Between 20, the number increased between 11% and 22% per year .
High rates of bacterial sexually-transmitted infections (STIs) including syphilis are reported for MSM coinfected with HIV from many countries, e.g.
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).
To assess the epidemiological dynamics of syphilis in Germany and to shape appropriate public health interventions, we analysed data of the mandatory syphilis notification system reported between 20.