Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Graduate School of Health Sciences, University of Bern, Bern, Switzerland.
BMC Public Health. 2023 Nov 3;23(1):2158. doi: 10.1186/s12889-023-17056-x.
BACKGROUND: Monitoring of HIV and sexually transmitted infection (STI) prevention is important for guiding national sexual health programmes for both the general population and key populations. The objectives of this study were to examine trends and patterns of condom use at last intercourse and lifetime HIV testing in 2007, 2012 and 2017 in Switzerland, and to explore factors associated with these behaviours in men and women with opposite-sex partners and with same sex partners. METHODS: We analysed data from the 2007, 2012 and 2017 Swiss Health Survey. For each time point, outcome and population group, we conducted a descriptive analysis of weighted data and conducted multivariable logistic regression to obtain adjusted odds ratios (aOR) with 95% confidence intervals (CI) and compared outcomes between the timepoints. RESULTS: In total, 46,320 people were interviewed: 21,847 men and 23,141 women, who reported having sex only with partners of the opposite sex, 633 men who reported sex with a male partner and 699 women who reported sex with a female partner. Among the three surveys the prevalence of condom did not change but varied from 22 to 26% of men and 15 to 21% in women with only opposite-sex partners (aOR men, 0.93, 95% CI 0.82, 1.06; women 0.98, 95% CI 0.86 to 1.11). In men with any same sex partner the prevalence of condom use was 40% in 2007, 33% in 2012 and 54% in 2017 (aOR 1.80, 95% CI 0.97, 3.34). In multivariable analysis, the factor most strongly associated with condom use was sex with an occasional partner at last intercourse. HIV testing ever increased across all three survey years in people with opposite sex partners: 2017 vs. 2007, aOR men with only opposite-sex partners 1.64 (95% CI 1.49, 1.82), women with only opposite-sex partners 1.67 (1.51, 1.85), men with any same sex partner 0.98 (0.49, 1.96), women with any same sex partner 1.31 (0.74, 2.30). CONCLUSIONS: Monitoring of condom use, and HIV testing should continue and contribute to the development of the national sexual health programme. Stronger promotion of condoms for people with opposite-sex partners might be needed, since overall condom use at last intercourse has not changed since 2007.
背景：监测艾滋病毒和性传播感染（STI）的预防情况对于指导普通人群和重点人群的国家性健康计划非常重要。本研究的目的是分析 2007 年、2012 年和 2017 年瑞士最后一次性交时使用安全套和终生艾滋病毒检测的趋势和模式，并探讨与具有异性伴侣和同性伴侣的男性和女性的这些行为相关的因素。
方法：我们分析了 2007 年、2012 年和 2017 年瑞士健康调查的数据。对于每个时间点、结果和人群组，我们对加权数据进行了描述性分析，并进行了多变量逻辑回归，以获得 95%置信区间（CI）的调整优势比（aOR），并比较了时间点之间的结果。
结果：共有 46320 人接受了采访：21847 名男性和 23141 名女性，他们报告仅与异性伴侣发生性行为，633 名男性报告与男性伴侣发生性行为，699 名女性报告与女性伴侣发生性行为。在这三项调查中，安全套的使用率没有变化，但异性恋伴侣中男性的使用率从 22%变化到 26%，女性从 15%变化到 21%（男性 aOR，0.93，95%CI 0.82，1.06；女性 0.98，95%CI 0.86 至 1.11）。在与任何同性伴侣发生性行为的男性中，2007 年安全套使用率为 40%，2012 年为 33%，2017 年为 54%（aOR 1.80，95%CI 0.97，3.34）。在多变量分析中，与安全套使用最密切相关的因素是最后一次性交时与偶尔伴侣发生性行为。在具有异性伴侣的人群中，所有三年的艾滋病毒检测都有所增加：2017 年与 2007 年相比，男性仅与异性伴侣发生性行为的 aOR 为 1.64（95%CI 1.49，1.82），女性仅与异性伴侣发生性行为的 aOR 为 1.67（1.51，1.85），男性与任何同性伴侣发生性行为的 aOR 为 0.98（0.49，1.96），女性与任何同性伴侣发生性行为的 aOR 为 1.31（0.74，2.30）。
结论：应继续监测安全套使用情况和艾滋病毒检测情况，并为国家性健康计划的制定做出贡献。可能需要加强对异性恋伴侣使用安全套的宣传，因为自 2007 年以来，最后一次性交时安全套的使用率并未发生变化。
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