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No Evidence for a Sustained Increase in Sexually Transmitted Diseases Among Heterosexuals in Amsterdam, The Netherlands A 12-Year Trend Analysis at the Sexually Transmitted Disease Outpatient Clinic Amsterdam

Van der Bij, Akke K. MD*; Geskus, Ronald B. PhD*†‡; Fennema, Han S. A. PhD§; Adams, Karin; Coutinho, Roel A. PhD*†‡¶; Dukers, Nicole H. T. M. PhD*†‡

Sexually Transmitted Diseases: July 2007 - Volume 34 - Issue 7 - p 461-467
doi: 10.1097/01.olq.0000251230.62493.f3

Objectives: Sexually transmitted diseases (STDs) are on the rise, mainly among men having sex with men (MSM).

Goal: The goal of this study was to evaluate whether STD increases as seen in MSM are also visible among heterosexuals.

Study Design: Attendees of the STD clinic in Amsterdam, The Netherlands, are routinely tested for chlamydia, gonorrhea, and syphilis. Additionally, all women are tested for trichomoniasis. STD time trends of heterosexual attendees between 1994 and 2005 were analyzed by logistic regression and generalized linear models with a negative binomial distribution.

Results: The number of consultations doubled since 1994. However, no long-term increase was seen in the number of syphilis and gonorrhea infections. Additionally, the trichomonas prevalence declined. However, the number of chlamydia infections increased over time.

Conclusions: Although the number of attendees increased, no evidence for increasing STD incidence was found among heterosexuals. The increase in chlamydia infections can probably be explained by increased screening resulting from increased numbers of attendees.

Although the number of heterosexuals attending the Amsterdam sexually transmitted disease clinic, The Netherlands, increased considerably, no sustained increase was found in the number of gonorrhea or syphilis infections.

From the *Department of Research, Cluster Infectious Diseases, Health Service of Amsterdam, Amsterdam, The Netherlands; the †Department of Internal Medicine and the ‡Center for Infection and Immunity Amsterdam, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands; the §STD Outpatient Clinic and the ∥Public Health Laboratory, Cluster Infectious Diseases, Health Service of Amsterdam, Amsterdam, The Netherlands; and the ¶Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands

The authors thank Ineke G. B. Linde, senior laboratory technician, for supervising laboratory diagnosis of NG and TV, the Public Health Nurses of the STD outpatient clinic in Amsterdam for data collection, Jannie van der Helm for providing STD numbers and data of 2005, and to Lucy Phillips for editing the manuscript.

Correspondence: Nicole H. T. M. Dukers, PhD, Department of Research, Cluster of Infectious Diseases, Health Service of Amsterdam, P.O. Box 2200, 1000 CE Amsterdam, The Netherlands. E-mail:

Received for publication March 17, 2006, and accepted October 2, 2006.

© Copyright 2007 American Sexually Transmitted Diseases Association