title: Recent trends in diagnoses of HIV and other sexually transmitted infections in England and Wales among men who have sex with men.
abstract: OBJECTIVE
  To examine trends in rates of diagnoses of HIV and other sexually transmitted infections (STIs) in men who have sex with men (MSM) in England and Wales between 1997 and 2002.
  
  
  METHODS
  Estimates of the MSM population living in England and Wales, London and the rest of England and Wales were applied to surveillance data, providing rates of diagnoses of HIV and STIs and age group specific rates for HIV and uncomplicated gonorrhoea.
  
  
  RESULTS
  Between 1997 and 2002, rates of diagnoses of HIV and acute STIs in MSM increased substantially. Rates in London were higher than elsewhere. Rises in acute STIs were similar throughout England and Wales, except for uncomplicated gonorrhoea and infectious syphilis, with greater increases outside London. Rates of gonorrhoea diagnoses doubled between 1999 and 2001 (661/100,000, 1271/100,000, p<0.001) in England and Wales followed by a slight decline to 1210/100,000 (p=0.03) in 2002-primarily the result of a decline in diagnoses among men aged 25-34 (1340/100,000, 1128/100,000, p<0.001) and 35-44 (924/100,000, 863/100,000, p=0.03) in London. HIV was the third most common STI diagnosed in MSM in England and Wales and the second in London, with the highest rate (1286/100,000) found among men aged 35-44 in London in 2002.
  
  
  CONCLUSIONS
  Rates of diagnosis of HIV and other STIs have increased substantially among MSM in England and Wales. Increases show heterogeneity by infection, geography, and age over time. Rates in London were twice those seen elsewhere, with greatest changes over time. The observed changes reflect concomitant increases in high risk behaviour documented in behavioural surveillance survey programmes.
authors.affiliation: HIV and Sexually Transmitted Infections Department, Health Protection Agency, Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ, UK. neil.macdonald@hpa.org.uk.
authors.forename: N
authors.initials: N
authors.lastname: Macdonald
authors.forename: S
authors.initials: S
authors.lastname: Dougan
authors.forename: C A
authors.initials: CA
authors.lastname: McGarrigle
authors.forename: K
authors.initials: K
authors.lastname: Baster
authors.forename: B D
authors.initials: BD
authors.lastname: Rice
authors.forename: B G
authors.initials: BG
authors.lastname: Evans
authors.forename: K A
authors.initials: KA
authors.lastname: Fenton
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D004739:England / Q000453:epidemiology; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology; D006306:Health Surveys; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D015995:Prevalence; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000453:epidemiology; D014852:Wales / Q000453:epidemiology