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Re-emerging syphilis in gay men: a case-control study of behavioural risk factors and HIV status
  1. M A Bellis1,
  2. P Cook1,
  3. P Clark1,
  4. Q Syed2,
  5. A Hoskins3
  1. 1North West Public Health Observatory, Public Health Sector, School of Health and Human Sciences, Liverpool, UK
  2. 2Communicable Disease Surveillance Centre, North West, Chester, UK
  3. 3Manchester Health Authority, Manchester, UK
  1. Correspondence to:
 Professor M A Bellis, North West Public Health Observatory, Public Health Sector, School of Health and Human Sciences, 70 Great Crosshall Street, Liverpool L3 2AB, UK;

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Over the later half of the 20th century levels of syphilis dropped dramatically in western European countries. Between 1990 and 1998, an area such as Greater Manchester in the UK (population, 2.7 million) reported fewer than 10 cases per year. In contrast, between January 1999 and May 2001 120 cases of syphilis were reported in Greater Manchester. Other areas within the UK (Brighton, Peterborough and Cambridgeshire), elsewhere in Europe (Dublin and Paris)1 and in the USA (Southern California),2 have recently experienced outbreaks of syphilis. Although epidemiological information on cases has been collected in some settings, controlled studies are urgently required in order to identify behaviours specifically associated with re-emerging syphilis. Here, we present results from such a case-control study.


Of 58 diagnosed cases of syphilis in Greater Manchester (May 1999 and August 2000), 38 were approached through genitourinary medicine clinics to participate in a structured interview regarding their sexual, social, and drug using behaviour during 12 months before syphilis diagnosis. Characteristics of the 27 people …

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  • Funding: Manchester Health Authority.

  • Conflicts of interest: none.

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