Condom use and HIV testing among adults in Switzerland: repeated national cross-sectional surveys 2007, 2012, and 2017

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 patterns of condom use at last intercourse and lifetime HIV testing from 2007 to 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. At 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, 43,949 people were interviewed: 21,274 men and 22,675 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 use varied from 24 to 26% of men and 18 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 increased from 43% in 2007 to 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 all groups: 2017 vs. 2007, aOR men with only opposite-sex partners 1.57 (95% CI 1.42, 1.74), women with only opposite-sex partners 1.54 (1.39, 1.71), men with any same sex partner 1.85 (0.96, 3.55), 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.