Skip to main content
PMC home page
Genitourinary Medicine logoLink to Genitourinary Medicine
. 1990 Jun;66(3):148–155. doi: 10.1136/sti.66.3.148

Declining gonorrhoea rates in The Netherlands, 1976-88: consequences for the AIDS epidemic.

M J van de Laar 1, J Pickering 1, J A van den Hoek 1, G J van Griensven 1, R A Coutinho 1, H P van de Water 1
PMCID: PMC1194493  PMID: 2370059

Abstract

The national notification gonorrhoea data are analysed over the period 1976-88 in conjunction with detailed data from the two STD clinics in Amsterdam in order to get an insight into the underlying reasons for the downward trend of gonorrhoea in The Netherlands. Possible effects of variations in reporting bias, seasonality, resistance against antibiotics, and sexual behaviour on gonorrhoea rates are considered. In 1981 the incidence of gonorrhoea started to decrease, thus preceding the onset of the AIDS epidemic in The Netherlands. Since 1983 the decline in gonorrhoea further accelerated and has been most apparent among homo- and bisexual men, presumably as a result of behavioural changes because of AIDS. There is less evidence for massive (AIDS related) behavioural changes among heterosexuals. The increasing percentage of gonorrhoea patients with recurrent episodes of STDs in Amsterdam may suggest that highly sexually active individuals continue to put themselves at risk of STDs and persist in acquiring and transmitting gonorrhoea.

Full text

PDF
148

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson R. M., May R. M. Epidemiological parameters of HIV transmission. Nature. 1988 Jun 9;333(6173):514–519. doi: 10.1038/333514a0. [DOI] [PubMed] [Google Scholar]
  2. Centers for Disease Control (CDC) Toxic-shock syndrome--United States, 1970-1980. MMWR Morb Mortal Wkly Rep. 1981 Jan 30;30(3):25-8, 33. [PubMed] [Google Scholar]
  3. Coutinho R. A., Schoonhoven F. J., van den Hoek J. A., Emsbroek J. A. Influence of special surveillance programmes and AIDS on declining incidence of syphilis in Amsterdam. Genitourin Med. 1987 Jun;63(3):210–213. doi: 10.1136/sti.63.3.210. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Evans B. A., McLean K. A., Dawson S. G., Teece S. A., Bond R. A., MacRae K. D., Thorp R. W. Trends in sexual behaviour and risk factors for HIV infection among homosexual men, 1984-7. BMJ. 1989 Jan 28;298(6668):215–218. doi: 10.1136/bmj.298.6668.215. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Fennema J. S., van den Hoek J. A., Rijsdijk A. J., van der Linden M. M., Coutinho R. A. Het vórkomen van seksueel overdraagbare aandoeningen bij bezoekers van twee geslachtsziektenpoliklinieken in Amsterdam, 1981-1987. Ned Tijdschr Geneeskd. 1989 Apr 29;133(17):886–890. [PubMed] [Google Scholar]
  6. Gellan M. C., Ison C. A. Declining incidence of gonorrhoea in London: a response to fear of AIDS? Lancet. 1986 Oct 18;2(8512):920–920. doi: 10.1016/s0140-6736(86)90440-x. [DOI] [PubMed] [Google Scholar]
  7. Golubjatnikov R., Pfister J., Tillotson T. Homosexual promiscuity and the fear of AIDS. Lancet. 1983 Sep 17;2(8351):681–681. doi: 10.1016/s0140-6736(83)92557-6. [DOI] [PubMed] [Google Scholar]
  8. Hayward R. A., Shapiro M. F., Oye R. K. Laboratory testing on cerebrospinal fluid. A reappraisal. Lancet. 1987 Jan 3;1(8523):1–4. doi: 10.1016/s0140-6736(87)90698-2. [DOI] [PubMed] [Google Scholar]
  9. Judson F. N. Fear of AIDS and gonorrhea rates in homosexual men. Lancet. 1983 Jul 16;2(8342):159–160. doi: 10.1016/s0140-6736(83)90138-1. [DOI] [PubMed] [Google Scholar]
  10. Lawrence A. G., Singaratnam A. E. Changes in sexual behaviour and incidence of gonorrhoea. Lancet. 1987 Apr 25;1(8539):982–983. doi: 10.1016/s0140-6736(87)90334-5. [DOI] [PubMed] [Google Scholar]
  11. Martin J. L., Garcia M. A., Beatrice S. T. Sexual behavior changes and HIV antibody in a cohort of New York City gay men. Am J Public Health. 1989 Apr;79(4):501–503. doi: 10.2105/ajph.79.4.501. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Martin J. L. The impact of AIDS on gay male sexual behavior patterns in New York City. Am J Public Health. 1987 May;77(5):578–581. doi: 10.2105/ajph.77.5.578. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. May R. M., Anderson R. M. Transmission dynamics of HIV infection. Nature. 1987 Mar 12;326(6109):137–142. doi: 10.1038/326137a0. [DOI] [PubMed] [Google Scholar]
  14. McKusick L., Horstman W., Coates T. J. AIDS and sexual behavior reported by gay men in San Francisco. Am J Public Health. 1985 May;75(5):493–496. doi: 10.2105/ajph.75.5.493. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Rothenberg R. B. The geography of gonorrhea. Empirical demonstration of core group transmission. Am J Epidemiol. 1983 Jun;117(6):688–694. doi: 10.1093/oxfordjournals.aje.a113602. [DOI] [PubMed] [Google Scholar]
  16. Schechter M. T., Craib K. J., Willoughby B., Douglas B., McLeod W. A., Maynard M., Constance P., O'Shaughnessy M. Patterns of sexual behavior and condom use in a cohort of homosexual men. Am J Public Health. 1988 Dec;78(12):1535–1538. doi: 10.2105/ajph.78.12.1535. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Schechter M. T., Jeffries E., Constance P., Douglas B., Fay S., Maynard M., Nitz R., Willoughby B., Boyko W. J., MacLeod A. Changes in sexual behaviour and fear of AIDS. Lancet. 1984 Jun 9;1(8389):1293–1293. doi: 10.1016/s0140-6736(84)92465-6. [DOI] [PubMed] [Google Scholar]
  18. Weller I. V., Hindley D. J., Adler M. W., Meldrum J. T. Gonorrhoea in homosexual men and media coverage of the acquired immune deficiency syndrome in London 1982-3. Br Med J (Clin Res Ed) 1984 Oct 20;289(6451):1041–1041. doi: 10.1136/bmj.289.6451.1041. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Winkelstein W., Jr, Lyman D. M., Padian N., Grant R., Samuel M., Wiley J. A., Anderson R. E., Lang W., Riggs J., Levy J. A. Sexual practices and risk of infection by the human immunodeficiency virus. The San Francisco Men's Health Study. JAMA. 1987 Jan 16;257(3):321–325. [PubMed] [Google Scholar]
  20. Winkelstein W., Jr, Wiley J. A., Padian N. S., Samuel M., Shiboski S., Ascher M. S., Levy J. A. The San Francisco Men's Health Study: continued decline in HIV seroconversion rates among homosexual/bisexual men. Am J Public Health. 1988 Nov;78(11):1472–1474. doi: 10.2105/ajph.78.11.1472. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. van Griensven G. J., de Vroome E. M., Goudsmit J., Coutinho R. A. Changes in sexual behaviour and the fall in incidence of HIV infection among homosexual men. BMJ. 1989 Jan 28;298(6668):218–221. doi: 10.1136/bmj.298.6668.218. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. van Griensven G. J., de Vroome E. M., Tielman R. A., Goudsmit J., van der Noordaa J., de Wolf F., Coutinho R. A. Impact of HIV antibody testing on changes in sexual behavior among homosexual men in The Netherlands. Am J Public Health. 1988 Dec;78(12):1575–1577. doi: 10.2105/ajph.78.12.1575. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. van Griensven G. J., van den Hoek J. A., Leentvaar A., Coutinho R. A. Surrogate markers for HIV incidence among homosexual men. J Infect Dis. 1989 Jun;159(6):1157–1158. doi: 10.1093/infdis/159.6.1157. [DOI] [PubMed] [Google Scholar]

Articles from Genitourinary Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES