title: 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.
abstract: OBJECTIVE
  Sexually transmitted diseases (STDs) are on the rise, mainly among men having sex with men (MSM).
  
  
  OBJECTIVE
  The goal of this study was to evaluate whether STD increases as seen in MSM are also visible among heterosexuals.
  
  
  METHODS
  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.
authors.affiliation: Department of Research, Cluster Infectious Diseases, Health Service of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Akke K
authors.initials: AK
authors.lastname: Van der Bij
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Geskus
authors.forename: Han S A
authors.initials: HS
authors.lastname: Fennema
authors.forename: Karin
authors.initials: K
authors.lastname: Adams
authors.forename: Roel A
authors.initials: RA
authors.lastname: Coutinho
authors.forename: Nicole H T M
authors.initials: NH
authors.lastname: Dukers
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D005260:Female; D020010:Heterosexuality; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening; D009426:Netherlands / Q000453:epidemiology; D009819:Office Visits / Q000706:statistics & numerical data; D015995:Prevalence; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*