A Recent Increase in the Incidence of Male Urethritis in France

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Abstract
At-risk sexual behaviors appear to have increased recently in France, possibly because of the reassuring efficacy of highly active antiretroviral treatments. The objective of this study was to assess the pattern of change.The goal was to analyze trends in the incidence of male urethritis, a marker of at-risk sexual behavior, between 1989 and 2000.The general practitioners of the Sentinelles Network reported, through an online computer system, all cases of male urethritis they diagnosed, together with the patients' age, presence of discharge, sexual preference, history of sexually transmitted disease, prescriptions, and results of microbiologic findings.After falling markedly between 1989 and 1995, the incidence of urethritis increased slightly in 1996 and then stabilized. The percentage of homosexual/bisexual men was higher among the cases than in the general population. Homosexual/bisexual men were younger than heterosexual men with urethritis; they were more likely to have a discharge and a history of sexually transmitted disease and had more sex partners. The main causative organisms were chlamydiae (18%) and Neisseria gonorrhoeae (13%).The increasing incidence of urethritis in France calls for a readjustment of preventive strategies.