Silent Battles: Women’s Rights and the Challenge of Sexually Transmitted Infections in Ukraine

In a nation scarred by war, displacement and economic disruption, public health challenges often unfold in the background — quietly but with deep, long-lasting consequences. Amongst the most urgent and under-addressed of these is the rising threat of sexually transmitted infections (STIs) and their disproportionate impact on women in Ukraine. While national resilience has been rightfully celebrated, Ukraine now faces a subtler struggle: one for bodily autonomy, access to care and gender justice in the face of overlapping health crises.

STIs are not simply clinical concerns. They are public health indicators, social justice markers, and — in the context of Ukraine — symptoms of broader structural inequalities. Addressing them requires more than clinics and medication: it demands the protection of women’s rights, the dismantling of stigma, and the integration of care into the fabric of post-war recovery.

A Growing Health Crisis Amidst War and Displacement

Even before Russia’s full-scale invasion in 2022, Ukraine faced persistent public health challenges related to HIV, syphilis, gonorrhoea, and other STIs. The World Health Organization ranked Ukraine amongst the highest in Europe for HIV prevalence, particularly amongst women of reproductive age and key populations such as sex workers and internally displaced persons (IDPs). Since the war’s escalation, these risks have only deepened.

War has disrupted the continuity of healthcare systems. Displacement has severed women from primary care providers and left many without access to regular screening, contraception and treatment. According to estimates by the Ministry of Health and UNAIDS, hundreds of thousands of women — especially in frontline and occupied regions — now live without guaranteed access to sexual and reproductive health services.

Moreover the collapse of informal social safety nets has led to increased transactional sex and vulnerability to sexual violence, particularly among IDPs, refugees and those living in economically distressed areas. The result is a hidden epidemic, especially of untreated and undiagnosed infections — many of which can cause infertility, chronic illness and neonatal harm if left unmanaged.

Barriers to Diagnosis and Treatment

A core problem is access — to clinics, information, and protection. Many public STI clinics have been destroyed, underfunded or made inaccessible by security risks. Where facilities remain, stigma and fear of discrimination — especially for unmarried or displaced women — discourage visits. In rural areas and frontline zones, testing is often unavailable, forcing women to rely on self-diagnosis or forgo treatment altogether.

Access is further complicated by:

• Shortages of antibiotics and antiretrovirals, especially in the east;

• Undertrained health workers in makeshift IDP clinics;

• The collapse of school-based sexual health education, which limits prevention among adolescent girls;

• A still-strong cultural taboo around discussing sexual health in public or professional settings.

Although Ukraine’s national health strategy includes a reproductive health component, funding shortfalls and wartime priorities have severely undercut implementation — particularly in women-led civil society efforts that had once filled critical gaps.

Sexual Violence and Rights in Conflict

The sexual health crisis cannot be separated from the issue of conflict-related sexual violence. Ukraine has seen numerous documented cases of rape and sexual abuse committed in occupied territories, detention centres, and refugee routes — overwhelmingly targeting women and girls. Many survivors lack safe reporting mechanisms, trauma-informed care or basic access to post-exposure prophylaxis, emergency contraception or counselling.

Rape is not only a weapon of war — it is a catalyst for silent health crises. Survivors often experience HIV transmission, HPV-related complications and psychosomatic reproductive disorders, made worse by a culture of silence and inadequate institutional response. Addressing these layered harms demands a rights-based approach — one that centres survivors’ autonomy, privacy, and access to medical and psychological care.

Advocacy, Resilience and the Road Ahead

Despite these challenges, women’s rights organisations, healthcare NGOs, and survivor-led networks across Ukraine continue to fight for visibility, justice, and care. Organisations such as La Strada Ukraine, Insight NGO, and local women’s clinics in Lviv, Odesa, and Dnipro have been instrumental in:

• Running mobile testing clinics for STIs and HIV;

• Distributing dignity kits in displacement centres;

• Providing legal advocacy for survivors of sexual violence;

• Developing educational materials on STI prevention and reproductive rights.

International partnerships — particularly with UNFPA, Doctors Without Borders, and GIZ — have also enabled emergency responses. But longer-term progress requires national commitment.

Policy Priorities Moving Forward

1. Restoration and funding of sexual health services in IDP hubs and rural areas;

2. Free and confidential STI testing and treatment as a basic component of universal health coverage;

3. Integration of sexual violence response into all humanitarian protection frameworks;

4. Community-based education programmes to destigmatise testing, especially for young women and survivors;

5. Legal protection of women’s health rights in wartime and peacetime under constitutional and EU-aligned frameworks.

Conclusion: Health is a Human Right

In Ukraine’s war-torn landscape, the challenge of sexually transmitted infections is not just a matter of disease — it is a matter of dignity, access and justice. It is about protecting the bodies of women who are too often unheard. To build a strong, democratic and resilient Ukraine, we must not only reconstruct buildings — we must rebuild systems that protect women’s health and rights from the inside out.

The war may have stolen much — but it cannot be allowed to steal women’s futures.