Gender/Sex Disparities in the COVID-19 Cascade From Testing to Mortality: An Intersectional Analysis of Swiss Surveillance Data.

Objectives: This study investigates gender and sex disparities in COVID-19 epidemiology in the Canton of Vaud, Switzerland, focusing on the interplay with socioeconomic position (SEP) and age. Methods: We analyzed COVID-19 surveillance data from March 2020 to June 2021, using an intersectional approach. Negative binomial regression models assessed disparities between women and men, across SEP quintiles and age groups, in testing, positivity, hospitalizations, ICU admissions, and mortality (Incidence Rate Ratios [IRR], with 95% Confidence Intervals [CI]). Results: Women had higher testing and positivity rates than men, while men experienced more hospitalizations, ICU admissions, and deaths. The higher positivity in women under 50 was mitigated when accounting for their higher testing rates. Within SEP quintiles, gender/sex differences in testing and positivity were not significant. In the lowest quintile, women's mortality risk was 68% lower (Q1: IRR 0.32, CI 0.20-0.52), with decreasing disparities with increasing SEP quintiles (Q5: IRR 0.66, CI 0.41-1.06). Conclusion: Our findings underscore the complex epidemiological patterns of COVID-19, shaped by the interactions of gender/sex, SEP, and age, highlighting the need for intersectional perspectives in both epidemiological research and public health strategy development.

Transactional sex among young people in Switzerland: a cross-sectional study.

Background The aim of this research was to determine the prevalence and characteristics of youths having ever exchanged sex and to assess if there were differences depending on whether they had done it once or several times. We also investigated what they exchanged sex for and their relationship with the last person they did it with. Methods A cross-sectional national survey was carried out in Switzerland in 2017 among young adults. The 5175 participants (51% males, mean age 26.3years) who answered the question 'Have you ever received something or obtained an advantage in exchange for a sexual act?' were divided into three groups: Never (96.8%), Once (1.5%) and Several (1.7%). Results In the multivariate analysis, compared to the Never group, those in the Once group were significantly more likely to be males, to have a poor mental health, to be non-exclusively heterosexual and to have had 10+ lifetime sexual partners. Those in the Several group reported the same characteristics, but were also more likely to be younger at first sexual contact, to have their parents not living together, to report a lower socioeconomic status and a history of sexual abuse, and to have ever sent sexual images/videos of themselves. They were also less satisfied with their financial situation. Conclusions Results indicate that transactional sex is a reality for some youths in Switzerland, and health professionals dealing with them should include this question in their sexual anamnesis. From a public health perspective, sexual education and prevention campaigns should include this phenomenon.

Trends in COVID-Related Activity in Sentinel Family Medicine Practices: An Observational Study.

Objectives: During the COVID pandemic, data collected in family medicine were scarce. The COVID-FM project aimed to monitor trends of COVID-related activity in family medicine practices of the canton of Vaud, Switzerland, during the year 2021. Methods: Practitioners were invited to join an ad hoc sentinel surveillance system. Online data collection was based on daily activity reports and monthly questionnaires. Participants categorized daily counts of consultations and phone calls into predefined categories. Data were reported and discussed on a weekly basis with public health authorities. Results: On the target of 50 physicians, 37 general physicians from 32 practices finally constituted the COVID-FM sentinel network, contributing to 901 practice-weeks of surveillance in family medicine and 604 in paediatrics. In paediatrics, COVID-related activity corresponded mostly to COVID-19 diagnostic consultations (2911/25990 face-to-face consultations = 11.2%) while in family medicine, other COVID-related topics-such as questions on vaccination-predominated (4143/42221 = 9.8%). Conclusion: COVID-related consultations constituted an important part of primary care practices' activity in 2021. Monitoring COVID-related activity in primary care provided health authorities with valuable information to guide public health action.

Transition from paediatric to adult care: What about the healthy ones?

OBJECTIVE: To compare the characteristics of and use of the healthcare system by healthy youths depending on whether they had discussed transition to adult health care with their paediatrician or not. METHODS: Data were drawn from the fourth wave of the GenerationFRee study (2018-2019) conducted in the 11 post-mandatory schools of the canton of Fribourg, Switzerland. The sample included 931 young people (mean age 19.4 years). Participants were categorised into three groups: those who had discussed transition with their p ediatrician (n = 176; 19%), those who had not (n = 286; 31%) and those who did not know (n = 469; 50%). Analyses were stratified by gender through bivariate analysis and post-hoc tests with a Bonferroni-type adjustment. RESULTS: The majority of participants did not know whether or not they had discussed transition. Across all groups, it was found that youths met their primary care physician at a higher rate through family. Meeting with the primary care physician through the paediatrician occurred at a higher rate when youths had discussed transition. Girls with a below average socioeconomic status and boys with advanced puberty onset were more likely to have discussed transition. CONCLUSION: Our results show that youths are not well informed about the transition process. However, youths who have discussed transition appear to be more involved with the healthcare system as they are more likely to have a primary care provider. In order to avoid discontinuity of care, professionals should approach transition to adult care systematically with all their patients.

Virgins at age 26: who are they?

Background Studies on virgins remain scarce. This study explores the characteristics of virgin young adults, the reasons for remaining virgin, and its potential social and health implications. METHODS: Data were drawn from the 2017 Swiss study on sexual health and behaviour among young adults. A total of 5175 participants (mean age 26 years ± 0.01) were divided into virgins and non-virgins. Virginity was defined as never having had a sexual partner, defined as a person with whom the participant has had sexual contact with or without penetration. RESULTS: A total of 275 (5.3% (95% CI: 4.7-6.0), 58% males) were virgins. Virgins had higher odds of being male (aOR: 2.27 (95% CI: 1.62-3.17)) and reporting poorer health (1.43 (1.07-1.92)). They had lower odds of living on their own (0.24 (0.18-0.32)), being satisfied with their social life (0.78 (0.72-0.85)), having experimented with substances (e.g. drunkenness, 0.27 (0.19-0.67)) and having used online dating (0.52 (0.26-1.12)) or pornography (0.67 (0.42-0.94)). The main reason for remaining virgin was 'I have not found the right person' for females, and 'I have not had the occasion' for males. CONCLUSIONS: Among young adults, 1 in 20 is a virgin. Virgins do not seem to have gone through the usual experimentations of adolescence, are less socially driven and reported more health challenges. The main reason for remaining a virgin reveals gender-stereotyped responses. Sexual inactivity among young adults should be considered by health professionals to ensure the absence of distress and open discussion for potential questions.

Losing your virginity safely? A Swiss national survey.

WHAT IS KNOWN ON THE SUBJECT: Good practice and knowledge in terms of contraception at first sexual intercourse may lead adolescents to a safer sexual life. To date, research studies have mostly focused on women when investigating contraception use or on condom use only when addressing both genders. WHAT DOES THIS ARTICLE ADD: The present study adds to the current knowledge by offering a more in-depth view of contraception use at first intercourse among youths. This is achieved through a large selection of variables, the fact that we address both males and females and that we have considered a wide range of contraceptive means. AIM OF THE STUDY: To determine the rate of contraception use at first intercourse by youth in Switzerland and its association with social and personal characteristics. METHODS: Data were obtained from a self-administrated national survey on sexual behaviour among young adults (mean age 26 years). Participants (n = 4036) were divided into three groups based on the means of contraception used at first intercourse: condom, with or without contraceptive (86.4%), contraceptive only (8.3%) and non-use (5.3%). RESULTS: Only 5.3% did not use any contraception. Compared with the condom group, individuals in the non-use group were more likely to report a lower family socioeconomic status, to be foreign born, to have foreign-born parents, to have a non-intact family and to live in a Catholic canton. They were also more likely to have had their first intercourse in the context of a casual relationship, to have been intoxicated at the time and more likely to regret it. Participants in the contraceptive group reported a higher family socioeconomic status, had intact families, did not live in Catholic cantons, were older and in a steady relationship at first intercourse. CONCLUSION: Contraception is generally used at first intercourse in Switzerland. Improvements can still be made concerning contraception use in the most vulnerable social strata such as low income families or foreign status.

Anal Intercourse among Heterosexual Young Adults: A Population-Based Survey in Switzerland.

Anal intercourse (AI) among heterosexuals is an understudied and taboo subject. This 2017 Swiss national study aimed to describe the characteristics and motivations of heterosexual young adults practicing AI. Participants with any same-sex experience, same-sex attraction or non-heterosexual identity were excluded. The Federal Statistical Office provided the initial sample and potential participants were recruited through postal mail inviting them to an online survey (response rate 15.1%). The sample comprised 3892 participants (52% males; 54% of the overall sample, mean age 26.3 years). Overall, 55% of women and 56% of men had never experienced AI, 17% and 12% had done it once and 28% and 32% more than once, respectively. We found that participants engaging in AI had higher odds of practicing intercourse while intoxicated, being younger at first sexual experience, not using a condom at last intercourse and reporting a history of sexual transmitted infections. The main reason reported by both genders for engaging in their first AI was being curious followed by being in love. In conclusion, AI is a widespread practice among heterosexual young adults and health professionals should be especially attentive to it.

Contraception use: is everything played at first intercourse?

OBJECTIVES: The rate of condom and other contraception use varies depending on social, personal and sexual characteristics. We present a study covering various contraceptive means, considering sexual orientation and considering a large panel of co-variables among Swiss resident young adults. METHODS: Data were obtained from a self-administrated national survey on sexual behavior. Participants (N=4703, 49% males) were divided into three groups based on the mean of contraception used at last intercourse: CONDOM (55.1, 54.3% males), CONTRACEPTIVE (34.3, 43.1% males) and NON-USE (10.5, 50.7% males). By gender, groups were compared on sociodemographic and personal characteristics, contraception used at first intercourse (FI) and sexual life. RESULTS: Globally, 90% of participants used a reliable contraception at last intercourse. Compared to the CONDOM group, participants in the CONTRACEPTIVE group were more likely to have already used a contraceptive at FI, and individuals in the NON-USE group were more likely to have had a non-use or to have used a contraceptive only at FI. CONCLUSIONS: Contraception at FI seems to have a considerable impact on the further use of contraception. It seems thus essential to make all necessary efforts in order to promote the best contraception and protection at FI.

Youths and poor emotional wellbeing: is it just a matter of stress? A longitudinal survey.

WHAT IS KNOWN ON THE SUBJECT: To date, research on emotional wellbeing among youths has been mostly based on cross-sectional studies, and little is known about its evolution over time. WHAT DOES THIS ARTICLE ADD: Our study adds a longitudinal approach to emotional wellbeing and defines different groups of youths according to their evolution over a two-year period. Stress and perceived health status seem to be the most important factors related to emotional wellbeing. Our research shows the importance of health care professionals exploring psychological health, especially when a youth has atypical somatic complaints. This could allow the early detection of psychological problems and the provision of proper timely treatment. AIM OF THE STUDY: To assess how emotional wellbeing evolves over a two-year period among youths in Switzerland, and to assess their characteristics. METHODS: Data were obtained from the first and third waves of the GenerationFRee study (n = 1311, aged 15–24 at baseline). The sample was divided into four groups according to the evolution of their emotional wellbeing (WB): good at both waves (GoodWB: 67.9%), poor at T1 and good at T3 (BetterWB: 8.4%), good at T1 and poor at T3 (WorseWB: 13.2%), or poor at both waves (PoorWB: 10.4%). Significant variables at the bivariate level were included in a multinomial regression analysis using GoodWB as the reference category. Results are given as relative risk ratios (RRRs). RESULTS: The BetterWB group reported more stress at T1 (RRR 1.34), as did the WorseWB group at T3 (1.43). Those in the WorseWB group were more likely to report poorer health status at T3 (6.51). Finally, the PoorWB group reported more stress at T1 (1.33) and T3 (1.44), and poorer health status at T1 (9.39) and T3 (5.75). Other variables not significant in all groups were perceived onset of puberty, having a chronic condition, area of residence and relationships with parents. CONCLUSION: Using a longitudinal approach, stress and perceived health status seem to be the main factors that change with emotional wellbeing among youths. Inquiring about stress could be a good proxy for emotional wellbeing, especially among males, who tend to underestimate their emotional worries.

Far from acceptable: youth-reported risk behaviour screening by primary care physicians.

BACKGROUND: Adolescence and early adulthood are periods of experimentation during which health detrimental behaviours might be acquired. OBJECTIVE: This study's purpose is to evaluate physicians' likelihood of addressing health risk behaviours with youths depending on the youths' wishes, risk behaviours and personal characteristics. METHODS: Data were drawn from the third wave (2017-18) of the GenerationFRee longitudinal study carried out on a sample of 1970 youths aged 17-26 in Switzerland. Analysed risk behaviours were: eating disorders, substance use, emotional wellbeing, problematic Internet use and gambling. Bivariate and multivariate analyses were performed, results are presented as adjusted odds ratios (aORs). RESULTS: Physicians discussed most risk behaviours with less than half of the youths. The odds of addressing risk behaviours were seldom raised when the risk behaviour was present, or when the youth wished to discuss it. Emotional wellbeing was addressed with half as many males as females (aOR 0.47), and drugs were found to be addressed more frequently with youths reporting a low family socio-economic status (aOR 6.18). When a risk behaviour is addressed it is mostly alongside an extended screening. CONCLUSIONS: This study confirmed the low levels of health risk behaviours screening, regardless of the youths' wish to discuss the topic with their physician. Despite the low levels, physicians do tend to screen systematically, especially when discussing substance use. There is a need to improve physicians training in risk behaviour screening and counselling in order to increase this practice.

Non-consensual sexting: characteristics and motives of youths who share received-intimate content without consent.

Background:One of the possible negative consequences of sexting is the non-consensual sharing of received-intimate content. This study aimed to determine the characteristics and motives of youths who shared received-intimate images without consent. Methods: Data were obtained from a self-administrated Swiss survey on sexual behaviours among young adults (aged 24-26 years). Out of the 7142 participants, 5175 responded to the question 'Have you ever shared (forwarding or showing) a sexy photograph/video of someone else (known or unknown) without consent'?; 85% had never shared (Never), 6% had shared once (Once) and 9% had shared several times (Several). Data are presented as relative risk ratios with 95% confidence intervals. Results: Participants who had shared received-intimate content without consent had higher odds of being male [2.73 (2.14-3.47)], foreign-born [1.45 (1.04-2.03)], reporting a non-heterosexual orientation [1.46 (1.10-1.93)], having sent one's own intimate image [1.76 (1.32-2.34)] and receiving a shared-intimate image of someone unknown [4.56 (3.28-6.36)] or known [2.76 (1.52-5.01)] compared with participants who had never shared. The main reported motivations were for fun (62%), showing off (30%) and failure to realise what they were doing (9%). Conclusions: Given the reported motivations, it appears crucial to remind youths of the seriousness of non-consensual sharing. Although females may also be perpetrators, the behaviour was more prevalent among males. Prevention and education need to consider a broad range of young people in their scenarios. Even if a particular focus on understanding and preventing males' perpetration must be considered, overall perpetration, including female's, must be discussed.