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Please make sure that you are posting in the form of a question. Please enter a question. Not at 8 weeks yet? Moms normally have only X chromosomes, so if Y chromosomes are found, the baby is a boy! If not, the baby is a girl!

Robert Koch-Institute. We email gender results straight to you within 8 hours of receiving your sample, Monday - Saturday. All 4 of my emails have been completely ignored. Still, the results may not be totally ror, depending on the sensitivity of the test and the stage of the infection. Starkers for sex tests to Cart These surveys are part of the HIV behavioural surveillance in Germany implemented in the late s [ 22 ]. Urology Clinics of North America.

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We analysed syphilis surveillance data and data of four behavioural surveys on men who have sex with men MSM in Germany , , , to assess if this rise is ongoing and to find possible explanations for it. This was mainly due to increasing notifications in MSM of all age groups in larger German cities. Data from the behavioural surveys on MSM in Germany showed a simultaneous increase of selective condom use as HIV-status-bases risk management strategy and the number of syphilis cases.

A risk adapted routine screening for sexually active MSM and potentially innovative approaches to increase early screening and treatment of syphilis such as internet counselling, home sampling, home testing and broadening venue-based rapid testing, should be critically evaluated to effectively reduce syphilis infections.

Syphilis incidence among men who have sex with men MSM has been on the rise globally during the last years. Especially in western countries, sharp increases in numbers of syphilis infections were observed [ 1 - 4 ]. In Europe, the syphilis incidence was 5.

Since , the syphilis incidence increased in Europe in men, especially in western European countries, while the incidence decreased in women concurrently.

In Germany, the number of reported syphilis cases doubled between and to over 3, per year and remained mainly stable until Australia, Canada, England, Germany, and Spain [ 6 - 10 ]. We discuss reasons for the increasing syphilis incidence in MSM, in particular the increase in risky sexual behaviour, such as a higher frequency of condomless sexual intercourse, while applying HIV serostatus knowledge-based risk management strategies, particularly HIV-serosorting [ 11 - 16 ].

Syphilis is a STI caused by Treponema pallidum. It has different stages of disease primary, secondary, latent, and tertiary syphilis , of which especially the first and second stages are highly infectious. Syphilis can lead to severe sequelae such as serious cardiovascular or neurological impairments and also death, and increases the risk of HIV acquisition and transmission [ 17 , 18 ]. As congenital syphilis, T. Syphilis can still be treated effectively with penicillin [ 17 ].

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 and Additionally, we analysed data of four waves of a behavioural survey among MSM in Germany to assess potential changes in relevant sexual behaviours.

In Germany, syphilis diagnoses have been notified anonymously on the basis of the Protection against Infection Act in Germany [ 19 ] since by laboratories, with physicians inserting relevant clinical information. Syphilis cases are defined as cases diagnosed by direct detection of T.

Potential double notifications were identified by comparing cases by demographic data, diagnosis date, antibody titres, and clinical information. We analysed syphilis cases by year of diagnosis, age, sex, area of residence, and transmission group. Self-reported data on sexual risk behaviours and diagnoses of HIV and syphilis among MSM were collected during four waves of a behavioural MSM survey in , , , and Survey participants were recruited exclusively online in the and surveys, and by a combination of print questionnaires distributed by gay magazines and online questionnaires in the and surveys.

The methods and the results of this survey have been published elsewhere in German [ 20 - 23 ]. These surveys are part of the HIV behavioural surveillance in Germany implemented in the late s [ 22 ]. Although they use the same or very similar questions, their comparability is restricted, mainly due to the different recruitment methods.

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 , 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.

This subgroup is less affected by the change in recruitment methods. Data on syphilis testing were only collected in and in the behavioural surveys. As at 1 March , 54, newly diagnosed cases of syphilis had been notified in Germany between 1 January and 31 December , with cases increasing since Figure 1.

In , 6, cases were reported, corresponding to a Incidence was 8. They were especially high in Berlin inner city areas with Notified cases increased in 14 of 16 German federal states in Men accounted for The transmission route was reported for In , Since , the proportion of MSM diagnosed in primary or secondary stages of disease has remained between Since , physicians provided information on re-infection for The trend of self-reported syphilis cases was similar to the trend in syphilis notifications Figure 3 ; the increasing trend was almost entirely based on respondents with HIV.

The total number of syphilis notifications fulfilling the inclusion criteria was 10, HIV-testing in the previous 12 months increased from Among all MSM reporting a syphilis diagnosis in the previous 12 months 29; 60; ; 58 , the proportion of MSM diagnosed with HIV increased from Partly, sexual behaviour differed considerably by self-reported HIV status.

Testing for syphilis was reported much more frequently by survey respondents diagnosed with HIV compared with survey respondents not diagnosed with HIV. Among respondents tested for, but not diagnosed with HIV this proportion increased from We found an accelerating increase of syphilis notifications in Germany since This increase was mainly due to a rise in the number of newly diagnosed cases in MSM, acquired domestically. The epidemic is mostly concentrated in larger cities and more densely inhabited regions of Germany, where the proportion of MSM is higher [ 24 , 25 ].

Berlin as a centre of sex tourism for MSM [ 26 ] was heavily affected. The increase applied to MSM in all age groups, and was strongest in older age groups in terms of absolute numbers. The analysis of survey data on sexual behaviours of MSM in Germany provided an indication that changes in sexual behaviours of MSM taking place during the last years may have played an important role in the increase in the number of syphilis cases. However, we believe that for the increasing syphilis incidence, the increase in cAI with non-steady partners is much more relevant because having different sex partners is one of the major risk factors for acquiring syphilis among MSM [ 26 ].

We can confirm from our data that increased reporting of cAI can be observed independently of the HIV testing history. However, we argue that MSM never tested for HIV are participating in serostatus communication, most of them assuming that they are not infected. This assumption was supported by our data since the proportion of men reporting cAI with partners of unknown HIV status was stable or even declined, based on a question which was not used in the US surveillance.

An increase in syphilis cases was seen in both first and second generation surveillance. However, variation in recruitment methods, sample sizes and sample composition of the MSM surveys limit the generalisability of behavioural trends to the overall MSM population in Germany. Although no increase in the proportion of self-reported syphilis diagnoses could be observed among survey respondents without diagnosed HIV, we would like to point out that the absolute numbers of syphilis cases in this population could still be higher than the number of syphilis infections among MSM living with HIV.

Survey participants could not be proven representative either for all MSM diagnosed with HIV or for the total MSM population, and differing self-selection biases may distort the composition of the survey respondents. We hypothesise that the susceptible population connected to sexual networks created by online- and smartphone-dating might have expanded over the recent years [ 30 ].

This could explain increasing numbers of syphilis cases among HIV-negative MSM without an increase in the proportions observed in the surveys. The increasing total number of survey participants over time is compatible with this hypothesis.

Molecular epidemiological data would allow for an in-depth analysis of the transmission dynamics of syphilis in Germany and could generate evidence if syphilis infections occurred mainly in core sexual networks of HIV-positive MSM, but these data are not yet available. Until , the German syphilis notification system provided no data on the HIV status of the reported person. Since , the notification system has been amended and reporting of coinfection with HIV and other STIs has been implemented.

This change will enable us to better evaluate the impact of HIV coinfection on the dynamics of syphilis. About a third of notified cases among MSM were diagnosed with syphilis in late stages of disease, and reinfections were common. This underlines the importance of effective behavioural prevention and broad screening offers for MSM regarding syphilis and other STIs [ 31 ].

Consistent condom use independent of HIV status should be promoted for anal intercourse to reduce syphilis transmission. In our subsample from the behaviour surveys, a large majority of MSM diagnosed with HIV have been screened for syphilis in the last 12 months [ 32 ].

This does not seem to have a large impact on syphilis incidence in this group. While guidelines have changed and consecutively also screening practices may have changed over time in Germany so far no direct audits of practices and adherence to guidelines have been conducted , practices are more likely to be influenced by reimbursement rules and concerns rather than by guidelines.

In Germany, syphilis testing is easily reimbursable for people diagnosed with HIV through a special reimbursement framework for HIV care while syphilis screening testing without symptoms of MSM not diagnosed with HIV may be restricted by reimbursement concerns, in the absence of an official screening programme irrespective of guideline recommendations. Modelling exercises in Australia and Canada concluded that the frequency of syphilis screening probably needs to be increased to at least biannual screening, in order to achieve an epidemiological impact [ 33 - 35 ].

German guidelines advise for a risk-adapted frequency of screening for MSM [ 36 ]. For sexually active MSM especially with changing sex partners, routine screening for syphilis seems to be paramount [ 37 ]. To foster this, potentially innovative approaches to increase early screening and treatment such as Internet counselling, home sampling, home testing and broadening venue-based rapid testing, should be critically evaluated.

Conflict of interest: None declared. Ulrich Marcus conducted data analysis and drafted the article. Axel Schmidt, Jochen Drewes and Viviane Bremer conducted data analysis and discussed the data and perspectives. All authors provided contributions to the paper and approved the final version.

National Center for Biotechnology Information , U. Journal List Euro Surveill v. Euro Surveill. Klaus Jansen , 1 Axel J. Axel J. Author information Article notes Copyright and License information Disclaimer. Correspondence: Klaus Jansen ed. Received Apr 12; Accepted Jul Copyright This article is copyright of The Authors, You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence, and indicate if changes were made.

This article has been cited by other articles in PMC. Keywords: syphilis, men who have sex with men — MSM, epidemiology, surveillance, sexual behaviour. Introduction Syphilis incidence among men who have sex with men MSM has been on the rise globally during the last years. Methods Mandatory syphilis notification In Germany, syphilis diagnoses have been notified anonymously on the basis of the Protection against Infection Act in Germany [ 19 ] since by laboratories, with physicians inserting relevant clinical information.

Behavioural surveys Self-reported data on sexual risk behaviours and diagnoses of HIV and syphilis among MSM were collected during four waves of a behavioural MSM survey in , , , and

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Please make sure that you are posting in the form of a question. Please enter a question. Not at 8 weeks yet? Moms normally have only X chromosomes, so if Y chromosomes are found, the baby is a boy! If not, the baby is a girl! Inside your SneakPeek test kit, you will find everything you need to collect your DNA sample only drops of blood which takes just under minutes.

Y-chromosomes would only be present if mom is pregnant with a boy. If no Y-chromosomes are found, mom is carrying a girl. This method is known as noninvasive prenatal testing NIPT and is safe for both mom and baby. In the case of identical twins, if male DNA is found, then both babies are boys.

If no male DNA is found, then both babies are girls. For fraternal twins or more! We know information surrounding your DNA is sensitive. To protect your privacy we do the following:. No data is gathered about disease states or other health-related information. After the test is run, your DNA sample is transferred to a professional chemical management company for immediate disposal in compliance with federal regulations.

SneakPeek never shares your results with anyone other than the email address you provide. See our peer-reviewed study in the International Journal of Pregnancy and Childbirt h. We email gender results straight to you within 8 hours of receiving your sample, Monday - Saturday. Would you like to tell us about a lower price?

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If we can't repair it, we'll replace it or reimburse the purchase price with an Amazon e-gift card. Plans are only valid for new or certified refurbished products purchased in the last 30 days with no pre-existing damage. Protection plan documents will be delivered via email within 24 hours of purchase. Add No Thanks. Learn more. Image Unavailable Image not available for Color:. Style: SneakPeek Standard.

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Thank you for your feedback. Share your thoughts with other customers. Write a customer review. Customer images. See all customer images. Read reviews that mention sneak peek came back easy to use said boy test at 9 weeks anatomy scan enough blood sneak peak highly recommend baby girl follow the directions male dna baby boy weeks pregnant gender reveal followed the instructions super easy definitely recommend fast track days later. Top Reviews Most recent Top Reviews. There was a problem filtering reviews right now.

Everything went fine until I received the check-in email telling me that my sample was received. I didn't receive another email until almost 36 hours later not the within 24 hours promised telling me that there was a quality issue and my sample could not be processed -- no further explanation. Customer service is non-existent. There is no number that you can call. All 4 of my emails have been completely ignored. Wish I had saved my money and the disappointment this product caused.

It was wrong. I did everything except swim in bleach. Got a boy result at 10 weeks and followed instructions to a T!! Cleaned and sanitized everything and had no males around. A girl after 2 boys so we are happy it was wrong, but still wouldn't reccomend this test to anyone!!! This review was a little bitter sweet for me.