Decreasing incidence of PID in Amsterdam.

OBJECTIVE To study the incidence of pelvic inflammatory disease (PID) in Amsterdam in the period 1983-1990. METHODS Patients diagnosed with PID based on a clinical definition were reported weekly by 30 general practices who covered 11% of the Amsterdam population. Annual age specific incidences were calculated using the number of women in the participating practices as the denominator. RESULTS The PID incidence was approximately 50 per 10,000 women through 1986, and then started to decrease in 1987 to reach 24 per 10,000 in 1990. The decreasing trend since 1987 was seen in the age-groups 20-24, 25-34 and 35-44 years, but not among teenagers. The moment of decline coincided with extensive attention given in the Dutch media to the risk of heterosexual transmission of the human immunodeficiency virus (HIV). CONCLUSION It is plausible that the declining incidence of PID was influenced by a change of heterosexual behaviour under the threat of AIDS.