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Transition from HIV control to HIV elimination in Switzerland

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Abstract

Purpose

This article proposes a strategy for Switzerland to change the goal from HIV control to HIV elimination. In Switzerland, HIV treatment is well organized and available for all with good access.

Methods

An important challenge that obstructs prevention is the new infections originating from people who are unaware of their status. Since the majority of new infections in Switzerland are within the group of men who have sex with men (MSM), this strategy targets MSM who do not know their HIV status and engage in risky sexual behavior.

Results

The strategy focuses on three pillars: collaboration and leadership, key actions and important indicators. To guide this effort, we proposed a task force to be responsible for leading this strategy. Its actions are centered around four aspects: learn from MSM, promote and facilitate testing, and include PrEP and PEP in the prevention package together with partner information. This article also provides important indicators that must be measured to inform the task force and to adapt or strengthen the strategy to reach the goal.

Conclusion

Reaching the right persons and offering the right “prevention package” are the key challenges for Switzerland to be among the first countries to eliminate HIV transmission.

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Acknowledgments

We would like to acknowledge our classmates A.Z. Barreto Solano, K. Bezani, R. Cadlini, S.K. Cestonato, I. Gil, A.Ilic, C.M. Jarach, Y.E. Leon Lopez, E. Leoni, V. Pedercini, C. Tettamanti, F. Torelli and A. Szczypkowski for their collaboration, critical reviews and helpful suggestions for this project.

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Authors and Affiliations

  1. Institute of Communication and Health, University of Lugano, Via Giuseppe Buffi 13, 6904, Lugano, Switzerland

    T. A. Haakma, S. Luder, E. Müller & B. Somaini

  2. Public Health Promotion, Dentenbergstrasse 57a, 3076, Worb, CH, Switzerland

    B. Somaini

Authors
  1. T. A. Haakma
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  2. S. Luder
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  3. E. Müller
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  4. B. Somaini
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Corresponding author

Correspondence to T. A. Haakma.

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Conflict of interest statement

The authors state that there was no conflict of interest in writing this article. This article is a product of 2016 class work in Public Health at the University of Lugano (taught by B. Somaini) during the Master in Communication, Management and Health.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Glossary

ART

Antiretroviral therapy, the current treatment for HIV-infected people. It reduces the virus to undetectable levels in nearly all patients.

FCSH

Federal Commission for Sexual Health

FOPH

Federal Office of Public Health Switzerland, part of the Federal Department of Home Affairs, has responsibility for public health and development of health policies in Switzerland.

MSM

Men who have sex with men.

PEP

Post-exposure prophylaxis, an oral chemoprophylaxis, is intended to serve as an emergency measure by taking anti-retroviral drugs for about 28 days after having a risky sexual encounter to prevent HIV.

PrEP

Pre-exposure prophylaxis, another oral chemoprophylaxis, is intended for people who regularly engage in sexual risky encounters by daily use of antiretroviral drugs. It should be taken for a sufficient length of time before and after risky sexual behavior to prevent HIV.

STI

Sexually transmitted infection

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Haakma, T.A., Luder, S., Müller, E. et al. Transition from HIV control to HIV elimination in Switzerland. J Public Health 25, 565–571 (2017). https://doi.org/10.1007/s10389-017-0819-y

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  • DOI: https://doi.org/10.1007/s10389-017-0819-y

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