Background Since 2003, an epidemic of Lymphogranuloma venereum (LGV) among men who have sex with men (MSM) in Europe has been on-going. This study determined how the epidemic of LGV in MSM visiting STI clinics in the Netherlands has evolved since 2006.

Methods Data on MSM from the national STI surveillance system for 2006–2011 were analysed. LGV testing and positivity rates were calculated and multivariable logistic regression analysis was applied to study risk factors for LGV. In addition, data on the number of cases and positivity rate for the first six months of 2012 were analysed.

Results Between 2006 and 2011, 75% of cases of anorectal chlamydia in MSM were tested for LGV, but this varied between regions from 7% to 97%. In this period, 414 LGV cases were diagnosed, with a mean positivity rate of 8.7%. Positivity rate decreased from 14% in 2007 to 6% in 2011. However, results from the first half year of 2012 showed that positivity rate increased sharply to 14.7% (n = 106 new cases). In multivariable analyses on all cases, risk factors for LGV were HIV positivity (OR = 4.1; 95% CI: 3.2–5.3), STI symptoms (OR = 4.1; 95% CI: 3.1–5.4), > 50 sex partners in the past 6 months (OR = 3.7; 95% CI: 1.1–12.4), older age (40–44: OR = 2.1; 95% CI: 1.5–2.8), no condom use with last partner (OR = 2.2; 95% CI: 1.2–3.9) and exclusively having sex with men (OR = 2.2; 95% CI: 1.1–4.2), No significant changes over time were found in risk behaviour.

Conclusions Since 2006, the annual incidence for LGV fluctuated but was consistently higher than before 2003 and is increasing sharply in the first half of 2012. Regional differences in LGV testing rates limit nationwide LGV surveillance, leading to an underestimation of the real LGV incidence. Characteristics of MSM affected by LGV did not change over time, so prevention strategies and timely and adequate diagnostic towards this specific high-risk group should be intensified.