Measuring female genital mutilation/cutting in Switzerland: from indirect prevalence estimates to Swiss University Hospital data

The aim of this PhD was to evaluate the available FGM/C data in Switzerland to help improve future FGM/C monitoring and routine data collection. It is based on five interrelated studies, employing indirect, direct and routine hospital data collection methods: Firstly, an update of the national indirect estimates for women and girls living with FGM/C in Switzerland was conducted, with the use of annual estimates for 2010-2018. Secondly, based on systematic reviews and available literature on complications of FGM/C, we compiled a comprehensive list of diseases, disorders and health-related consequences of FGM/C in alignment with the International Classification of Diseases (ICD) ninth and tenth revisions. Thirdly, we gathered anonymized data from Swiss University hospitals about women and girls with a primary or secondary ICD diagnosis of FGM/C and their co-morbidities. And finally, we conducted a national exploratory cross-sectional study, assisted by the Swiss HIV Cohort (SHCS). We administered two questions on history of FGM/C and previous discussion about it with a healthcare professional during routine visits between June and December 2019 to help validate our estimates for the number of women living with FGM/C in Switzerland

Estimating the indirect prevalence of female genital mutilation/cutting in Switzerland

BACKGROUND: We updated the indirect estimates for women and girls living with Female Genital Mutilation Cutting (FGM/C) in Switzerland, using data from the Swiss Federal Statistical Office of migrant women and girls born in one of the 30 high-prevalence FGM/C countries that are currently living in Switzerland. METHODS: We used Yoder and Van Baelen's "Extrapolation of FGM/C Countries' Prevalence Data" method, where we applied DHS and MICS prevalence figures from the 30 countries where FGM/C is practiced, and applied them to the immigrant women and girls living in Switzerland from the same 30 countries. RESULTS: In 2010, the estimated number of women and girls living with or at risk of FGM/C in Switzerland was 9059, whereas in 2018, we estimated that 21,706 women and girls were living with or at risk of FGM/C. CONCLUSION: Over the past decade, there have been significant increases in the number of estimated women and girls living with or at risk of FGM/C in Switzerland due to the increase in the total number of women and girls originally coming form the countries where the practice of FGM/C is traditional

Diagnoses and procedures of inpatients with female genital mutilation/cutting in Swiss University Hospitals: a cross-sectional study

BACKGROUND: Female genital mutilation/cutting (FGM/C) can result in short and long-term complications, which can impact physical, psychological and sexual health. Our objective was to obtain descriptive data about the most frequent health conditions and procedures associated with FGM/C in Swiss university hospitals inpatient women and girls with a condition/diagnosis of FGM/C. Our research focused on the gynaecology and obstetrics departments. METHODS: We conducted an exploratory descriptive study to identify the health outcomes of women and girls with a coded FGM/C diagnose who had been admitted to Swiss university hospitals between 2016 and 2018. Four of the five Swiss university hospitals provided anonymized data on primary and secondary diagnoses coded with the International Classification of Diseases (ICD) and interventions coded in their medical files. RESULTS: Between 2016 and 2018, 207 inpatients had a condition/diagnosis of FGM/C. The majority (96%) were admitted either to gynaecology or obstetrics divisions with few genito-urinary and psychosexual conditions coded. CONCLUSIONS: FGM/C coding capacities in Swiss university hospitals are low, and some complications of FGM/C are probably not diagnosed. Pregnancy and delivery represent key moments to identify and offer medical care to women and girls who live with FGM/C. TRIAL REGISTRATION: This cross-sectional study (protocol number 2018-01851) was conducted in 2019, and approved by the Swiss ethics committee

Results of a World Health Organization scoping of sexual dysfunction-related guidelines: what exists and what is needed

BACKGROUND: Sexual dysfunction has long been overlooked in the broader context of sexual and reproductive health services. As a result, and in the absence of international sexual dysfunction treatment guidelines, recommendations have instead been developed by a variety of professional associations, worldwide. AIM: We conducted a mapping of existing recommendations addressing a wide array of conditions related to sexual function/dysfunction. METHODS: We contacted 25 professional associations from around the world and held an online open call for guidelines. OUTCOMES: Eligible submissions had to provide recommendations on treatment related to male or female sexual dysfunction. RESULTS: Twelve guidelines from 11 associations were included. Of the 195 recommendations extracted, 61% were related to men, 53% were related specifically to treatment, and 48% did some form of evidence assessment. CONCLUSION: Recommendations from this exercise are provided for WHO, international and national research institutions, ministries of health, and professional associations. Gonsalves L, Cottler-Casanova S, VanTreeck K, et al. Results of a World Health Organization Scoping of Sexual Dysfunction-Related Guidelines: What Exists and What Is Needed. J Sex Med 2020;XX:XXX-XXX

Prescription Drug Abuse among Ecstasy Users in Miami

This study examines the nature, extent and consequences of prescription drug abuse among 143 ecstasy users in Miami. Participants were recruited through nightclub and college campus outreach, and through respondent referrals. Instrumentation included the Risk Behavior Assessment, Substance Abuse Module and Center for Epidemiological Studies Depression Scale. Median age was 23, 42% were female and 50% Hispanic. An arrest history was reported by 44%, and 33% reported prior drug/alcohol treatment. Prescription drug abuse was reported by 87%; alprazolam (57%), oxycodone (36%), hydrocodone (32%) and diazepam (30%) were cited most often. Prescription drug abusers were more likely to report polydrug use, drug treatment histories, risky drug use behaviors, and symptoms of depression. They also reported numerous physical, psychological and social consequences of prescription drug abuse. Additional studies among larger samples are needed to understand the processes of prescription drug access and the extent of integration in club drug using cultures