Sexual behaviour of men that consulted in medical outpatient clinics in Western Switzerland from 2005-2006: risk levels unknown to doctors?

<p>Abstract</p> <p>Background</p> <p>To determine male outpatient attenders' sexual behaviours, expectations and experience of talking about their sexuality and sexual health needs with a doctor.</p> <p>Methods</p> <p>A survey was conducted among all male patients aged 18-70, recruited from the two main medical outpatient clinics in Lausanne, Switzerland, in 2005-2006. The anonymous self-administered questionnaire included questions on sexual behaviour, HIV/STI information needs, expectations and experiences regarding discussion of sexual matters with a doctor.</p> <p>Results</p> <p>The response rate was 53.0% (N = 1452). The mean age was 37.7 years. Overall, 13.4% of patients were defined as at STI risk - i.e. having not consistently used condoms with casual partners in the last 6 months, or with a paid partner during the last intercourse - regarding their sexual behaviour in the last year. 90.9% would have liked their physician to ask them questions concerning their sexual life; only 61.4% had ever had such a discussion. The multivariate analysis showed that patients at risk tended to have the following characteristics: recruited from the HIV testing clinic, lived alone, declared no religion, had a low level of education, felt uninformed about HIV/AIDS, were younger, had had concurrent sexual partners in the last 12 months. However they were not more likely to have discussed sexual matters with their doctor than patients not at risk.</p> <p>Conclusion</p> <p>Recording the sexual history and advice on the prevention of the risks of STI should become routine practice for primary health care doctors.</p

La place des registres dans la surveillance des maladies transmissibles. [The role of registries in the surveillance of transmissible diseases].

Registries are among the oldest methods used in public health for epidemiological surveillance and decision making in the area of communicable diseases. Although other sources of data are now available in many developed countries, registries still provide important information. This article reviews the main aims and characteristics of modern registries, providing several examples of current epidemiological problems. Practical advantages and disadvantages of registries are also discussed, as well as some developmental perspectives in this area

Inefficacy of the commercial live oral Ty 21a vaccine in the prevention of typhoid fever

The efficacy of the live oral typhoid fever vaccine Ty 21a marketed in Switzerland in 1981 was investigated. Forty-seven Swiss travellers to Third World countries contracted typhoid fever in 1982 and 1983; 20 (43%) of these persons had been vaccinated with Ty 21a. The incidence of typhoid fever in vaccinees was 1.1 per 10,000 doses of Ty 21a vaccine sold, which was similar to the incidence of 0.9 per 10,000 doses for the ineffective killed Ty 2 vaccine. Comparison of the incidence of vaccination in patients with typhoid fever in 1983 and in healthy travellers to India revealed vaccination efficacy rates which were not significantly different from zero. It is suggested that Ty 21a vaccine in the form marketed in Switzerland in 1981-1983 is not sufficiently potent or heat-stable, so that the doses of viable bacteria ingested were too low

Typhusepidemiologie in der Schweiz 1980-1983. Geringe oder fehlende Wirksamkeit des Lebendimpfstoffes Vivotif bei Tropenreisenden

214 cases of typhoid fever (TF) occurring in Switzerland between January 1980 and December 1984 were analyzed for travel history, vaccine status and nationality. A subgroup of Swiss tourists who acquired TF in India was compared to a sample of healthy Swiss tourists who travelled to India in 1983 to determine the factors predisposing to TF. Eighty cases of TF occurred in Swiss tourists to the Third World, of whom 26 had travelled in India. Among the latter, the length of stay was longer than in the control sample of 258 healthy tourists, and "trekking" (travelling off the usual tourist routes with backpacking) was more frequent. 20 of the 80 patients had been vaccinated with the live oral typhoid vaccine Vivotif (strain S. typhi Ty 21a, contained in gelatine capsules, to be taken with bicarbonate capsules), marketed in Switzerland in 1981-1984. Comparison of the vaccination rates in case and control groups indicated that the vaccine efficacy was not significantly different from 0% during the time of observation. This lack of efficacy may be related to inadequate dosage and to the lack of stability of the vaccine. Forty cases of TF occurred in Swiss who had travelled in European countries, of whom 8 had not travelled outside Switzerland. The remaining 94 cases occurred in non-Swiss travellers, a majority of whom were from Mediterranean countries. TF in Switzerland was associated with a history of travel in 96% of cases. The live oral typhoid vaccine Vivotif was ineffective between 1981 and 1983

Transition from HIV control to HIV elimination in Switzerland

Purpose This article proposes a strategy for Switzerland to change the goal from HIV control to HIV elimination. In Switzerland, HIV treatment is well organized and available for all with good access. Methods An important challenge that obstructs prevention is the new infections originating from people who are unaware of their status. Since the majority of new infections in Switzerland are within the group of men who have sex with men (MSM), this strategy targets MSM who do not know their HIV status and engage in risky sexual behavior. Results The strategy focuses on three pillars: collaboration and leadership, key actions and important indicators. To guide this effort, we proposed a task force to be responsible for leading this strategy. Its actions are centered around four aspects: learn from MSM, promote and facilitate testing, and include PrEP and PEP in the prevention package together with partner information. This article also provides important indicators that must be measured to inform the task force and to adapt or strengthen the strategy to reach the goal. Conclusion Reaching the right persons and offering the right “prevention package” are the key challenges for Switzerland to be among the first countries to eliminate HIV transmission