APH 2004, 62, 259 - 270 :

Preliminary results of STI Sentinel Surveillance System in Belgium.

A. Defraye, A. Sasse

Keywords: STI - Sexually transmitted infections - STD - syphilis - sentinel surveillance - HIV

Objectives: To determine STI incidence trends. Additional objectives: to identify subpopulations at risk that could be prioritised target groups for prevention.

Methods: The network consists of gynaecologists, dermatologists, general practitioners, urologists, STI clinics, student centres and sexual education centres. Three years in a row, the number of STI patients has been registered during a 4-month period, from October until January. In the 2002-2003 period, 69 sites reported a total of 282 patients. Trends were analysed on the basis of results from 23 sites that reported in all periods.

Results: Between October 2000 and January 2003, an increasing, but not significant trend in chlamydia in women was observed (p-value=0.25). The syphilis trend started to increase in 2001-2002 (+600%; p-value<0.01) and continued throughout 2002 and 2003, al be it at a slower pace (+38%; p-value=0.06). The increase in syphilis infections in men was largely attributable to infections in men who have sex with men (MSM).Overall, an increasing trend in HIV infections among STI patients was seen, particularly among syphilis patients. This high HIV prevalence among patients diagnosed with syphilis (up to 60% in third period) may be partly linked to the specificity of the sites participating in the STI sentinel surveillance.

Conclusions: The results of this surveillance indicate an important increase of syphilis in MSM and show a large proportion of HIV positive cases among them. The data for syphilis may point out an increase in unsafe sex. This calls for intensification of prevention programmes and for an improved surveillance system countrywide. Even more stress should be put on the recommendation of HIV tests to STI patients.