PubMed Health⌕ Search

Biomedical subjects

F Dubois-Arber

Publications and source records attributed to F Dubois-Arber.

At least 19 recordsLinked to original sources
PubMed1996

[Monitoring of the activities of low-threshold access structures for drug users in Switzerland: distribution of sterile injection equipment, results for 1993 and various cantonal examples].

In Switzerland numerous structures distribute or sell sterile injecting equipment for i.v. drug users, low threshold centres (LTC's) being the major provider. A national survey of these centres was initiated by the UEPP in january 1993, in the context of the global evaluation of the new set of the federal measures to reduce the problems related to illegal drug use. This article concentrates mainly on the results of the monitoring activity of the LTC's, which in 1993 distributed 7.1 millions syringes. This important offer is not, however, uniform across the different regions of the country. Some examples of regional variations are presented, as are fluctuations of demand in many LTC's. The observed variations can be correlated with season (increased demand in summer), but also with the development of LTC's (opening /closing down of centre, change in the structure, opening hours, etc.) and with external events (policy, increased pressure from police, etc.). This type of monitoring is useful not only for researchers in the field of drug addiction and prevention of HIV/AIDS, but also for decision makers and actors in the field of public health. The recommendations based on the first three years of this monitoring suggest that efforts to prevent sexual transmission of HIV among i.v. drug users should be reinforced as well as measures to supply sterile injecting equipment and condoms at low threshold level must be continued and further developed.

Community Health Services↗
PubMed1996

[AIDS prevention in homosexuals in Switzerland: adaptation to risks according to type of partner].

OBJECTIVE: To evaluate the effectiveness of AIDS prevention and modes of adaptation to risk among gay men. Swiss results are presented from an international study conducted in 8 European countries. METHOD: A self-administered questionnaire was published in gay magazines and distributed by gay organizations and clubs. 934 questionnaires were returned in Switzerland. RESULTS: More than 80% of the respondents report no risk behaviours in the last 12 months. Among all respondents three main modes of adaptation to risk were found: avoidance (no partner, no penetration), protection (condom use), non-use of condoms by stable couples (this assumes an agreement between partners). With casual partners 39% avoid penetration, 49% use condoms and 12% do not use them consistently. With stable partners penetration is more frequent; protection and non use of condoms are found with equal frequency. Nevertheless, 10% of those who report always using condoms say that they have been exposed to a risk, while a third of those who do not always use condoms admitted having taken such a risk. CONCLUSIONS: Prevention campaigns must continue and focus especially on factors linked to the non use of condoms in couples in stable relationships (poor communication, exaggerated trust).

Acquired Immunodeficiency Syndrome↗
PubMed1996

Adolescent sexuality: the gender gap.

The aim of this paper is to determine gender differences as regards adolescent sexuality, in order to improve the adjustment of prevention programmes to boys' and girls' specific needs. Data were collected as part of the Swiss Multicentric Adolescent Survey on Health. Anonymous questionnaires were distributed in school classes among a national representative sample of about 9,300 adolescents (15 to 20 years old). About 45% of the total sample reported a previous sexual experience. Differences between boys and girls were identified by means of bivariate and multivariate analyses. A higher proportion of Swiss girls report intra-family discussions about sexuality, having had a previous sexual experience, having sexual intercourse regularly, having had only one partner, and using contraception regularly. A higher proportion of Swiss boys report positive attitudes towards condoms and using condoms regularly. Variables independently associated with the occurrence of first sexual intercourse before 15 years old also show gender differences, notably as regards health behaviours and social adjustment. The findings suggest that prevention programmes should emphasize, among boys, responsibility in contraception and the need for protection in situations of multipartnership, and among girls, a positive attitude towards condom use and an increased familiarity with condoms presented both in a perspective of contraception and prevention of STDs.

Adolescent↗
PubMed1995

[Practice and needs of Swiss physicians in matters of prevention of HIV infection in their office--experience, reflections and recommendations].

General practitioners play an important role in HIV/AIDS prevention. They are expected to take patients' risk histories, to assess gaps in knowledge and preventive behaviours, and to practise individualised counselling. This article reviews research conducted between 1988 and 1994 on preventive activities of Swiss general practitioners. Proposals are made for improving pre- and post-graduate training, for sensitizing the audience, and concerning cost policy. Aimed at intensifying prevention efforts, these suggestions reflect the increasing recognition of counselling and patient education as key elements in prevention and treatment.

AIDS Serodiagnosis↗
PubMed1995

Identifying adolescent drug users: results of a national survey on adolescent health in Switzerland.

OBJECTIVE: To explore the proportion and characteristics of adolescents who use illicit drugs and contrast them with adolescents who do not use such drugs in Switzerland. To facilitate the detection of adolescents with drug related difficulties. METHODS: We used data from a national survey on adolescent health in Switzerland (N = 9,273) conducted in 1992 and 1993. The survey is based on self-administered questionnaires among a representative sample of adolescents enrolled in schools and apprenticeship programs. We used exploratory analysis for identifying characteristics which set the drug user apart from non-users and performed confirmatory multivariate logistic regression analysis to examine which variables remain independently associated with heroin or cocaine use. RESULTS: In Switzerland, 3.1% of adolescents have taken heroin or cocaine at least once in their life, and 27.7% have already used cannabis. Analysis of lifestyles and health of adolescents show that young drug users present difficulties in integrating in society, have health problems and difficulties in relationships, situations which tend to be less common among other adolescents. Yet, they also display marked similarities, most notably in that over 70% had seen a physician in the past year. However, while 40% of the drug users expressed a need for help with drug related problems, only 6% had actually talked about them with a physician. Characteristics that remained independently associated with heroin and cocaine use after controlling for confounding factors were age, sex, nationality, type of education, feelings of suicide, past and present smoking, and use of cannabis. CONCLUSION: The level of illicit drug use among Swiss adolescents is high compared to other European countries but lower than the United States. Drug-using adolescents display a constellation of characteristics which should make it possible to identify them and offer help. Yet, even though they may have frequent contact with the health services, their drug problems are generally not recognized by the gatekeepers of the health services and no specific aid is available to them. Drug prevention must be intensified and medical doctors sensitized to the drug problems which adolescents may face.

Adolescent↗
PubMed1994

[Prevention of AIDS in drug addicts in Switzerland: an encouraging development].

Switzerland has adopted a prevention strategy including the promotion of non-sharing injection material and use of condoms. The access to sterile equipment has been made easier, but regional differences still exist. Studies conducted between 1989 and 1992 among drug users in different Swiss regions are reviewed in order to examine if progress in prevention occurred. Syringe sharing diminished everywhere, but rather high sharing rates persist where sterile material is less accessible. Condom use increased, but the situation is still unsatisfactory considering the high HIV prevalence among i.v. drug users. Where several surveys have been conducted consecutively, a stabilization of HIV prevalence was observed. This suggests a slowing down of the progression of the epidemic among drug users. These results, obtained in few years, are encouraging in the light of the pessimism which prevailed at the beginning of the epidemic about the ability of drug users to adopt preventive behaviour.

Condoms↗
PubMed1994

[Has the age of onset of sexual activity in youths changed in the time of AIDS? Literature review 1972-1992].

This article on the sexuality of adolescents (aged 16 to 20) presents results of a secondary analysis of Swiss studies completed on the subject between 1972 and 1992. The aim of the study was to follow up the evolution of three aspects of sexual behaviour since 1972 as a contribution to answering the following question: "What influence have the AIDS epidemic and the 'STOP-Aids' campaign had on the time of onset of sexual activity in young people?" Three aspects of sexual behaviour have been analyzed: 1. The proportion of young people who have already had sexual intercourse. This research shows that the percentage of sexually active 17-year-olds increased in the last 20 years for girls from 33% to 46% and for boys of the same age, from 23% to 51%. This increase took place before 1987. Since then, the proportion of sexually active young people of this age has not changed. 2. The number of life-time partners. In 1992, 28% of girls and 23% of boys aged 17 to 20 years had had more than 4 sexual partners. There had been no changes in these percentages since 1987. 3. The use of contraception. The use of contraception during the first sexual intercourse has become more frequent. In girls aged 16 to 20 years it rose from 47% in 1976 to 76% in 1992; in boys it increased from 50% in 1976 to 76% in 1992. For 17- to 20-year-olds, condom use with an occasional sexual partner rose from 16% in 1987 to 69% in 1992.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1994

Assessing AIDS/HIV prevention: what do we know in Europe?

An EC concerted action on the assessment of AIDS/HIV prevention strategies was conducted between 1989 and 1992. The aim of this concerted action (CA) was to bring together researchers who are active in this assessment field, make an initial appraisal of the results of AIDS prevention efforts, in various population groups in Europe and develop an assessment methodology. Five areas of study were selected for the CA: the population as a whole ("general population"), men who have sexual relations with other men, intravenous drug users, migrant populations, monitoring of sexually transmitted diseases (STDs) to determine changes in behaviour. For each of these areas, a working group composed of the leading researchers in the field in Europe was constituted and commissioned by the project administration and coordination team to collate and analyse data on prevention efforts and their assessment in different countries of Europe. This review presents the main results from the groups responsible in each area in the concerted action. A number of general conclusions from the results of this concerted action are drawn.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Sexual behaviour of gay and bisexual men in eight European countries.

To compare the sexual behaviour and HIV risk reduction strategies of gay and bisexual men in Europe, a survey, disseminated via the gay press and gay associations, was conducted amongst gay and bisexual men in Austria, Switzerland, Germany, Denmark, France, Great Britain, Italy and the Netherlands during the autumn and winter of 1991. By end March of 1992, 12,347 completed questionnaires had been obtained. A preliminary analysis shows striking similarities in patterns of sexual behaviour of gay men in the 8 European countries but indicates that strategies of risk management concerning HIV and AIDS vary widely. While the majority of gay men have multiple partners, and intercourse is more common with stable partners than with causal partners. The proportion of men who, during the past 12 months, engaged in unprotected anal intercourse with a partner with different or unknown HIV-status ranged from 1/3 in East Germany to 1/6 in UK. However, reported incidence over the past 12 months of STDs, other than HIV infection, was similar in all countries (2%-3%). The reported HIV antibody prevalence varied from less than 7% in East Germany, Italy and the United Kingdom to 15% in Denmark and 17% in France. HIV risk reduction strategies appear to be most common in those countries where the gay community had been included in targeted prevention campaigns during the early phase of the AIDS epidemic. Considering the high proportion of gay men engaging in high risk activities it is imperative that prevention efforts are sustained and improved.

Acquired Immunodeficiency Syndrome↗
PubMed1994

HIV testing in Switzerland.

OBJECTIVES: To obtain information about the prevalence of, reasons for, and adequacy of HIV testing in the general population in Switzerland in 1992. DESIGN: Telephone survey (n = 2800). RESULTS: Some 47% of the sample underwent one HIV test performed through blood donation (24%), voluntary testing (17%) or both (6%). Of the sample, 46% considered themselves well or very well informed about the HIV test. Patients reported unsystematic pre-test screening by doctors for the main HIV risks. People having been in situations of potential exposure to risk were more likely to have had the test than others. Overall, 85% of those HIV-tested had a relevant, generally risk-related reason for having it performed. CONCLUSIONS: HIV testing is widespread in Switzerland. Testing is mostly performed for relevant reasons. Pre-test counselling is poor and an opportunity for prevention is thus lost.

Acquired Immunodeficiency Syndrome↗
PubMed1993

[Health survey of 15-20-year-old adolescents in French-speaking Switzerland].

During the year 1992, under the auspices of the Federal Office for Public Health, the Institute for Social and Preventive Medicine of Lausanne conducted a survey on the health and life-style of a representative sample of adolescents aged 15 to 20 years from the French speaking part of Switzerland. The main objective of the study was to explore adolescent health attitudes and behavior as well as health needs. After exclusion of non valid questionnaires (1.2%), 3324 subjects have been included in the analysis (females: 1477; males: 1847; apprentices: 59%; students: 41%). The majority of the respondents feel in good health (females: 87.5%; males: 94.3%), but a large proportion express needs in various areas: stress, depression, love, professional future, nutrition etc. Comparisons with earlier surveys show that cannabis use has become more common (lifetime prevalence: females: 24.1%; males: 39.3%). The use of hard drugs such as cocaine and heroin is not exceptional (lifetime prevalence: 1-3%). By 18 years of age, the majority of respondents are sexually active (17 years: 49.0%; 18 years: 62.6%; 19 years: 72.0%). 76.6% of respondents have used contraception on their first coitus and thereafter. Girls exhibit a tendency towards more perceived health problems and more use of health care structures, whereas boys express their problems in a more "external" way, i.e. violent behavior (injuries, fighting, theft etc.). Differences between apprentices and students are minimal, although apprentices tend to be more sexually active. The paper comments on the results in different areas such as health care, prevention and general setting.

Adolescent↗
PubMed1993

[Evaluation of AIDS-related knowledge and behavior among seasonal workers in Switzerland].

Although an increasing number of AIDS prevention programmes are addressing migrants and ethnic minorities, few are either solidly research-based or adequately evaluated. Reported on here is a baseline evaluation of a marginal foreign population, Spanish and Portuguese seasonal workers in Switzerland. AIDS-related knowledge, attitudes and behaviours were assessed with both qualitative and quantitative methods during the winter of 1989-1990. The seasonal workers studied had been reached by prevention programmes both in the host country and in the country of origin, and knowledge was better than expected. Zones of ambiguity, such as confusion between AIDS and treatable STDs, persist however. Legal restrictions which prohibit family reunification affect sexual behavior: respondents report both more abstinence and more transitory sexual relations than the comparison Swiss population. Only about one in five report always using condoms during transitory relations. Qualitative material is used to suggest a relation between attitudes and protective behaviors. HIV/AIDS prevention programmes for Spanish and Portuguese populations in Switzerland are being established on the basis of the research findings.

Acquired Immunodeficiency Syndrome↗
PubMed1993

[The Swiss population and drug problems: perception of the problems and proposals for solutions].

The aim of this study is to investigate which problems in relation with drug abuse are considered to be the most important by the Swiss population and which measures do they support to reduce them. Base for this study are the results of a representative telephone survey realized in october 1991 with 1004 Swiss residents. People are mostly concerned with problems related to the danger for youth and those concerning public order but also with the human condition of addicts. Drug addicts are considered as people who have lost the sense of live, as sick but also as dangerous and less truthful. Supported are overall prevention, offers for therapies, the repression of trafficking and money-laundering but not of drug users as well as measures going in the direction of harm-minimisation (shooting rooms, medical prescription of drugs). Younger people, those with higher education and the german-speaking population have a more positive view of drug addicts and support measures in the sense of harm-minimisation. Elder people and the french-speaking population have a rather negative view of drug addicts and don't favour measures for harm-minimisation.

Adolescent↗
PubMed1993

Evaluation of AIDS prevention among homosexual and bisexual men in Switzerland.

Attitudinal and behavioural change among gay men in Switzerland was measured between 1987 and 1990 to evaluate the effectiveness of AIDS prevention activities. The methodology used included a self-administered questionnaire published in Swiss gay magazines and distributed by gay organizations (N = 795 in 1987, N = 720 in 1990) and in-depth interviews with men recruited through advertisements and through the questionnaire (N = 42 in 1987, N = 24 in 1990). The two independent sampling procedures yielded similar samples with regard to socio-demographic characteristics, allowing comparisons to be made between the 1987 and 1990 data. Personal confrontation with AIDS (knowing someone who is HIV-positive, or who is ill or dead from AIDS) increased significantly during the period but more adequate ways of coping developed. Behavioural change towards safer sex began well before the first study. The majority of responding homosexuals have adapted their sexual behaviour to the new situation created by AIDS and generally maintain a protective behaviour. However, "exceptions" (condom rupture or episodes of non-protection) are not infrequent and should deserve more attention. Three indicators of sexual behaviour (number of sexual partners, anal sex and use of condom and oral sex with ejaculation), reported for the last 3 months before each study, exhibit few changes between 1987 and 1990: number of partners remained stable, unprotected oral sex decreased. Anal sex slightly increased, the use of condoms remaining stable. Sixty-seven percent of the sample knew their serostatus in 1990 (57% in 1987), and 13% of these stated that they were HIV+ (14% in 1987).

Acquired Immunodeficiency Syndrome↗
PubMed1992

Evaluating the drug dependency unit.

An evaluation of the St Mary's Drug Dependency Unit is described. Unit staff were interviewed and a retrospective analysis of 156 records was performed. The advent of HIV infection has led to an emphasis on public health priorities in the treatment of drug misuse. However, DDU staff retain a highly individualistic approach to their work. Staff aiming at abstinence within treatment may compromise important advice on harm minimization. The mean delay between first contact and entering treatment was 10 days; 42% of clients failed to complete the initial assessment. The need to extend access to the service is not easy to reconcile with the increasingly specialised support role for such units implied in recent strategy documents. Little is known of the effectiveness of different services for drug misusers. In this study, only 6% of clients were known to have achieved abstinence at one year. The efficiency of the DDU could be improved by closer definition of the unit's goals and target population, regular progress reviews, shortening the assessment procedure and the computerisation of data collection.

Adult↗
PubMed1990

[The attitude of hospital personnel to AIDS].

Caregivers of 13 hospital services in Switzerland--confronted at various degrees with the aids problem--have been interviewed. The study indicates that hospital caregivers still strongly fear an HIV infection through professional contacts. At the same time they have difficulties to balance correctly risks at work against risks in their private lives. The attitudes of caregivers might negatively influence patient care. They could, however, be modified by a better management of aids related information in hospitals.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Evaluation of campaigns for the prevention of AIDS in Switzerland in 1987].

Since 1985 the Swiss Federal Office of Public Health and the Swiss AIDS Foundation have been promoting AIDS prevention campaigns. A multi-media information campaign with the main slogan "STOP-AIDS" began in February 1987 and is still underway. Multiplying effects are stimulated. The evaluation of that strategy, based on 13 complementary studies, confirms its efficiency and feasibility. The evaluation process will continue in 1988. The campaign and its objectives reached the general population and the target groups. Noticeable changes in attitudes and behaviours are taking place in the way of better protection in various observed groups, moderately or strongly exposed to HIV infection. Condom sales have increased by nearly 60% in 1987 compared with 1986.

Acquired Immunodeficiency Syndrome↗