Primary and secondary syphilis, 20 years' experience. 1. Epidemiology.

The case notes of 946 patients with primary and 854 with secondary syphilis who attended the department of genitourinary medicine at the Middlesex Hospital in 1965-84 were analysed retrospectively. Most patients were homosexual men, and the proportion of homosexuals showed a significant (p less than 0.0005) upward trend during the study period. There was also a significant upward trend in the percentage of British attenders (p less than 0.0001), as well as an increase in patients in social classes I, II, or III non-manual (p less than 0.0001). Homosexual men had a greater number of sexual partners than heterosexuals or women, and were also more likely to have had a sexually transmitted disease. The proportion of homosexuals with multiple partners showed a significant (p less than 0.0005) upward trend during the study period.