Clinical settings and specialties notifying cases of bacterial sexually transmitted infections in Switzerland: cross-sectional study.

QUESTIONS UNDER STUDY In the next Swiss National HIV and Sexually Transmitted Infection (STI) Strategy 2011-2017, STI control will be integrated with HIV prevention. Information is needed which will improve the targeting of professional education. The objective of this study was to describe the clinical specialities and settings to which patients with bacterial STI present in Switzerland. METHODS We analysed notifications of chlamydia from 01.08.2008-30.11.2008, and of gonorrhoea and syphilis from 01.07.2007-30.11.2008. We recorded patient details, the speciality of the notifying physician and the setting (primary or secondary care). RESULTS We included 2150 notifications of chlamydia, 1360 of gonorrhoea and 935 of syphilis. In 12.5% of notifications (556/4445) a speciality or setting could not be assigned. Most chlamydia (1282/2150, 59.6%) and gonorrhoea (902/1360, 66.3%) notifications were from primary care. Slightly more syphilis notifications (429/935, 45.9%) were from secondary than from primary care. General practitioners (GPs) were the single largest group of specialists notifying gonorrhoea (609/1360, 44.8%) and syphilis (223/935, 23.9%) and the second largest speciality notifying chlamydia (446/2150, 20.7%) after gynaecologists in primary care (702/2150, 32.7%). Where male sexual orientation was recorded, 52.5% (180/343) of gonorrhoea cases and 30.3% of syphilis cases in men who have sex with men (50/165) were notified by GPs. CONCLUSIONS GPs and other specialists in primary care notify the majority of chlamydia and gonorrhoea and a substantial percentage of syphilis in Switzerland. These physicians will be at the forefront of STI management and secondary prevention to be delivered as part of an integrated HIV and STI strategy.