Background:
Men who have sex with men (MSM) are at increased risk for multiple sexually transmitted diseases (STDs). Data on STDs among MSM in our nation's capital is limited. Whitman-Walker Clinic is a non-profit community-based health organization serving the Washington, D.C. metropolitan region that was established by and for the gay and lesbian community.

Objective:
To describe the temporal trends of chlamydia, gonorrhea, and syphilis among MSM attending Whitman-Walker Clinic for STD services.

Method:
As part of CDC's MSM Prevalence Monitoring Project, MSM tested for STDs at Whitman-Walker Clinic between January 2001-December 2004 were selected. Chlamydia results were only available from 2002-2004. Logistic regression was utilized to assess for overall linear trends in positive tests, among those tested, for syphilis, chlamydia and gonorrhea.

Result:
A total of 7,408 patient visits were recorded from 2001-2004, with annual total visits ranging from 1,692 to 1,953. Annually, the percentage of patient visits with tests for syphilis did not vary (range: 83.5%-86.2%), however there was a decline in the percentage of total patient visits with tests for gonorrhea (78.6% vs. 46.2%) and chlamydia (64.7% vs. 26.3%) from 2002 to 2004. Among persons tested, there was a significant linear increase (OR=1.5 [1.3-1.8]) in high-titer syphilis, but there were significant linear decreases in the percentage testing positive for chlamydia (OR=0.51 [0.27-0.96]) and gonorrhea [urethral (OR=0.88 [0.78-1.00]); rectal (OR=0.80 [0.65-0.99]); pharyngeal (OR=0.55 [0.35-0.86])].

Conclusion:
Although it appears chlamydia and gonorrhea has decreased among MSM tested at Whitman-Walker Clinic, the number of high-titer syphilis cases has increased. Risk factors for this increase need to be further evaluated.

Implications:
More research is needed to identify reasons for trends in STDs among MSM and also to identify appropriate interventions in Washington, D.C.