epidemiological modeling method for the organization of preventive interventions is discussed. the prospects of the multidisciplinary behavioral approach to STI prevention are demonstrated.

The article summarizes the experience in developing, implementing and effectiveness evaluating of the sexually transmitted infection prevention program in the subpopulation of injecting drug users in St. Petersburg, Russia. The preventive intervention was aimed to correct behaviors leading to infection and was based on a multidisciplinary patient-centered approach. Long-term medical, social and psychological support of injecting drug users, combined with the group training sessions based on the peer-to-peer model has allowed to reduce their injecting and sexual risk, as well as to decrease the HIV infection incidence in the intervention group 1.84 times against the control group.

A review article presents theoretical basics of the development of innovative STI prevention programs for high-risk groups Urgent need for integrated multidisciplinary preventive strategies aimed at correcting risky behaviors and adapted for the particular vulnerable populations is justified.

International audience; Chorus-type whistler waves are one of the most intense electromagnetic waves generated naturally in the mag-netosphere. These waves have a substantial impact on the radiation belt dynamics as they are thought to contribute to electron acceleration and losses into the ionosphere through resonant wave–particle interaction. Our study is devoted to the determination of chorus wave power distribution on frequency in a wide range of magnetic latitudes, from 0 to 40 •. We use 10 years of magnetic and electric field wave power measured by STAFF-SA onboard Cluster spacecraft to model the initial (equatorial) chorus wave spectral power, as well as PEACE and RAPID measurements to model the properties of energetic electrons (∼ 0.1–100 keV) in the outer radiation belt. The dependence of this distribution upon latitude obtained from Cluster STAFF-SA is then consistently reproduced along a certain L-shell range (4 ≤ L ≤ 6.5), employing WHAMP-based ray tracing simulations in hot plasma within a realistic inner magnetospheric model. We show here that, as latitude increases, the chorus peak frequency is globally shifted towards lower frequencies. Making use of our simulations, the peak frequency variations can be explained mostly in terms of wave damping and amplification, but also cross-L propagation. These results are in good agreement with previous studies of chorus wave spectral extent using data from different spacecraft (Cluster, POLAR and THEMIS). The chorus peak frequency variations are then employed to calculate the pitch angle and energy diffusion rates, resulting in more effective pitch angle electron scattering (electron lifetime is halved) but less effective acceleration. These peak frequency parameters can thus be used to improve the accuracy of diffusion coefficient calculations. Keywords. Electromagnetics (wave propagation) – magne-tospheric physics (energetic particles precipitating) – space plasma physics (wave–particle interactions)

A review article is addressed the issue of the diagnosis and treatment of neurosyphilis that is developing against the background of HIV-infection. HIV-infected patients are at higher risk of neurologic, ocular and auricular manifestation of syphilis as well as treatment failures and relapses. Diagnosis of neurosyphilis in HIV-positive patients is complicated because both infections cause similar changes in the cerebrospinal fluid (CSF). The effectiveness of neurosyphilis treatment in patients with HIV co-infection is difficult to estimate, since the normalization of their CSF goes slower comparing to HIV-negatives. The increase in incidence of syphilis and HIV co-infection is anticipated in the coming years. This necessitates a comprehensive study of the problem and requires the development of new approaches to neurosyphilis diagnosis and treatment in co-infected patients.

The introduction of penicillin has been a breakthrough in the treatment of syphilis. For 70 years, penicillin remains the preferred drug for the treatment of all forms of the disease; its effectiveness has been proven by wide experience gained from clinical observations. However, a very limited number of published meta-analyzes, systematic reviews and data from randomized controlled trials on the comparative assessment of the effectiveness of various antibiotics and treatment regimens are currently available. Some aspects of syphilis treatment are insufficiently developed, particularly, the treatment schedules for neurosyphilis, syphilis in pregnancy, syphilis in HIV-infected individuals and persons allergic to penicillin. There are disagreements in the assessment of the clinical significance of serofast state after a course of antibiotic therapy. There is no uniform approach to the management of patients with treatment failures. This article compares the Russian standards for syphilis treatment set out in the «Federal guidelines for the management of patients with syphilis» with the current European recommendations of the International Union against Sexually Transmitted Infections (IUSTI) and the recommendations of the US Centers for Disease Control and Prevention (CDC). The peculiarities of these guidelines, their strengths and shortcomings, as well as controversial issues of syphilis therapy are discussed. The differences between the domestic and foreign recommendations are more significant in the section concerning the treatment of syphilis than in the section of diagnosis.

Despite the abundance of existing laboratory methods the diagnosis of syphilis still faces many challenges. Though direct detection of T. pallidum plays an important role in early manifest forms of the disease, serological tests remain the mainstay of diagnosis. Traditional syphilis screening algorithm based on nontreponemal tests with subsequent confirmation using treponemal tests is a standard worldwide. Recently, the ability to automate the treponemal tests promotes the increasingly widespread implementation of reverse algorithm when these tests are used for syphilis screening. None of the current serological algorithms are able to reliably differentiate between active and previously treated syphilis, which causes uncertainty in the management of patients. There is no «gold standard» for the diagnosis of neurosyphilis, ocular, auricular and visceral syphilis. The interpretation of serological tests in children born to seropositive mothers is also complicated. Diagnosis of congenital syphilis in newborns and, consequently, the prescription of antibiotic therapy often depends on assessment of the adequacy of maternal treatment during pregnancy, which leads to subjective decisions. This article provides a comparative analysis of the «Federal guidelines for the management of patients with syphilis» and their foreign analogues, discusses significant peculiarities of these guidelines and reviews current concerns and controversies in syphilis diagnosis.

The tertiary cutaneous syphilis has become extremely rare as a result of the effective treatment of early syphilis with penicillin and occasional antibiotic therapy for concomitant infections. We report a case of tertiary gummatous syphilis associated with asymptomatic neurosyphilis that was initially misdiagnosed as basal cell carcinoma of the skin. A 67-year-old woman presented with the 18-month history of multiple, firm, bluish-red asymptomatic nodes on the parietal scalp, chin and lateral part of the trunk that had developed without preceding trauma. One node on the trunk had small central ulceration covered with dry yellowish crust. On the left retroauricular area the brownish-purple atrophic scar was observed. Blood tests revealed reactive VDRL, ELISA and TPHA assays. Skin biopsy has showed endarteritis with endothelial swelling and caseating granulomas along with plasmocytic infiltrate in the dermis and subcutaneous tissue. Increased lymphocyte count and the positive VDRL test with cerebrospinal fluid have confirmed the diagnosis of asymptomatic syphilitic meningitis in this patient. The treatment with aqueous penicillin intravenously has lead to resolution of the skin infiltrates and progressive more than 4-fold reduction of follow-up serum VDRL titers. This case is reported as a reminder of the possibility of tertiary syphilis with misleading clinical patterns in patients infected during the epidemics of 1995-2000. We would like to emphasize the necessity to perform timely serological and pathomorphological study to prevent misdiagnosis and mistreatment.

The relationship between level of childhood abuse (physical and emotional) and sexual risk behavior of sexually transmitted disease (STD) clinic patients in St. Petersburg, Russia was examined through path analyses. Mediating variables investigated were: Alcohol Use Disorder Identification Test (AUDIT), drinking motives (for social interaction, to enhance mood, to facilitate sexual encounters), intimate partner violence (IPV), anxiety, and depression symptoms. Results showed a significant indirect effect of childhood abuse on women’s sexual risk behavior: higher level of childhood abuse was associated with a greater likelihood of IPV, motivations to drink, leading to higher AUDIT scores and correlated to higher likelihood of having multiple, new or casual sexual partner(s). No significant effect was identified in paths to condom use. Among men, childhood abuse had no significant effect on sexual risk behavior. Reduction in alcohol-related sexual risk behavior may be achieved by addressing the effects of childhood abuse among female participants.

Cultural adaptation is an important step in the process of implementing health promotion interventions that, having been proven to be effective in one culture, are being applied in another. This study describes the results of a formative investigation to culturally adapt a STI/HIV risk reduction intervention for use in St. Petersburg, Russia. Analyses of data from brief elicitation interviews, focus groups, community experts, and a pilot test of the adapted intervention identified environmental, cognitive-information processing, and affect-motivation factors that needed to be addressed during the adaptation process. The participant/counselor relationship was adapted to reflect a hierarchical (cf. collaborative) relationship in order to accommodate Russian expectations about patient interactions with healthcare experts. Key skills building activities (e.g., identification of personal risk behaviors, role-playing) were approached gradually or indirectly in order to maintain participants' engagement in the intervention, and close-ended questions were added to assist participants in understanding unfamiliar concepts such as "triggers" and self-efficacy. Information about the prevalence of HIV/STI infections and alcohol use included data specific to St. Petersburg to increase the personal relevance of these materials and messages. Intervention components were tailored to participants' risk reduction and informational needs. No gender differences that would have justified adaptation of the intervention approach or content were noted. Examples of specific adaptations and the key issues to attend to when adapting behavioral interventions for use in Russian clinical settings are discussed.

The study examined the efficacy of a brief theory-based counseling intervention to reduce sexual HIV risk behaviors among STI clinic patients in St. Petersburg, Russia. Men and women (n=307) were recruited to receive either: (1) a 60-minute motivational/skills-building counseling session dealing with sexual HIV risk reduction, or (2) written HIV prevention information material. Participants completed baseline and three- and six-month assessments in the period between July 2009 and May 2011. Compared to the control group, the face-to-face counseling intervention showed significant increases in the percentage of condom use and consistent condom use, and significant decreases in the number of unprotected sexual acts and frequency of drug use before sex at three-months follow-up. Intervention effects dissipated by six months. The brief counseling intervention may effectively reduce HIV sexual risk behaviors and enhance protective behaviors among STI clinic patients in Russia. Short-term positive effects were achieved with a single one hour counseling session.

We investigated whether inebriation was associated with having non-main partners and unprotected sex with non-main partners and whether drinking motivations were associated with sexual risk behaviors among patients attending an STD clinic in St Petersburg, Russia. A cross-sectional behavior survey was applied to 362 participants between 2008 and 2009. Multivariate logistic regression was used for analysis. At-risk drinking per Alcohol Use Disorders Identification Test (AUDIT-C) criteria (OR 2.5, 95% CI 1.4–4.4) was independently associated with having non-main sexual partners. Inebriation (OR 3.2, 95% CI 1.3–8.1) but not at-risk drinking or drinking prior to sex was associated with unprotected sex with non-main partners. Among drinkers, the consumption of alcohol to facilitate sexual encounters (OR 2.7, 95% CI 1.6–4.5) was associated with having non-main sexual partners. HIV prevention programs in Russia must address inebriation in addition to conventional patterns of problem drinking such as those measured by AUDIT-C and consider individuals’ motivations to drink that lead to sexual risk taking.

Sexually transmitted diseases (STDs) are a major public health problem in Russia.1 Although recent research demonstrates a decreasing incidence for syphilis and gonorrhea, and a stable incidence of genital chlamydial infection from mid-1990s to 2005 in Russia, these incidences are still higher than those of western European countries.1 The number of people living with HIV is also an important public health problem and has increased rapidly since mid-1990s.2,3 It is estimated that approximately 940,000 adults are currently living with HIV and the adult prevalence reaches 1.1%.4 In Russia, the HIV epidemic has been observed primarily among injection drug users.2 However, concerns have been raised that the epidemic is spreading to the general population through heterosexual transmission, which may exacerbate the HIV epidemic in Russia.2 The relatively higher incidence of STDs might have contributed, and continue contributing, to the prevalence of HIV in Russia because STDs facilitate HIV sexual transmission.5 Concurrent sexual partnerships play an important role in the spread of STDs and HIV.6–8 Results from mathematical models demonstrated that concurrent sexual partnerships may accelerate the spread of STDs and HIV by increasing the likelihood of exposure to infected persons and reducing the time between sexual contacts among infected and susceptible persons.9–11 Empirical studies have found that sexual concurrency is associated with a higher risk of STDs.12,13 For example, a study conducted among adolescents attending a municipal STD clinic in San Francisco showed that the odds of having STDs for adolescents with concurrent partnerships were 60% higher than those without concurrent partnerships after adjusting for the number of sexual partners.13 In addition, sexual concurrency has been hypothesized to contribute to the generalized epidemics of HIV in sub-Saharan Africa.14,15 Most concurrency studies focus on individual's practice of having concurrent partners (individual concurrency). There are relatively few studies that consider the effect of having partners who engage in concurrent sexual partnerships (partner concurrency) on an individual's risk for STDs. However, an individual's risk for STDs is associated with risk behaviors of both members of a sexual partnership which means that if an individual has a sexual partner who engages in concurrent sexual partnerships, this individual's risk of STDs may be high even if he/she only has 1 sexual partner for a long time. Because data on sexual concurrency (either an individual's or a person's sexual partner's concurrency) are very limited in Russia, we conducted a study in St. Petersburg, Russia, during 2006 to 2008 to investigate the following aims: (1) to examine the prevalence and correlates of both individual and partner concurrency among adults attending 2 STD clinics, and (2) to identify whether individual or partner concurrent sexual partnerships are associated with STDs.

We conducted a cross-sectional study to determine whether the time between two consecutive sexual partnerships (gap) is associated with sexually transmitted infections (STIs) in Russia. A self-administered questionnaire was administered to STI clinic patients in St. Petersburg and participant’s STI data at the time of enrollment in the study was collected from medical charts. The length of the gap between partnerships was divided into four categories: overlapping (0 or negative gap), short gaps (1–90 days), mid-length gaps (91–365 days), and long gaps (366 days or more). Among the 659 respondents, 22.6% had overlapping partnerships, and 13.7, 4.2, and 59.5% had short, mid-length and long gaps, respectively. Short gaps (OR 2.34; 95% CI 1.38–3.95), but not overlapping relationships, were independently associated with STIs when contrasted against long term gaps. HIV prevention programs for Russian STI clinic patients should therefore focus also on prolonging the gap between consecutive, monogamous sexual partnerships.

Aims: This study investigates whether sexual transmitted behaviors and infections (STIs) among injection drug users (IDUs) may promote the spread of HIV among and beyond IDUs in Russia. Methods: We conducted a cross-sectional survey of behavior and tested for STIs in a convenience sample of 159 IDUs in St. Petersburg, Russia. Results: The median age was 27 and 57% were male. Almost all were sexually active, half had casual partners and 40% reported ≧2 sex partners in the previous 3 months. Of those who answered, 81% reported sex without condoms, 44% reported having sex with at least one partner who was not an IDU. Of 139 (87%) subjects who were actively injecting, 29% reported receptive syringe sharing. Twenty percent of subjects were seropositive for HIV-1 and 42% of HIV-1-negative subjects tested positive for an STI. Conclusions: The sample exhibited high levels of sexual risk behaviors and STIs, and a large proportion had sexual partners who were not IDUs. This population requires comprehensive interventions that ensures access to condoms and sterile injection supplies and that encourage safer sexual behaviors in an attempt to keep sexual transmission of HIV low.

The essential issues of clinical and laboratory diagnosis, treatment and prevention of congenital syphilis are reviewed. Last decade the number of babies born with congenital syphilis increased significantly in Russia. Those women at highest risk for the disease seem to be alcohol and drug users, as well as those without antenatal care.

The aim of the project was to study human immunodeficiency virus (HIV) incidence, sociodemographic and behavioral correlates of HIV acquisition among injection drug users (IDUs). A total of 717 IDUs were recruited, tested, and counseled for HIV-1; 466 HIV-negative participants were enrolled and followed-up at 6 and 12 months. Sociodemographic and behavioral data were collected during each study visit. The association of sociodemographic and behavioral factors to HIV-1 incidence was assessed. During the 9-month recruitment period, 717 IDUs were screened and 466 participants were enrolled. HIV-1 prevalence at baseline was 35%. Most enrolled subjects were young (median age 30), male (75%), injected heroin in the previous 3 months (86%), about 50% had shared syringes and other paraphernalia, and 44% had unprotected sex in the last month. The retention rate at the 12-month follow-up was 72% and the adjusted retention rate was 88%. The HIV incidence rate was 7.2/100 person-years. HIV incidence was significantly associated with specific drug risk behaviors, including injecting the mixture of heroin and psychostimulants, the frequency of injecting in groups with other people, and having more drug dealers. The St Petersburg IDUs cohort demonstrates one of the highest HIV incidence rates in the world. In 2004 to 2006, the HIV incidence was 4.5, in 2005 to 2007—19.6, and in 2008 to 2009—7.2/100 person-years. The peak of HIV epidemic among IDUs in St Petersburg, as determined by 3 independent cohort studies, was in 2006 to 2007. Interventions targeting IDUs with long experience of heroin injection and high levels of injection risk behaviors are urgently needed.

Objectives To assess risk for unintended pregnancy, this study describes the correlates of unprotected sexual intercourse (UPSI) among women who inject illicit drugs or who have sexual partners who inject drugs in St Petersburg, Russia. Methods Data from a cross-sectional survey and biological test results collected between 2005 and 2008 from 202 Russian women (143 drug injectors and 59 non-drug injectors) were analysed. Multivariate regression was used to investigate the correlates of UPSI occurring at the women9s last sexual act. Independent variables included socio-demographics, age at sexual debut, first sexual encounter perceived as involuntary, number of pregnancies and number of children for which the participant is the primary caretaker, heavy sporadic drinking (i.e. consuming more than five drinks in 2 hours at least twice a month), at-risk drinking per the Alcohol Use Disorder Identification Test (AUDIT-C) score, and sexually transmitted infections (HIV-1, syphilis serology, Chlamydia trachomatis and Neisseria gonorrheae ). Results Sixty-seven percent of women reported UPSI at last intercourse. UPSI was independently associated with heavy sporadic drinking [odds ratio (OR) 2.8, 95% CI 1.2–6.6] and having been pregnant (OR 2.25, 95% CI 1.1–4.6). Conclusions Despite the high risk for HIV acquisition or transmission and unintended pregnancy, condom use among the study population is low. Programmes to investigate and improve contraceptive use, including condom use, among this vulnerable group of women are needed. Such programmes may require identifying and targeting female reproductive health concerns and problem drinking, particularly heavy sporadic drinking, rather than conventional measures of alcohol misuse.

BACKGROUND: Gender differences in the relationship between alcohol use and depressive symptoms are inconsistent, and few studies have addressed this issue in Russia. Because this finding may have important implications for interventions to reduce alcohol misuse or alcohol related problems in Russia, we conducted a study to investigate whether the association between alcohol use and depressive symptoms differs by gender at high risk for HIV. METHODS: We used the Alcohol Use Disorders Identification Test (AUDIT) and the 10-item Center for Epidemiological Studies Depression Scale to measure alcohol use and depressive symptoms among 307 patients who attended a clinic for sexually transmitted infections in St. Petersburg, Russia. Logistic regression models were applied for the analysis. RESULTS: The comparison of data between men and women revealed a significant quadratic term of alcohol use and significant interactions between alcohol use and gender on depressive symptoms. Men with an AUDIT score in the first and fourth quartiles were more likely to report depressive symptoms in comparison to men in the second quartile. Their odds ratios (ORs) and 95% confidence intervals (CIs) were 7.54 (2.00-28.51) and 5.06 (1.31-19.63), respectively. Among women, a linear trend was observed such that those who misused alcohol were three times more likely to have depressive symptoms than those who did not misuse alcohol (OR = 3.03, 95% CI, 1.05-8.80). CONCLUSION: The association between alcohol use and depressive symptoms differed by gender. Additional research is needed to investigate this relationship in Russia. Strategies to reduce alcohol-related problems in Russia may need to consider these differences.

Background Many women in Russia rely on abortion as a primary birth control method. Although refusal to use contraceptives, including condoms, may undermine public health efforts to decrease HIV sexual risk behaviors, few studies have investigated the risk factors associated with abortion among women at high risk for HIV. This study sought to identify the correlates of abortions and of lack of condom use among high risk STD clinic patients in St Petersburg Russia. Methods Cross-sectional analysis of data collected between 2009 and 2010 from women who had casual or multiple sexual partners in the previous three months was analyzed. Multivariate logistic regression assessed the independent correlates of abortion(s) and no condom use in the prior three months. Independent variables included socio-demographics, at risk drinking per alcohol use disorder identification test (AUDIT-C) criteria, having sex after drinking alcohol, having a sexual partner who injects illicit drugs, and parity. Results Of 87 participants, 45% had an abortion in their lifetime and 26% did not use condoms in the prior three months. Abortion was independently associated with low income (OR, 3.33, 95%CI, 1.13-9.78) and at risk drinking (OR, 3.52, 95%CI, 1.24-10.05). Lack of condom use was independently associated with being more likely to have sex after drinking (OR, 3.37, 95%CI, 1.10-10.28) and parity (OR, 3.69, 95%CI, 1.25-10.89). Conclusions Programs to increase contraceptive use including condom use among women at high risk for STD/HIV in Russia are needed. Programs to reduce sexual HIV risk and abortion rates must address alcohol misuse and target women with limited income.

Background Alcohol misuse has been linked to intimate partner violence (IPV). However, this association is not usually examined in Russia. Moreover, more investigation is required as to whether specific drinking contexts are also associated with IPV. The objectives of this study are: to investigate whether alcohol misuse is associated with IPV and to further examine whether specific drinking contexts among drinkers are associated with IPV. Methods A questionnaire was used to collect information on demographics, health status, alcohol use, and violence involving sexual partners among 440 participants who were recruited from an STI (sexually transmitted infection) clinic center in St. Petersburg, Russia for a cross-sectional study from 2008 to 2009. Multivariate logistic regression was used for analysis. Results Overall, 47.0% participants were classified as misusing alcohol and 7.2% participants perpetrated IPV in the past three months. Participants with alcohol misuse were 3.28 times (OR: 3.28; 95% CI: 1.34-8.04) as likely as those without alcohol misuse to perpetrate IPV. Among participants who had consumed alcohol in the past three months, those who usually drank on the streets or in parks (OR: 5.62; 95% CI: 1.67-18.90) were more likely to perpetrate IPV. Conclusions Both alcohol misuse and certain drinking contexts (e.g., drinking on the streets or at parks) were associated with IPV. The association between drinking contexts and IPV needs further investigation, as do the underlying mechanisms for this association. IPV prevention initiatives might benefit from reducing alcohol misuse. Drinking contexts such as drinking on the streets or at parks as well as the factors related to the use of alcohol in these contexts may also need to be addressed.

Background This cross-sectional study estimated the prevalence of contraceptive methods and investigated whether abortion rates influence contraceptive behaviour among injection drug-using (IDU) women in St Petersburg, Russia. Methodology A self-administered questionnaire of behaviour in the last 3 months was applied to a convenient sample of IDU women. Results Of 80 sexually active participants, 67% had had an abortion. No participant reported using hormonal contraceptives or intrauterine devices (IUDs). The only valid method of contraception used was condoms, which was reported by half of the participants. Consistent condom use was reported by 22% of participants and was no more likely among those who had an abortion. Condom use was significantly associated with having multiple or casual sex partners [prevalence ratio (PR) 1.75, 95% (confidence interval) CI 1.11–2.78, p = 0.01], having an IDU sex partner (PR 0.55, 95% CI 0.36–0.85, p = 0.029) and with a negative attitude toward condoms (PR 0.53, 95% CI 0.33–0.84, p = 0.01). Abortions were less likely among those who had multiple or casual sex partners (PR 0.69, 95% CI 0.49–0.97, p = 0.03). Conclusions Despite the high prevalence of abortions among IDU women, none reported the use of hormonal contraception or IUDs. Having had an abortion was not associated with greater likelihood of using condoms. Participants mostly used condoms with casual or multiple sex partners, suggesting that condoms were used mainly to prevent HIV/sexually transmitted infection transmission and not to prevent pregnancy. Programmes to prevent unwanted pregnancies and reduce abortion-related health risks among this understudied vulnerable group are needed.

International audience; Discrete ELF/VLF chorus emissions, the most intense electromagnetic plasma waves observed in the Earth's radiation belts and outer magnetosphere, are thought to propagate roughly along magnetic field lines from a localized source region near the magnetic equator towards the magnetic poles. THEMIS project Electric Field Instrument (EFI) and Search Coil Magnetometer (SCM) measurements were used to determine the spatial scale of the chorus source lo-calization region on the day side of the Earth's outer magne-tosphere. We present simultaneous observations of the same chorus elements registered onboard several THEMIS spacecraft in 2007 when all the spacecraft were in the same orbit. Discrete chorus elements were observed at 0.15–0.25 of the local electron gyrofrequency, which is typical for the outer magnetosphere. We evaluated the Poynting flux and wave vector distribution and obtained chorus wave packet quasi-parallel propagation to the local magnetic field. Amplitude and phase correlation data analysis allowed us to estimate the characteristic spatial correlation scale transverse to the local magnetic field to be in the 2800–3200 km range. Keywords. Electromagnetics (Random media and rough surfaces) – Magnetospheric physics (Plasma waves and in-stabilities) – Radio science (Remote sensing)

The Whisper instrument yields two data sets: (i) the electron density determined via the relaxation sounder, and (ii) the spectrum of natural plasma emissions in the frequency band 2–80 kHz. Both data sets allow for the three-dimensional exploration of the magnetosphere by the Cluster mission. The total electron density can be derived unambiguously by the sounder in most magnetospheric regions, provided it is in the range of 0.25 to 80 cm-3 . The natural emissions already observed by earlier spacecraft are fairly well measured by the Whisper instrument, thanks to the digital technology which largely overcomes the limited telemetry allocation. The natural emissions are usually related to the plasma frequency, as identified by the sounder, and the combination of an active sounding operation and a passive survey operation provides a time resolution for the total density determination of 2.2 s in normal telemetry mode and 0.3 s in burst mode telemetry, respectively. Recorded on board the four spacecraft, the Whisper density data set forms a reference for other techniques measuring the electron population. We give examples of Whisper density data used to derive the vector gradient, and estimate the drift velocity of density structures. Wave observations are also of crucial interest for studying small-scale structures, as demonstrated in an example in the fore-shock region. Early results from the Whisper instrument are very encouraging, and demonstrate that the four-point Cluster measurements indeed bring a unique and completely novel view of the regions explored.Key words. Space plasma physics (instruments and techniques; discontinuities, general or miscellaneous)

Background To date, the great majority of Russian HIV infections have been diagnosed among IDUs and concerns about the potential for a sexual transmission of HIV beyond the IDU population have increased. This study investigated differences in the prevalence of sexual risk behaviors between IDUs and non-IDUs in St. Petersburg, Russia and assessed associations between substance use patterns and sexual risks within and between those two groups. Methods Cross-sectional survey data and biological test results from 331 IDUs and 65 non-IDUs who have IDU sex partners were analyzed. Multivariate regression was employed to calculate measures of associations. Results IDUs were less likely than non-IDUs to report multiple sexual partners and unprotected sex with casual partners. The quantity, frequency and intensity of alcohol use did not differ between IDUs and non-IDUs, but non-IDUs were more likely to engage in alcohol use categorized as risky per the alcohol use disorders identification test (AUDIT-C). Risky sexual practices were independently associated with monthly methamphetamine injection among IDUs and with risky alcohol use among non-IDUs. Having sex when high on alcohol or drugs was associated with unprotected sex only among IDUs. Conclusions Greater prevalence of sexual risk among non-IDUs who have IDU sex partners compared to IDUs suggests the potential for sexual transmission of HIV from the high-prevalence IDU population into the general population. HIV prevention programs among IDUs in St. Petersburg owe special attention to risky alcohol use among non-IDUs who have IDU sex partners and the propensity of IDUs to have sex when high on alcohol or drugs and forgo condoms.