title: Sexual behaviour and sexually transmitted infections in sexually transmitted infection clinic attendees in the Netherlands, 2007-2011.
abstract: High annual figures of sexually transmitted infections (STIs) are diagnosed in the Netherlands despite significant efforts to control them. Herein, we analyse trends and determinants of STI diagnoses, co-infections, and sexual risks among visitors of 26 STI clinics between 2007 and 2011. We recorded increased positivity rates of STIs (chlamydia, syphilis, gonorrhoea, and/or HIV) in women and heterosexual men up to 12.6% and 13.4%, respectively, in 2011, while rates in men having sex with men (MSM) were stable but high (18.8%) through the documented years. Younger age, origin from Surinam/Antilles, history of previous STI, multiple partners, or a previous notification are the identified risk factors for an STI in this population. Known HIV-infected men (MSM and heterosexuals) were at highest risk for co-infections (relative rate heterosexual men: 15.6; MSM: 11.6). STI positivity rates remained high (MSM) or increased over time (women and heterosexual men), a fact that highlights the importance of continuing STI prevention. Most importantly, the very high STI co-infection rates among HIV-positive men requires intensified STI reduction strategies to put an end to the vicious circle of re-infection and spread of HIV and other STIs.
authors: Centre for Infectious Disease Control, National Institute of Public Health and the Environment, Bilthoven, the Netherlands.
authors: E L M Op
authors: EL
authors: de Coul
authors: T D
authors: TD
authors: Warning
authors: F D H
authors: FD
authors: Koedijk
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D060085:Coinfection / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis / Q000453:epidemiology; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D055815:Young Adult
keywords: (Treponema pallidum); Human immunodeficiency virus; Netherlands; bacterial disease; chlamydia (Chlamydia trachomatis); epidemiology; gonorrhea (Neisseria gonorrhoeae); high-risk behaviour; prevalence; sexually transmitted infections; syphilis; viral disease