Recruitment bias affected information on age, city size, and sexual identity.This is why we restricted the analysis to a subgroup of men self-identified as gay, aged 30–44 years, and living in cities with more than 500,000 inhabitants (in descending order according to the number of inhabitants: Berlin, Hamburg, Munich, Cologne, Frankfurt am Main, Stuttgart, Dusseldorf, Dortmund, Essen, Bremen, Leipzig, Dresden, Hanover, Nuremberg).The subgroup of gay-identified men aged 30–44 years and living in cities with more than 500,000 inhabitants consisted of 1,039 (22%) men in 2003, 1,315 (16%) in 2007, 8,242 (15%) in 2010, and 1,547 (9.2%) in 2013.
We discuss reasons for the increasing syphilis incidence in MSM, in particular the increase in risky sexual behaviour, such as a higher frequency of condomless sexual intercourse, while applying HIV serostatus knowledge-based risk management strategies, particularly HIV-serosorting [11-16]. It has different stages of disease (primary, secondary, latent, and tertiary syphilis), of which especially the first and second stages are highly infectious.Survey participants were recruited exclusively online in the 20 surveys, and by a combination of print questionnaires distributed by gay magazines and online questionnaires in the 20 surveys.The methods and the results of this survey have been published elsewhere in German [20-23].In Germany, syphilis diagnoses have been notified anonymously on the basis of the Protection against Infection Act in Germany  since 2001 by laboratories, with physicians inserting relevant clinical information.Syphilis cases are defined as cases diagnosed by direct detection of T.
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Eurosurveillance remains in the updated list of the Directory of Open Access Journals (DOAJ).It was first added to the DOAJ on 9 September 2004.Incidence was 8.5 per 100,000 inhabitants overall, with highest incidences above 20.0 mainly in larger German cities such as Berlin (39.0), Cologne (35.6), Munich (30.0), Frankfurt am Main (29.5), Dusseldorf (26.6), Leipzig (23.7), Hamburg (21.4) and Stuttgart (20.4). voksen dating Ishøj They were especially high in Berlin inner city areas with 62.8–117.8/100,000 inhabitants.Since 2009, the syphilis incidence increased in Europe in men, especially in western European countries, while the incidence decreased in women concurrently.
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