Recent syphilis trends in Belgium and enhancement of STI surveillance systems

Abstract

Over the past five years, a series of syphilis outbreaks mainly occurring among gay men have been observed in Europe. One of these outbreaks was reported in the city of Antwerp, Belgium, during the first quarter of 2001. This outbreak is still ongoing in 2004. Furthermore, active syphilis diagnoses reported by the Sentinel Laboratory Network rose by 89% in the country during the fourth quarter of 2003. An increase in Brussels was also observed during the same quarter (+300%; 24 cases reported). Overall, the sentinel network of clinicians reported that 93.4% of patients were male; among them, 79.9% were men having sex with men (MSM). The overall proportion of patients co-infected with HIV was 50.5% (MSM: 58.6%; male heterosexuals: 23.8%; females: 8.3%); 76.1% of co-infected patients were already aware of their HIV infection at the time they were diagnosed with syphilis.

Syphilis

“…Similar outbreaks of syphilis have been reported in MSM in Western Europe ( Cowan, 2004 ;Marcus et al, 2004 ;Righarts et al, 2004 ;Sasse et al, 2004 ). The incidence of primary and secondary syphilis in U.S. males doubled from 2000 to 2005 ( CDC, 2006b ), and provisional data suggest a continuing increase of 5 -8% per year since that time.…”

Recently acquired HIV infection in men who have sex with men (MSM) in France, 2003-2008

“…In the early 2000s, epidemics of syphilis and then of LGV occurred in all Western European countries, mainly among HIV-infected MSM [26][27][28][29][30][31]. The number of new HIV diagnoses among MSM and bisexual men increased by 86% between 2000 and 2006 in 23 European countries [32].…”

Formation of Personal HIV Disclosure Policies among HIV-Positive Men Who Have Sex with Men

“…Concomitantly, incidence of HIV infection and markers for HIV infection (e.g., syphilis, gonorrhea) are rising among urban MSM, [1][2][3] which may indicate that prevention efforts are not keeping pace. Thus, it makes sense to extend efforts beyond infection risk reduction with presumably uninfected persons to transmission risk reduction.…”