[Declining trend in gonorrhea in The Netherlands; significance for the AIDS epidemic?]

Since 1981, the notified incidence of gonorrhoea has been decreasing in The Netherlands, thus preceding the onset of the AIDS epidemic. The declining trend of gonorrhoea and its underlying reasons are investigated. The reporting patterns may be influenced not only by the disease incidence but by other factors as well. Therefore the national notification gonorrhoea data over the period 1976-1988 are analysed in conjunction with detailed data from the two sexually transmitted diseases (STD) clinics in Amsterdam. Since 1983 the decline in gonorrhoea has been further reinforced by a dramatic decrease in gonorrhoea among homo/bisexual men, presumably as a result of behavioural changes because of AIDS. There is less evidence of massive behavioural changes among heterosexuals. The incidence of repeat infection among the gonorrhoea population in Amsterdam increases and may suggest that sexually highly active individuals continue to put themselves at risk of STDs, despite the educational campaigns with respect to the AIDS epidemic.