Despite lack of quality data, there is little doubt that most of the Newly Independent States (NIS) have been facing major sexually transmitted disease (STD) epidemics since the beginning of the 1990s. Changes in sexual norms and behaviors are likely to have contributed to the epidemics in the NIS, as are underlying socioeconomic and political changes. However, the limitations of STD policies and services, including lack of access to and shrinking affordability of quality STD care, and lack of e…