Influence of special surveillance programmes and AIDS on declining incidence of syphilis in Amsterdam

In 1976-8 the incidence of syphilis in Amsterdam doubled from 41 to 88 per 100,000. Contact tracers identified two major risk groups, homosexual men with multiple partners and prostitutes using drugs, and special surveillance programmes for these groups have been organised on a regular basis since 1979. As a result of these two programmes the incidence of syphilis started to decline appreciably in 1981-3. From 1984 onwards a further decline occurred in men as a result of a change of lifestyle by homosexual men, probably because of the appearance of AIDS. In 1985 the incidence of syphilis in Amsterdam had dropped to 30 per 100,000, the lowest level since notification started.