In another cohort of HIV-infected patients from Cologne, among approximately 1,600 patients enrolled between 2004 and 2008, 100 had acute syphilis and 84 % of them were MSM [22]. This should have implications for further prevention strategies which should not only focus on HIV but also on STIs in general. According to our results, a past or present STI such as syphilis seems to enhance the utilisation of HIV care in MSM and offers a chance for the earlier diagnosis of HIV infection. Since the proportion of late presentation to HIV diagnosis in MSM was found to increase again in Germany [12], which is in line with our observations, further efforts should be made to intensify screening for STIs, together with earlier HIV testing.