Increase of early syphilis in Rotterdam (1995-1997): more (addicted) prostitutes and their clients

OBJECTIVE: To detect risk groups in an increase of early (infectious) syphilis. DESIGN: Retrospective study of patient records. METHOD: Data from visitors with an early syphilis were collected from their respective medical records in the outpatient clinic for sexually transmitted diseases (STD) of the Academic Hospital Rotterdam-Dijkzigt, the Netherlands, over the years 1993-1997. In particular, data on risk behaviour and risk groups were collected. To obtain an indication of the (possible) causes of the increase in the number of visitors with early syphilis, (shifts in) characteristics of this population over the years were compared. RESULTS: 195 patients with early syphilis had visited the outpatient clinic, 130 males and 65 females, mean ages ranging from 30.9 (1993) to 38.1 years (1997). Most infected persons (68%) came to the outpatient clinic because of symptoms. The number of women who came to the outpatient clinic through partner notification increased considerably, from an average of 5% in 1993-1995 to 36% in 1996. Over the years a relative increase of (drug addicted) prostitutes and their clients was observed (1993-1995: 39%; 1996: 56%). CONCLUSION: The cause of the increase, or failure to decrease, of the number of syphilis-infected visitors in the STD outpatient clinic of the Academic Hospital Rotterdam-Dijkzigt should probably be sought among (drug addicted) prostitutes and their visitors.