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Background: Syphilis is a Sexually Transmitted Disease (STD) caused by Treponema pallidum with significant public health importance. Based on the clinical presentation syphilis is classified into primary, secondary, tertiary and latent syphilis. Lab diagnosis of syphilis can be done by serological methods using specific treponemal and non)treponemal tests. Testing strategies like traditional, reverse and European Centre for Disease Prevention and Control (ECDC) are currently used as principal diagnostic algorithms. Aim and Objectives: To compare the seropositivity among three diagnostic algorithms for syphilis serodiagnosis and data analysis using WHO NET software. Material and Methods: All the samples received for syphilis serology were tested by Rapid Plasma Reagin (RPR) and rapid immunochromatographic card methods. Three diagnostic algorithms were used. In traditional algorithm, the sample was first tested with RPR (non-treponemal test) and if reactive then interpreted as a case of syphilis. In reverse algorithm, a specific treponemal card test was done and if reactive a second non treponemal test like RPR was performed. Asecond rapid immunochromatographic test was also performed. In the case of the ECDC algorithm two specific card tests were performed and interpreted. WHO NET software was utilized for data entry and analysis. The coefficient of agreement (k value) was analyzed by using QuickCalcs GraphPad software. Results: A total of 1292 samples were tested, and 4 (0.3%) samples were reactive by traditional algorithm. By reverse and ECDC algorithm 14 (1.08%) of the samples were considered as reactive. Overall, four samples were identified as cases of definite/current syphilis and ten samples were considered as cases of probable early current / latent or treated syphilis. Reverse algorithm and ECDC algorithm detected more cases. The missed diagnosis percentage was 10 (71.42%) for traditional algorithm. Antenatal patients comprised of 334 (25.85%) samples with seropositivity of 0.29%. Maximum samples were received from the age group of 21 to 30 years 484 (37.46%). Strong degree of agreement was observed between reverse and ECDC algorithm (k value- 0.832). Conclusion: Reverse or ECDC algorithm can be implemented in the laboratory routinely to avoid missing cases of early syphilis. The specific treponemal card tests available in immunochromatography formats are easy to perform and interpret. The usage of WHO NET for analysis of data and along with including specific comments individualized for each patient in the lab reports could give valuable insight. [ABSTRACT FROM AUTHOR]

BACKGROUND: Syphilis is one of the oldest sexually transmitted infections caused by the bacterium Treponema pallidum subspecies pallidum. The epidemiology of syphilis has exhibited fluctuations and variations throughout its history. Nevertheless, syphilis remains a substantial public health issue. The lack of robust surveillance systems for sexually transmitted illnesses presents a tough situation in India. This study aims at assessing the high-risk behaviour and HIV association among syphilis patients. MATERIALS AND METHODS: A prospective, observational single centre study was carried out in the outpatient department (OPD) of the Dermatology, Venereology, and Leprosy (DVL) department at a tertiary care centre for duration of 12 months, spanning from November 2022 to November 2023. The relevant history, standard blood tests and serological examinations for syphilis and HIV were conducted. RESULTS: Among 20 cases, among them 4 cases were primary syphilis, 6 secondary syphilis, 7 early latent syphilis and 2 cases of congenital syphilis. Males were predominantly (85%) affected. HIV co-infection was seen in 4 cases of secondary syphilis. Out of 20 patients, 10 were men having sex with men (MSM) and 2 showed bisexual behaviour. CONCLUSION: Detection of syphilis within a limited timeframe, along with difficulties in partner treatment and contact tracing, can contribute to an escalation in the prevalence of syphilis. Moreover, it amplifies the susceptibility to contracting and disseminating HIV infection. Therefore, this study could potentially indicate increased syphilis cases among individuals with high-risk behaviours, necessitating the rigorous enforcement of measures to control syphilis. [ABSTRACT FROM AUTHOR]

Background: There is a change in the pattern and prevalence of acquired syphilis due to better awareness, surveillance, laboratory diagnosis, and treatment in India in recent years. However, restrictive measures for COVID-19 may produce different effects on incidence. Aims and Objectives: We aimed to study the changing trend of acquired syphilis in relation to COVID-19 outbreak in a tertiary care hospital in North India. Materials and Methods: A retrospective analysis of all the cases of sexually transmitted infections (STIs) was done from January 2016 to June 2022. Demographic, clinical, and laboratory data of acquired syphilis were recorded and analyzed for changing trends in prevalence, clinical presentations, association with HIV and other sexually transmitted diseases (STDs), and its relation to COVID-19. Statistical analysis was done using SPSS software. Results: A total of 1105 patients attended STD clinic from January 2016 to June 2022, of which 216 patients were venereal disease research laboratory and Treponema pallidum hemagglutination assay positive (19.5%). Before COVID-19, there was an increasing trend of acquired syphilis (late latent). Patients diagnosed with syphilis pre- and postlockdown did not differ significantly in their mean age, median age, male/female ratio, and HIV status. However, there is an increase in number of cases of primary and secondary syphilis postlockdown which was statistically significant. Conclusion: Restrictive measures for COVID-19 during the lockdown produced a declining trend of syphilis. It is unclear whether the observed decrease in number of STI cases was due to true decline, inadequate testing, underreporting, or avoidance of high-risk sexual activities. The upsurge in the number of cases of acquired syphilis after lockdown suggests the possibility that lockdowns did not completely disrupt STI transmission. [ABSTRACT FROM AUTHOR]

Background: Syphilis causes considerable morbidity not only in adults but also in children. Unfortunately, acquired syphilis in children has not received due attention and remains a relatively ignored field. Methods: This was a retrospective study, in which epidemiologic, clinical, and investigational data were analyzed from medical records of all sexually transmitted infection (STI) cases attending the STI clinic of Pt. B. D. Sharma, PGIMS, Rohtak from January 1992 to November 2018. Children of age ≤14 years with acquired syphilis were studied. Results: Of 9138 STD cases registered from January 1992 to November 2018, 39 were children with acquired syphilis, of whom 22 were males and 17 were females. The majority were in 12‐14 years age group (22 cases; 56.41%). A history of sexual abuse could be elicited in 10 patients. Three gave a history of voluntary sexual activity. Examination revealed secondary syphilis in 32, latent syphilis in 6 and only one case of primary chancre. Analysis of incidence of pediatric acquired syphilis cases over three‐year intervals during the last 27 years indicated an initial decreasing trend followed by recent slight rise in last 3 years. Conclusion: Social inhibitions and reluctance to report child sexual abuse may have led to an underestimate of actual prevalence. The prevalence in the 12‐ to 14‐year age group may indicate emerging trends of promiscuous sexual behavior. The recent rising trend in occurrence of childhood acquired syphilis may mirror the recent resurgence of adult syphilis. [ABSTRACT FROM AUTHOR]

Objectives: Syphilis has been called the great mimicker or the great imitator due to its myriad of clinical presentations. Despite strenuous concerted efforts toward the elimination of syphilis, it still remains a goal to be achieved. During recent years, many different trends of syphilis have been reported from around the globe. Methods: A retrospective observational clinico-investigative study was carried out to analyze the 10-year trends of syphilis at one of the largest public sector hospitals in India. Results and Conclusion: Both venereal disease research laboratory and Treponema pallidum Hemagglutination assay positivity rates showed a significant declining trend from 2007 to 2016, reflecting the success of the National Sexually Transmitted Infection Prevention and Control Program. [ABSTRACT FROM AUTHOR]

Introduction: Men who have Sex with Men (MSM) are at highrisk for acquiring Sexually Transmitted Infections (STIs). The high prevalence of STIs, such as syphilis, Human Immunodeficiency Virus (HIV), genital herpes, genital warts, gonorrhea, and hepatitis B, necessitates regular screening in the MSM group. Furthermore, the presence of these STIs increases the transmission of HIV. Unfortunately, limited data are available regarding STI prevalence among MSM in India. Understanding the prevalence in this high-risk group aids in rapid diagnosis and effective control of infections, thereby reducing their transmission. Aim: To analyse the prevalence of STIs in the MSM group in Venereology Outpatient Department (OPD) in a Tertiary care centre, Chennai, Tamil Nadu, India. Materials and Methods: A record-based cross-sectional study was conducted at a tertiary care centre in Chennai, Tamil Nadu, India over a period of one year (January 2023 - December 2023). The study included 110 men who were brought in by voluntary organisations or who walked in directly to the Venereology department and identified themselves as homosexuals. Their socio-demographic data, detailed contact history, chief complaints, relevant investigations, and treatments provided were recorded and analysed. All data were analysed using Statistical Package for the Social Sciences (SPSS) software. Results: Out of the 110 men enrolled in this study, most were in the 18 to 29 years age group, and a predominant 58 (52.72%) reported engaging in unprotected sexual practices. Specifically, 67 (60.91%) of the men identified themselves as strictly homosexuals, while 43 (39.1%) identified as bisexuals. Further inquiry about their partners revealed that 24 (21.82%) had contact with known partners, while 86 (78.18%) had contact with unknown partners, primarily through dating apps and social media platforms. Among the 42 patients diagnosed with STIs, syphilis was the most common, affecting 15 (13.63%) individuals. The second most common STI was HIV, seen in 10 (9.09%) of which 4 had co-infection with syphilis. The next most common STIs diagnosed were genital herpes in 7 (6.36%), gonorrhea in 6 (5.45%), genital warts in 3 (2.73%), hepatitis B in 3 (2.73%), and genital scabies in 2 (1.81%). Conclusion: The prevalence of STIs in this study was found to be 38.18%. This study underscores the importance of understanding the prevalence of STIs, which may aid in targeted interventions to address STI transmission, particularly among young adults and MSM populations. Efforts should focus on promoting safer sexual practices, increasing access to testing and treatment, and providing education and support to both individuals and their partners. [ABSTRACT FROM AUTHOR]

Background: Syphilis was brought under control with the advent of penicillin. However, in recent times, a rise in the incidence of syphilis has been reported by Centers for Disease Control and Prevention (CDC). Aim: To study the clinical and epidemiological profile of patients with syphilis attending sexually transmitted infection (STI) clinic at tertiary care center. Materials and Methods: Observational, cross-sectional analysis of sociodemographic, clinical, and investigational data of all syphilis patients visiting STI clinic from August 2019 to July 2021 was done and analyzed. Results: Out of 1330 STI patients that attended the clinic, 15.04% (n = 200) were diagnosed with syphilis, among them 72% (n = 144) were males, and 28% (n = 56) were females, with male-to-female ratio of 2.5:1. Of these 24.5% (n = 49) had primary, 44.5% (n = 89) had secondary, 30.5% (n = 61) had latent, and 0.50% (n = 1) had congenital syphilis. Among secondary syphilis patients, rash was the most common presentation seen in 43 patients, followed by condyloma lata in 30, palmoplantar syphilis in 17, oral mucous patch in 3, and iridocyclitis in 3 patients. Human immunodeficiency virus (HIV) was positive in 16.5% (n = 33). Herpes genitalis was the most common coinfection among 25 patients who were diagnosed with mixed venereal disease. RPR titer was positive in all 200 patients, with 1:16 titer being most common. Conclusion: India is experiencing a new trend in the prevalence of syphilis, mainly due to the changes in risk behavior, misconceptions, and social stigma associated with STIs, improved laboratory diagnosis, and increased public awareness. Particularly secondary and latent stages have shown a rising trend over the past few years. Awareness about safe sexual practices and contraception is very important to control the current resurgence. [ABSTRACT FROM AUTHOR]

Background: Sexually transmitted infections (STIs) during pregnancy are associated with adverse fetal outcome. They should be aggressively sought and treated. We did an analytical study with the primary aim to know the occurrence of STIs in pregnant women and their spouses. Materials and Methods: An observational cross-sectional analytical study of pregnant women with STIs and their spouses was conducted at a tertiary care hospital. Demographic parameters and medical history were recorded. Clinical examination and necessary investigations were done in pregnant females and their spouses. History about sexual behavior and knowledge of STIs were obtained from the questionnaire. Results: The prevalence of STIs in pregnant women was 2.1% (n = 61) out of 2894 pregnant women who attended our institute during the study period with the highest prevalence of HIV (1.1%), and out of 54 examined spouses, 32 spouses were suffering from STIs. Overall, women had poor awareness, knowledge of STIs, and preventive measures compared to men. A significant association was seen between level of education and awareness about HIV/AIDS and other STIs, both in pregnant women and their spouses. Conclusion: Our study showed an overall low prevalence of STIs among pregnant women but showed higher HIV and syphilis prevalence as compared to national prevalence. The serodiscordancy rate was found to be high in HIV, syphilis, and hepatitis B. [ABSTRACT FROM AUTHOR]

Focuses on the diagnosis of latent syphilis in India. Symptoms of the disease; Process of Treponema pallidum hemagglutination test; Details on the happenstance treatment of syphilis with antibiotics.

Purpose: To describe disease manifestations and outcomes of ocular syphilis in Asian Indian population.Methods: Retrospective analysis of patients diagnosed with ocular syphilis at a tertiary referral center in India. Demographics, history, extraocular and ocular manifestations, ocular and systemic investigations, treatment and visual acuity outcomes were noted. All patients were diagnosed after necessary laboratory investigations including HIV ELISA (Human immunodeficiency virus, enzyme-linked immunosorbent assay), VDRL (venereal disease research laboratory), and TPHA (treponema pallidum hemagglutination).Results: Totally, 20 patients with mean age at presentation 38.25 ± 9.76 were analyzed. 9/20 patients had bilateral involvement. 8/20 had concurrent HIV at presentation with an average CD4 counts of 592.25 ± 411.34 cells/microliter. The mean duration of symptoms at time of presentation was 15.45 ± 35.15 weeks. VDRL test was reactive in 45% (9/20) patients whereas, all patients had a reactive TPHA test. Clinical manifestations included outer retinal placoid chorioretinitis lesions (8/20, 40%), followed by retinitis mimicking acute retinal necrosis as the second most common phenotype (4/20, 20%). Other presenting manifestations noted were panuveitis, miliary retinitis lesions, retinal vasculitis, intermediate uveitis, and anterior uveitis. The clinical phenotypes in immunocompromised included panuveitis, acute retinal necrosis and isolated anterior uveitis. Mean follow up duration was 6.32 ± 6.15 months. An improvement in mean best corrected visual acuity (BCVA) of (0.63 LogMAR, approximately 6 Snellen lines, P < 0.02) was noted at last follow-up.Conclusion: Phenotypic manifestations of ocular syphilis are varied. Non-treponemal tests like VDRL may be unreliable when compared with treponemal tests in diagnosing ocular syphilis. Syphilitic uveitis is considered equivalent to neurosyphilis and is treated similar to neurosyphilis. [ABSTRACT FROM AUTHOR]

Context: Illnesses affecting sexual organs and its correlation with improper sexual behavior lead to a negative attitude and discriminating behavior towards people affected by such disorders. Aim: The aim was to study the stigma associated with sexually transmitted infections (STIs) among patients attending Suraksha clinic at a tertiary care hospital in northern India. Settings and Design: This was a hospital-based cross-sectional study. Subjects and Methods: The present study was conducted at Suraksha (STI) clinic, King George's Medical University, Uttar Pradesh. A total of 487 STI patients (clinically and/or laboratory-confirmed) were contacted telephonically, of which 49 finally participated in the study. Stigma was assessed using modified and pretested version of India HIV-related stigma scale adapted in context to sexually transmitted diseases. Statistical Analysis: Quantitative variables were expressed as mean with standard deviation, and independent sample t-test was used to compare the mean values. P < 0.05 was considered statistically significant. Results: Mean scores of enacted, vicarious, felt normative, and internalized stigma for 49 patients (out 487) who finally participated in the study were 0.04±0.11, 0.55±0.70, 1.21±0.96, and 0.86±0.67, respectively. Unmarried/divorced/separated patients had significantly higher vicarious and felt normative stigma scores as compared to married individuals. Mean score for felt normative stigma was significantly higher among homosexual/bisexuals in comparison to heterosexual individuals. Conclusions: Efforts should be directed towards the provision of integrated services through sexual health-oriented campaigns to address the stigma associated with STI in a more comprehensive way. [ABSTRACT FROM AUTHOR]

We examined associations with HIV recent infection and estimated transmitted drug resistance (TDR) prevalence among 3345 men at sexually transmitted infection clinics in Mumbai (2002-2005). HIV seroincidence was 7.92% by the BED-CEIA and was higher at a clinic located near brothels (12.39%) than at a hospital-based clinic (3.94%). HIV recent infection was associated with a lifetime history of female sex worker (FSW) partners, HSV-2, genital warts, and gonorrhea. TDR prevalence among recent infection cases was 5.7%. HIV testing services near sex venues may enhance case detection among high-risk men who represent a bridging population between FSWs and the men’s other sexual partners. [ABSTRACT FROM AUTHOR]

Background: Outbreak of syphilis, i.e., 16 cases of rapid plasma reagin (RPR) reactive cases of syphilis was reported in Community Based Organization (CBO) Sahyog of Surat, India, from April to August 2014. The aim of the study was to find risk factors and take immediate actions to prevent spread. Materials and Methods: Outbreak investigation of 16 Female Sex Workers of CBO Sahyog in Surat who were found Rapid Plasma Reagin (RPR) and Treponema Pallidum Hemagglutination Assay (TPHA) positive from April to August 2014; was carried out. Clinico-epidemiological and laboratory-based evidence for different sexually transmitted infections (STIs) conducted at Government Medical College, New Civil Hospital, Surat. Root cause analysis (RCA) of index case was carried out. Results: Desk review for the past 3 years data of STI revealed total STI cases as 88 (2011), 95 (2012), and 130 (2013), of which 4, 2, and 2 found RPR reactive, respectively. Data from April to August 2014 revealed 16 RPR reactive cases and confirmed by TPHA. On examination, one had ulcerative cervical lesion, rest did not have any symptoms of syphilis. Eleven had vaginal/cervical discharge, 11 had lower abdominal pain. A total of 11 had unprotected sex, 7 encountered condom tear in the past 6 months, and 5 reported sexual violence. Seven had sexual activity under influence of alcohol. Laboratory investigation revealed two as HIV-positive. RPR reactivity reported highest (9 out of 16) from same area of hotspot. RCA of probable index case revealed factors responsible as violence and nonuse of condoms. Conclusions: Outbreak investigation revealed one probable index case. All 16 treated with injection Penidure. Violence or condom tear is responsible for the spread. Crisis management team should be strengthened. [ABSTRACT FROM AUTHOR]

Introduction: Routine pre-procedural screening for bloodborne infections is a common practice despite lack of standard guidelines. The incidence of syphilis has shown an upward trend in recent years. Aim: To determine the prevalence and clinical significance of routine screening for syphilis in pre-procedural patients in tertiary care cardiac centre. Materials and Methods: This prospective study included consecutive patients undergoing surgical and percutaneous invasive procedures at a tertiary cardiac care centre from March 2017 to August 2017. All patients were screened for syphilis using ELISA for detection of Treponema pallidum IgG antibodies. All patients who were positive for ELISA were confirmed with Treponema pallidum Haemagglutination Assay (TPHA). Results: A total of 13,865 patients were screened and the seropositive rate was 0.45%. Most patients were in the age group of 51-70 years (71.4%) and were male (76.2%). Three patients had manifestation of cardiovascular syphilis and two patients were positive for HIV also. There was no reported incidence of needlestick injury or mucus membrane exposure to blood products during the procedures. Conclusion: Routine pre-procedural screening for syphilis is not beneficial due to low seroprevalence. Screening must be limited to at risk individuals. [ABSTRACT FROM AUTHOR]

Venereology-the study of venereal diseases or more recently, the sexually transmitted infections (STI) includes a variety of pathogens namely viruses, bacteria, fungi and protozoa for which the common factor is the mode of transmission and acquisition: Sexual relations between human beings. Medical and other historians have often suggested that well-known diseases such as syphilis, gonorrhea, chancroid and lymphogranuloma venereum have existed since earliest times. However, it is difficult to identify modern disease entities based on written historical record. Studying the origin of STIs helps us to learn the political, economic and moral conditions that led to the disease. Effective management of STI rests on three pillars of diagnosis, prevention and treatment. For most of past 50 years in India, the diagnostic pillar has been the least well-supported. Until well into present century, diagnosis of STI in India was clinical. Treatment of STIs in India followed the methods used in England. Of course in the 19th century, in many parts of the world, only a few had access to modern methods of treatment; in India, there was extensive use of Ayurvedic treatment with traditional medicines. This article thus gives just an overview and evolution of venereology in India with regard to venereal diseases (now more often known as STIs/disease), control measures, academic, association and journal development and finally future perspective. [ABSTRACT FROM AUTHOR]

The true incidence of STD will never be known not only because of inadequate reporting but because of the secrecy that surrounds them. More of them are not even notificable. All available data however, indicate a very high prevalence of STD (from 1 percent to 14%) in the vulnerable population groups (total patient) 3000 primi para who visited for routine ANC check-up were study with RPR test. Out of which 120 came to be positive. This study was conducted in rural population of Bhopal district and associated areas. This study was great value because it was done exclusively in the population which is most vulnerable that is between 20-35 yrs. [ABSTRACT FROM AUTHOR]

Sexually transmitted infections (STIs) are more dynamic than other infections prevailing in the community. It is important that such dynamic epidemiological changes in STIs are acknowledged and kept track of in a vast and populous developing country like India, particularly in this HIV era. It is with this aim that the authors have reviewed the relevant literature in STI epidemiology in India during the past 25 years. Admittedly, there has been heterogeneity of data to account for the subcontinental dimension of this country. But a basic pattern in the changing epidemiology is discernible. Like the developed countries, in India too the bacterial STIs like chancroid and gonorrhea are declining, while viral STIs like HPV and herpes genitalis are on an upswing. The overall decline in the prevalence of STIs has to be interpreted with caution, however. This may partially reflect the improved facilities of treatment in the peripheral centres that obviates the need of many patients in attending the STD clinics in the tertiary centres. Also, the improved pharmacotherapy of many of the bacterial STIs may result in partial clearance and non-reporting of many of these infections. [ABSTRACT FROM AUTHOR]

Background: The prevalence of sexually transmitted infections (STI) varies widely from region to region in our country. Aims: To highlight the pattern of STIs and the profile of patients with HIV infection in STD patients as seen at our hospital. Methods: A retrospective chart analysis of clients attending STI clinic, JIPMER, Puducherry, from June 2004 to June 2006 was done. Results: A total of 866 clients attended our STI clinic, out of whom 435 (50.2%) had proven STI. STIs were more common in men, with a male (290): female (145) ratio of 2:1. Their age ranged from 1 year to 75 years (mean age = 32.38 years) with the maximum number of patients in the age group of 21-30 years, while children constituted only 2.8%. Herpes genitalis (107 patients, 32.8%) was the most common ulcerative STI, while genital wart was the most common nonulcerative STI (56 patients, 17.1%). Non-gonococcal urethritis (46 patients, 14.1%) was more common than gonococcal urethritis. HIV infection was the most common STI in our study, at an alarmingly high rate of 34.5% (151/435). HIV seropositivity was more common in patients who presented with ulcerative STIs than with nonulcerative STIs. Conclusions: Herpes genitalis was the most common ulcerative STD, while genital wart was the most common nonulcerative STI in our study. The prevalence of HIV among STI clients in India has been on the rise, but has quite alarmingly become the most common STI in our study. [ABSTRACT FROM AUTHOR]

Background & Objectives: Sexually transmitted infections (STIs) a major public health problem in India show various trends in different parts of the country. However, there are limited data on the changing profile of laboratory proven STIs in the same clinic over the years. The present study was thus aimed to determine the changing trends of the profile of STIs and HIV seropositivity in STD clinic attendees over a 15 yr period, and also to detect change, if any, in the antimicrobial resistance pattern of Neisseria gonorrhoeae., Methods: The STIs were diagnosed clinically and confirmed by standard laboratory techniques. Socio-demographic data were collected through pre-designed proformae. The STI profile and HIV seropositivity were compared between 1990-1993 (A), 1994-1997 (B), 1998-2001 (C) and 2002-2004 (D). Antimicrobial resistance pattern of N. gonorrhoeae was determined by standard techniques and compared between the last three periods., Results: Of the 78,617 STD attendees, 12,709 (16.2%) had STIs. During period A, genital discharges and during B, C and D, genital ulcerative diseases were predominant. Syphilis was the commonest STI. There was significant rise in the cases of syphilis, herpes progenitalis and genital warts and reduction in that of chancroid, lymphogranulomavenereum (LGV), donovanosis, candidiasis, trichomoniasis and bacterial vaginosis cases. The number of cases with primary syphilis diminished significantly (P<0.001), with a concomitant rise in secondary and early latent syphilis. A rising trend was observed in the HIV seropositivity during the different periods. The association of HIV seropositivity was consistently more in patients presenting with genital ulcers specially syphilis, and rose significantly from A (0.6%) to C (8.8%), but became stationary during D. A drastic change in the antimicrobial resistance of N. gonorrhoeae from B to C and C to D and the emergence of less sensitive isolates to ceftriaxone during the later part of the study were observed., Interpretation & Conclusion: Our study showed a definite changing trend in the profile of STIs in the clinic attendees of a major STD centre during a 15 yr period. However, the significant rise in the cases of viral STIs and syphilis contrasted with reduction in the rest.