title: Primary syphilis in HIV-negative patients is on the rise in Greece: epidemiological data for the period 2005-2012 from a tertiary referral centre in Athens, Greece.
abstract: BACKGROUND
  Epidemiological data on primary syphilis in Greece are limited.
  
  
  OBJECTIVE
  The purpose of the present study was to investigate the trends of the disease in Greece during the last few years and whether they are in accordance with the trends in other European countries and the United States of America.
  
  
  METHODS
  We conducted a retrospective analysis based on records of patients who visited the Sexually Transmitted Infections Unit of 'A. Sygros' Hospital in Athens, Greece, during the period 2005-2012. Our hospital is a tertiary referral centre for sexually transmitted infections covering an area of more than four million people, which is almost half the population of Greece. We documented the total annual number of patients, the male to female ratio, sexual orientation, patients' ethnic origin and education level.
  
  
  RESULTS
  We reviewed the records of 1185 patients with a confirmed diagnosis of primary syphilis. The total number of patients with primary syphilis has risen from 111 in 2005 to 158 in 2012, an increase of 42.3%. The mean annual number is 148. The mean male to female ratio is 4.76 : 1, with a peak value of 8.50 : 1 in 2011. The majority of patients are of Greek origin, ranging from 67.4% to 87.2%. Within the male patients group, it seems that the percentage of men having sex with men has risen steadily from 2005 (20.7%) up to 2010 (59.1%) with a decline in 2012 (46.0%). The mean value over 8 years is 45.0%.
  
  
  CONCLUSIONS
  Primary syphilis in Greece is on the rise. Τhe majority of our patients are Greek, despite immigrant influx. Men clearly outnumber women, representing more than 80% of the total number of patients. Furthermore, there seems to be a trend towards predominance of men having sex with men as the core group among male patients.
authors.affiliation: 1st Department of Dermatology and Venereology, Sexually Transmitted Infections Unit, University of Athens School of Medicine, 'A. Sygros' Hospital, Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Kanelleas
authors.forename: C
authors.initials: C
authors.lastname: Stefanaki
authors.forename: I
authors.initials: I
authors.lastname: Stefanaki
authors.forename: G
authors.initials: G
authors.lastname: Bezrondii
authors.forename: V
authors.initials: V
authors.lastname: Paparizos
authors.forename: A
authors.initials: A
authors.lastname: Arapaki
authors.forename: Z
authors.initials: Z
authors.lastname: Kripouri
authors.forename: C
authors.initials: C
authors.lastname: Antoniou
authors.forename: E
authors.initials: E
authors.lastname: Nicolaidou
mesh_terms: D000328:Adult; D005260:Female; D006115:Greece / Q000453:epidemiology; D018023:HIV Seronegativity; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D013587:Syphilis / Q000453:epidemiology* / Q000208:ethnology; D062606:Tertiary Care Centers