Sexually transmitted disease morbidity trends in the Haifa district during 2001-2004]

To describe trends in sexually transmitted disease morbidity in the Haifa District during the years 2001-2004 according to subdistrict, age, gender and nationality.Epidemiological data were taken from notifications on gonorrhea, chlamydia, syphilis, HIV carriers and AIDS patients. Reports are sent by physicians and diagnostic laboratories of hospitals and Health Maintenance Organizations ("Kupot") in the Haifa District. Denominators for calculating specific incidence rates were based on the data from the Central Bureau of Statistics. Time trends were calculated using Haifa District Health Office's former epidemiological reports.A total of 74 chlamydia trachomatis patients were notified during 2004, an incidence rate of 8.8/100,000, of whom 71 were notified from the Haifa subdistrict (13.4/ 100,000). In the Hadera subdistrict only 3 patients were reported (0.96/100,000). Notification of 57 gonorrhea patients was sent to the Health District (incidence rate 6.8/100,000) including 42 from Haifa subdistrict (7.9/100,000) and 15 from Hadera subdistrict (4.8/100,000). Only 6 patients with primary or secondary syphilis were notified (0.7/100,000): 3 from the Haifa subdistrict and 3 from the Hadera subdistrict. Thirty new HIV carriers were reported and 2 AIDS patients (3.8/100,000), 23 from the Haifa subdistrict (4.3/100,000) and 7 carriers from the Hadera subdistrict (2.2/100,000). Most of the STD patients were Jewish males (2-3 times more than the number of women or Arab patients). Age specific rates were highest among persons 25-44 years old. During the last 4 years a decline was noted in the incidence of all reportable STD's with the exception of chlamydia.The main indices that reflect the population's present sexual behavior are incidence rates of gonorrhea and primary and secondary syphilis. These indices demonstrate a decline during the years 2001-2004. Reports of new HIV carriers to the Health district also declined. For the first time, chlamydia became the leading notified STD in Haifa District in 2004. Therefore, it is apparent that a true decline in STD's incidence rates has occurred during the last few years in the Haifa District especially in the Haifa subdistrict. This may be attributed to a reduction in the availability of paid sexual services. The increase in chlamydia incidence is most probably related to better diagnostic procedures.