SURVEILLANCE OF SEXUALLY-TRANSMITTED DISEASES IN SWITZERLAND, 1973-1994 - EVIDENCE OF DECLINING TRENDS IN GONORRHEA AND SYPHILIS

The HIV/AIDS epidemic has led to growing interest in the epidemiology of sexually transmitted diseases (STDs) in Switzerland. STD surveillan ce data from three sources are presented: reports from six policlinics of dermatovenereology since 1973, laboratory reports of Neisseria gon orrhoeae, Treponema pallidum and Chlamydia trachomatis since 1988, and reports by the Swiss Sentinel Network between June 1991 and December 1993. The data indicate that there has been a decline in the number of cases of syphilis and, in particular, gonorrhoea since the early 1980 s in Switzerland. Since many factors could explain the declines (e.g. more effective treatments, more widespread use of antibiotics, marked changes in behaviour such as increased levels of condom use) it is dif ficult to identify their exact causes. Evidence for two of the before- mentioned factors exists and these probably played important roles in the declines. Firstly as a result of the emergence of penicillinase pr oducing strains of N. gonorrhoeae, the introduction of new treatments for gonorrhoea in the early 1980s which were simpler to administer and more effective (in particular the use of spectinomycin). Secondly the national AIDS prevention campaign which began in 1987 and has been as sociated with major increases in condom use in the Swiss population.