Prevalence, awareness and treatment of type 2 diabetes mellitus in Switzerland : the COLAUS study

Le diabète de type 2 (DT2) a une prévalence élevée dans les pays industrialisés, et on s'attend à une augmentation dans les années à venir en raison du vieillissement de la population ainsi que des modifications du mode de vie. Il existe malheureusement peu de données épidémiologiques sur la prévalence et la prise en charge du diabète en Suisse. Les objectifs de cette étude étaient donc 1) évaluer la prévalence du DT2 dans une cohorte lausannoise ; 2) caractériser la prise en charge des patients atteints de DT2, et 3) identifier les facteurs associés à la prévalence, la connaissance par les patients de leur maladie et le traitement du DT2. Pour ce faire, 6181 sujets (3246 femmes), âgés de 35 à 75 ans et vivant à Lausanne ont été inclus dans l'étude. La prévalence totale du DT2 était de 6.3% (intervalle de confiance à 95%: 5.7-7.0%), une valeur comparable à celle des pays avoisinants. La prévalence était plus élevée chez les hommes que chez les femmes (9.1% contre 3.8%, p<0.001), et augmentait avec l'âge. Deux tiers des patients avec DT2 (65.3% ; 60.4-70.0%) avaient connaissance de leur situation, et plus de trois-quarts d'entre eux étaient traités. Les hommes étaient plus fréquemment traités que les femmes (91.3% contre 75.9%, p<0.001). La plupart des patients suivait une monothérapie (majoritairement par biguanides). Parmi les sujets avec une thérapie multiple, une prévalence plus élevée de glycémie à jeun >7 mmol/1 était présente. L'analyse multivariée a montré que le sexe masculin, l'âge croissant et un indice de masse corporelle élevé étaient associés à une plus grande prévalence du DT2, alors qu'aucune association n'a été trouvée pour l'activité physique et la consommation d'alcool. Parmi les sujets atteints de DT2, l'âge croissant était positivement associé à la connaissance du diabète, de même que l'âge croissant et le sexe masculin étaient associés à une plus grande prévalence du traitement. Le faible taux de connaissance de diabète pourrait être dû à un manque de dépistage par les médecins de premier recours. La présence d'autres facteurs de risque cardiovasculaire devrait inciter les médecins à un dépistage du diabète pour obtenir un meilleur profil de risque. Cette étude a des limitations. D'abord, aucune mesure de l'hémoglobine glyquée n'a été mesurée, et par conséquent la détermination de la prise en charge uniquement par la glycémie à jeun peut être difficile. Ensuite, le taux de participation était bas et pourrait limiter l'interprétation des résultats ; néanmoins, il est comparable à celui d'autres études effectuées dans les pays occidentaux. Il existe peu de données épidémiologiques du DT2 en Suisse, cette étude permet donc d'évaluer la situation actuelle et de déterminer la prévalence et la prise en charge du diabète à Lausanne à travers la cohorte CoLaus. Une telle étude a par conséquent son importance dans le contexte actuel, au vu du vieillissement de la population et de l'augmentation des facteurs de risque cardio-vasculaires.

Access Management Awareness Program Phase II Report, TR-402, 1997

This report presents the results of a number of detailed Iowa access management case studies. Case studies were selected to provide a cross-section of locations and community sizes in Iowa as well as a variety of project types. Generally, access management projects completed during the mid-1990s were chosen as case studies. Projects ranging from driveway consolidation to full raised medians were analyzed on a before and after basis in terms of traffic safety, traffic operations, and adjacent business vitality. Sources of information used for the case study analysis included: road project files; traffic accident records; state sales tax records; and personal interviews of business owners, business customers, and local officials. The case study results from Iowa essentially confirm results of previous access management research from around the nation. Recent access in Iowa had significant, positive impacts in terms of traffic safety. The average reduction of annual accidents and accident rates on improved roadways was approximately 40%. Improvements in access management also led to significantly better roadway operations for most case studies. Although a small number of individual businesses do report sales losses and/or customer complaints once projects have been completed, access management projects in Iowa have not had an adverse impact on the majority of businesses located along them. In fact, some access management projects in Iowa seem to have contributed to an improved business environment along the corridors that have been improved. The results from the Iowa case studies presented in this report will be used to develop access management education materials for Iowa transportation professionals and other audiences interested in the impacts of access management.

Prevalence, awareness and control of diabetes in the Seychelles and relationship with excess body weight.

BACKGROUND: The evidence for a "diabesity" epidemic is accumulating worldwide but population-based data are still scarce in the African region. We assessed the prevalence, awareness and control of diabetes (DM) in the Seychelles, a rapidly developing country in the African region. We also examined the relationship between body mass index, fasting serum insulin and DM. METHODS: Examination survey in a sample representative of the entire population aged 25-64 of the Seychelles, attended by 1255 persons (participation rate of 80.2%). An oral glucose tolerance test (OGTT) was performed in individuals with fasting blood glucose between 5.6 and 6.9 mmol/l. Diabetes mellitus (DM), impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) were defined along criteria of the ADA. Prevalence estimates were standardized for age. RESULTS: The prevalence of DM was 11.5% and 54% of persons with DM were aware of having DM. Less than a quarter of all diabetic persons under treatment were well controlled for glycemia (HbA1c), blood pressure or LDL-cholesterol. The prevalence of IGT and IFG were respectively 10.4% and 24.2%. The prevalence of excess weight (BMI > or = 25 kg/m2) and obesity (BMI > or = 30 kg/m2) was respectively 60.1% and 25.0%. Half of all DM cases in the population could be attributed to excess weight. CONCLUSION: We found a high prevalence of DM and pre-diabetes in a rapidly developing country in the African region. The strong association between overweight and DM emphasizes the importance of weight control measures to reduce the incidence of DM in the population. High rates of diabetic persons not aware of having DM in the population and insufficient cardiometabolic control among persons treated for DM stress the need for intensifying health care for diabetes.

Who knew? Awareness of being recommended for influenza vaccination among US adults

Please cite this paper as: Maurer et al. (2012) Who knew? Awareness of being recommended for influenza vaccination among US adults. Influenza and Other Respiratory Viruses 6(4), 284-290. Background  Starting with the 2010-2011 influenza season, the Advisory Committee on Immunization Practices at the US Centers for Disease Control and Prevention recommends annual influenza vaccination to all people aged 6 months and older unless contraindicated. Objectives  To measure perceived influenza vaccination recommendation status among US adults (n = 2122) and its association with socio-demographic characteristics and recommendation status during the 2009-2010 pandemic influenza season. Methods  We analyze nationally representative data from longitudinal Internet surveys of US adults conducted in November-December 2009 and September-October 2010. Results  During the 2010-2011 vaccination season, 46·2 percent (95%-CI: 43·3-49·1%) of US adults correctly reported to be covered by a government recommendation for influenza vaccination. Awareness of being covered by a government influenza vaccination recommendation was statistically significantly higher among non-working adults and adults who had been recommended for seasonal vaccination or both seasonal and H1N1 vaccination during the 2009-2010 pandemic influenza vaccination season. Conclusion  Our results highlight that a majority of US adults do not know that they are recommended for annual influenza vaccination by the government. The fraction of adults who are unaware of their recommendation status is especially large among newly recommended healthy young adults. The universal vaccination recommendations will only be successful if they reach both patients and physicians and lead to changing vaccination practices. The universal nature of the new recommendation simplifies vaccination-related outreach and compliance with government vaccination guidelines considerably, as it does not require any identification of specific recommendation groups based on complex personal or health risk factors.

Prevalence, awareness and treatment of type 2 diabetes mellitus in Switzerland: the CoLaus study.

ABSTRACT: Aims To assess the prevalence, awareness and treatment levels of Type 2 diabetes in a Swiss city. Methods Population-based cross-sectional study of 6181 subjects (3246 women) aged 35-75 years living in Lausanne, Switzerland. Type 2 diabetes was defined as fasting plasma glucose >/= 7 mmol/l and/or oral hypoglycaemic treatment and/or insulin. Results Total prevalence of Type 2 diabetes was 6.3% (95% confidence interval: 5.7-7.0%), higher in men (9.1%) than in women (3.8%, P < 0.001) and increased with age. Two-thirds (65.3%; 60.4-70.0%) of participants with Type 2 diabetes were aware of their status and among those aware 86.0% (81.5-90.3%) were treated. Treatment was more frequent in men (91.3%) than in women (75.9%, P < 0.001). Two-thirds of those treated for Type 2 diabetes were on monotherapy. Biguanides were prescribed in 65.0% of Type 2 diabetes patients and represented 48% of all antidiabetic drugs. Multivariable analysis showed male gender, increasing age, waist or BMI to be positively associated with prevalence of Type 2 diabetes, while leisure-time physical activity and alcohol consumption were negatively associated. Among participants presenting with Type 2 diabetes, increasing age was positively associated with awareness of Type 2 diabetes. Among subjects diagnosed with Type 2 diabetes, male gender and increasing age were positively associated with treatment. Conclusion Prevalence of Type 2 diabetes in Switzerland is estimated to be between 5.7% and 7.0%. Two-thirds of patients with Type 2 diabetes are aware of their status, and over three quarters of those aware are treated.

Plasmaferese : veilig bij een goede indicatiestelling en kennis van de complicaties [Plasmapheresis, a safe treatment when applied to the correct indication and with awareness of the complications]

Plasmapheresis is an extracorporeal technique used to remove pathogenic macromolecules from the circulation, particularly autoantibodies. This is illustrated in 2 female patients. The first patient, aged 61 years, was treated successfully with non-selective plasmapheresis for acute humoral rejection shortly after receiving a renal allograft. In the second patient, aged 82 years, plasmapheresis for refractory myasthenia gravis had to be stopped because of bradycardia and hypotension during the procedure. She was treated successfully with immunoglobulins. Plasmapheresis is used to treat neurological, renal, haematological and systemic disorders. In nonselective plasmapheresis, the plasma is replaced with saline and albumin or donor plasma. In selective plasmapheresis a highly selective filter is used to remove a specific, pathogenic macromolecule. Adverse effects of the treatment include disturbances of the acid-base equilibrium or the coagulation, and allergic reactions. Most of these complications, however, can nowadays be avoided.

Awareness of HIV Testing Guidelines Is Low among Swiss Emergency Doctors: A Survey of Five Teaching Hospitals in French-Speaking Switzerland.

BACKGROUND: In Switzerland, 30% of HIV-infected individuals are diagnosed late. To optimize HIV testing, the Swiss Federal Office of Public Health (FOPH) updated 'Provider Induced Counseling and Testing' (PICT) recommendations in 2010. These permit doctors to test patients if HIV infection is suspected, without explicit consent or pre-test counseling; patients should nonetheless be informed that testing will be performed. We examined awareness of these updated recommendations among emergency department (ED) doctors. METHODS: We conducted a questionnaire-based survey among 167 ED doctors at five teaching hospitals in French-Speaking Switzerland between 1(st) May and 31(st) July 2011. For 25 clinical scenarios, participants had to state whether HIV testing was indicated or whether patient consent or pre-test counseling was required. We asked how many HIV tests participants had requested in the previous month, and whether they were aware of the FOPH testing recommendations. RESULTS: 144/167 doctors (88%) returned the questionnaire. Median postgraduate experience was 6.5 years (interquartile range [IQR] 3; 12). Mean percentage of correct answers was 59 ± 11%, senior doctors scoring higher (P=0.001). Lowest-scoring questions pertained to acute HIV infection and scenarios where patient consent was not required. Median number of test requests was 1 (IQR 0-2, range 0-10). Only 26/144 (18%) of participants were aware of the updated FOPH recommendations. Those aware had higher scores (P=0.001) but did not perform more HIV tests. CONCLUSIONS: Swiss ED doctors are not aware of the national HIV testing recommendations and rarely perform HIV tests. Improved recommendation dissemination and adherence is required if ED doctors are to contribute to earlier HIV diagnoses.

Enhancing Motorcycle Conspicuity Awareness in Iowa, 2010

Previous studies in the United States and internationally suggest that low motorcycle conspicuity, or the inability of the motorcyclist to be seen by other road users, is thought to be an important factor associated with risk of motorcycle crashes. However, there has been limited research on motorcycle conspicuity in the United States in the past two decades, while at the same time; there has been a renewed interest from states in increasing motorcycle conspicuity and motorist awareness. As such, this research revisits the motorcycle conspicuity problem by analysis of helmet-use and motorcycle crash data. First, this study reviews previous studies on motorcycle conspicuity with a focus on the effectiveness of proposed measures for enhancing motorcycle conspicuity. The major trends in motorcycle helmet use by time of day and road type for motorcyclists, as indicated from three roadside observational roadside surveys in Iowa, are also discussed. Then, using motorcycle crash data for Iowa from 2001 to 2008, this research compares single-and two-vehicle motorcycle crashes and examines the distribution of conspicuity related factors in light and dark conditions in two-vehicle crashes that could potentially relate to a collision between a motorcycle and another vehicle. The limitations of examining motorcycle conspicuity by analysis of crash data are also discussed. Finally, this report outlines recommendations based on the key findings of the study.

Access Management Research and Awareness Program : Phase IV, 1999

Access management involves balancing the dual roles that roadways must play - through travel and access to property and economic activity. When these roles are not in proper balance, the result is a roadway system that functions sub-optimally. Arterial routes that have a too high driveway density and provide overly extensive access to property have high crash rates and begin to suffer in terms of traffic operations. Such routes become congested, delays increase, and mean travel speeds decline. The Iowa access management research and awareness project has had four distinct phases. Phase I involved a detailed review of the extensive national access management literature so lessons learned elsewhere could be applied in Iowa. In Phase II original case study research was conducted in Iowa. Phase III of the project concentrated on outreach and education about access management. Phase IV of the Iowa access management project extended the work conducted during Phases II and III. The main work products for Phase IV were as follows: 1) three additional before and after case studies, illustrating the impacts of various access management treatments on traffic safety, traffic operations, and business vitality; 2) an access management handbook aimed primarily at local governments in Iowa; 3) a modular access management toolkit with brief descriptions of various access management treatments and considerations; and 4) an extensive outreach plan aimed at getting the results of Phases I through IV of the project out to diverse audiences in Iowa and elsewhere.

Risk and global change : developing scientific methods for advocacy and awareness raising

Les catastrophes sont souvent perçues comme des événements rapides et aléatoires. Si les déclencheurs peuvent être soudains, les catastrophes, elles, sont le résultat d'une accumulation des conséquences d'actions et de décisions inappropriées ainsi que du changement global. Pour modifier cette perception du risque, des outils de sensibilisation sont nécessaires. Des méthodes quantitatives ont été développées et ont permis d'identifier la distribution et les facteurs sous- jacents du risque.¦Le risque de catastrophes résulte de l'intersection entre aléas, exposition et vulnérabilité. La fréquence et l'intensité des aléas peuvent être influencées par le changement climatique ou le déclin des écosystèmes, la croissance démographique augmente l'exposition, alors que l'évolution du niveau de développement affecte la vulnérabilité. Chacune de ses composantes pouvant changer, le risque est dynamique et doit être réévalué périodiquement par les gouvernements, les assurances ou les agences de développement. Au niveau global, ces analyses sont souvent effectuées à l'aide de base de données sur les pertes enregistrées. Nos résultats montrent que celles-ci sont susceptibles d'être biaisées notamment par l'amélioration de l'accès à l'information. Elles ne sont pas exhaustives et ne donnent pas d'information sur l'exposition, l'intensité ou la vulnérabilité. Une nouvelle approche, indépendante des pertes reportées, est donc nécessaire.¦Les recherches présentées ici ont été mandatées par les Nations Unies et par des agences oeuvrant dans le développement et l'environnement (PNUD, l'UNISDR, la GTZ, le PNUE ou l'UICN). Ces organismes avaient besoin d'une évaluation quantitative sur les facteurs sous-jacents du risque, afin de sensibiliser les décideurs et pour la priorisation des projets de réduction des risques de désastres.¦La méthode est basée sur les systèmes d'information géographique, la télédétection, les bases de données et l'analyse statistique. Une importante quantité de données (1,7 Tb) et plusieurs milliers d'heures de calculs ont été nécessaires. Un modèle de risque global a été élaboré pour révéler la distribution des aléas, de l'exposition et des risques, ainsi que pour l'identification des facteurs de risque sous- jacent de plusieurs aléas (inondations, cyclones tropicaux, séismes et glissements de terrain). Deux indexes de risque multiples ont été générés pour comparer les pays. Les résultats incluent une évaluation du rôle de l'intensité de l'aléa, de l'exposition, de la pauvreté, de la gouvernance dans la configuration et les tendances du risque. Il apparaît que les facteurs de vulnérabilité changent en fonction du type d'aléa, et contrairement à l'exposition, leur poids décroît quand l'intensité augmente.¦Au niveau local, la méthode a été testée pour mettre en évidence l'influence du changement climatique et du déclin des écosystèmes sur l'aléa. Dans le nord du Pakistan, la déforestation induit une augmentation de la susceptibilité des glissements de terrain. Les recherches menées au Pérou (à base d'imagerie satellitaire et de collecte de données au sol) révèlent un retrait glaciaire rapide et donnent une évaluation du volume de glace restante ainsi que des scénarios sur l'évolution possible.¦Ces résultats ont été présentés à des publics différents, notamment en face de 160 gouvernements. Les résultats et les données générées sont accessibles en ligne (http://preview.grid.unep.ch). La méthode est flexible et facilement transposable à des échelles et problématiques différentes, offrant de bonnes perspectives pour l'adaptation à d'autres domaines de recherche.¦La caractérisation du risque au niveau global et l'identification du rôle des écosystèmes dans le risque de catastrophe est en plein développement. Ces recherches ont révélés de nombreux défis, certains ont été résolus, d'autres sont restés des limitations. Cependant, il apparaît clairement que le niveau de développement configure line grande partie des risques de catastrophes. La dynamique du risque est gouvernée principalement par le changement global.¦Disasters are often perceived as fast and random events. If the triggers may be sudden, disasters are the result of an accumulation of actions, consequences from inappropriate decisions and from global change. To modify this perception of risk, advocacy tools are needed. Quantitative methods have been developed to identify the distribution and the underlying factors of risk.¦Disaster risk is resulting from the intersection of hazards, exposure and vulnerability. The frequency and intensity of hazards can be influenced by climate change or by the decline of ecosystems. Population growth increases the exposure, while changes in the level of development affect the vulnerability. Given that each of its components may change, the risk is dynamic and should be reviewed periodically by governments, insurance companies or development agencies. At the global level, these analyses are often performed using databases on reported losses. Our results show that these are likely to be biased in particular by improvements in access to information. International losses databases are not exhaustive and do not give information on exposure, the intensity or vulnerability. A new approach, independent of reported losses, is necessary.¦The researches presented here have been mandated by the United Nations and agencies working in the development and the environment (UNDP, UNISDR, GTZ, UNEP and IUCN). These organizations needed a quantitative assessment of the underlying factors of risk, to raise awareness amongst policymakers and to prioritize disaster risk reduction projects.¦The method is based on geographic information systems, remote sensing, databases and statistical analysis. It required a large amount of data (1.7 Tb of data on both the physical environment and socio-economic parameters) and several thousand hours of processing were necessary. A comprehensive risk model was developed to reveal the distribution of hazards, exposure and risk, and to identify underlying risk factors. These were performed for several hazards (e.g. floods, tropical cyclones, earthquakes and landslides). Two different multiple risk indexes were generated to compare countries. The results include an evaluation of the role of the intensity of the hazard, exposure, poverty, governance in the pattern and trends of risk. It appears that the vulnerability factors change depending on the type of hazard, and contrary to the exposure, their weight decreases as the intensity increases.¦Locally, the method was tested to highlight the influence of climate change and the ecosystems decline on the hazard. In northern Pakistan, deforestation exacerbates the susceptibility of landslides. Researches in Peru (based on satellite imagery and ground data collection) revealed a rapid glacier retreat and give an assessment of the remaining ice volume as well as scenarios of possible evolution.¦These results were presented to different audiences, including in front of 160 governments. The results and data generated are made available online through an open source SDI (http://preview.grid.unep.ch). The method is flexible and easily transferable to different scales and issues, with good prospects for adaptation to other research areas. The risk characterization at a global level and identifying the role of ecosystems in disaster risk is booming. These researches have revealed many challenges, some were resolved, while others remained limitations. However, it is clear that the level of development, and more over, unsustainable development, configures a large part of disaster risk and that the dynamics of risk is primarily governed by global change.

Awareness of human immunodeficiency virus screening guidelines is low in emergency departments of western Switzerland.

Background: Human immunodeficiency virus (HIV) prevalence in Switzerland is 0.4% and 30% of HIV patients are diagnosed with CD4 counts <200 cells/microliter. In 2010, the Swiss Federal Office of Public Health (SFOP) published updated guidelines regarding Physician- Initiated Counseling and Testing (PICT) for HIV. In the new guidelines, when acute HIV infection is suspected or HIV is among the differential diagnoses, an HIV test is performed without risk assessment nor prior counseling, unless the patient specifically refuses it. Counseling and verbal consent are still required when the patient asks for an HIV test or belongs to a high risk group. Whist HIV testing in the emergency departments (ED) is recommended, only 1% of patients are currently screened. Lack of awareness among physicians has been cited in the literature as the first barrier to guideline implementation. Objectives: To test if physicians working in EDs of 5 large teaching hospitals in western Switzerland, admitting 175,000 patients / year, were aware of the updated SFOP guidelines. Methods: A survey was delivered to 167 ED physicians in the summer of 2011. The survey consisted of 26 vignettes designed to test whether physicians would request an HIV test according to the new guidelines and if they knew when the PICT strategy was allowed or counseling required. Finally, physicians were asked the number of HIV tests they had requested in the previous 4 weeks, and if they were aware of the new HIV guidelines. Results are presented as mean and standard deviation, median and interquartile range (IQR), or as proportions; Student's t test was used to compare continuous variables; Results: 143 physicians returned the survey (86%); mean age was 32 ± 8 years, and median postgraduate experience of 6 years (IQR 3-12); 52% were male and 17% were attendings. The percentage of correct responses was 60 ± 13% with no difference between attendings and residents (p = 0.31); 2 of the 3 questions with the lowest scores were failure to recognize situations in which HIV testing was indicated, and the third one a failure to recognize acute HIV infection. 82% of physicians were not aware of the new guidelines. The median number of test requests was 1 (IQR 0-2, range 1-10). Conclusion: ED physicians are not aware of current HIV screening guidelines published by the SFOP, and rarely perform HIV tests. An information campaign is required if ED physicians are expected to play a significant role in the reduction of undiagnosed HIV patients.

Creating Brand Awareness for a B2B Professional Services Subsidiary

Tutkielman tavoitteet: Tutkielman tavoitteena oli selvittää miten branditunnettuutta voidaan kasvattaa yritysasiantuntijapalveluiden markkinoilla toimivassa tytäryhtiössä yleensä, ja erityisesti case yrityksessä. Vaikka yritysasiantuntijapalvelualan markkinointia on tutkittu melko paljon, ovat tutkimukset keskittyneet pääasiallisesti henkilökohtaiseen myyntityöhön ja suhdemarkkinointiin. Myös branditunnettuuden kehittämistä on tutkittu, mutta enimmäkseen kuluttajamarkkinoilla. Tutkimusmetodologiat: Tutkimus on toteutettu kvalitatiivisena deskriptiivis-analyyttisenä case-tutkimuksena. Tutkimuksen teoriaosuus perustuu kirjallisuuskatsaukseen ja empiirinen tutkimus puolistrukturoituun teemahaastatteluun.. Haastateltaviksi valittiin tutkittavan case organisaation ylin johto, sekä viestinnästä ja markkinoinnista vastaava henkilö. Tutkimustulokset ja päätelmät: Tutkimuksen tuloksena syntyi ehdotus siitä, millä tavoin case-yritys voisi kasvattaa branditunnettuuttaan potentiaalisten asiakkaidensa keskuudessa. Ehdotus etenee teoriarakenteen mukaisesti muodostaen mallin jossa kaikki viestintäprosessin oleelliset vaiheet on käyty läpi. Branditunnettuus rakennetaan viestintäprosessissa johon kuuluu: kohdeyleisönidentifiointi, viestinnän tavoitteiden asettaminen, viestin suunnittelu, viestintäkanavien valinta ja toimenpiteiden suunnittelu.

Semantics-supported cooperative learning for enhanced awareness

Awareness is required for supporting all forms of cooperation. In Computer Supported Collaborative Learning (CSCL), awareness can be used for enhancing collaborative opportunities across physical distances and in computer-mediated environments. Shared Knowledge Awareness (SKA) intends to increase the perception about the shared knowledge, students have in a collaborative learning scenario and also concerns the understanding that this group has about it. However, it is very difficult to produce accurate awareness indicators based on informal message exchange among the participants. Therefore, we propose a semantic system for cooperation that makes use of formal methods for knowledge representation based on semantic web technologies. From these semantics-enhanced repository and messages, it could be easier to compute more accurate awareness.

Hepatitis C Virus Awareness Among Men Who Have Sex With Men in Southwest Switzerland.

BACKGROUND: In Switzerland, the incidence of hepatitis C virus (HCV) infection in HIV-positive men who have sex with men (MSM) rose 18-fold between 1998 and 2011. We aimed to evaluate transmission risk factors, awareness, and seroprevalence of HCV among MSM in southwest Switzerland. METHODS: From 1st June 2011 to 31st August 2012, trained health care professionals invited individuals attending (1) MSM screening clinics and (2) indoor and outdoor meeting areas to complete an anonymous questionnaire. Consenting participants were rapid tested for HCV (OraQuick HCV Rapid Antibody Test). RESULTS: Of 918 MSM approached, 654 agreed to participate, most of whom (536, 82%) were enrolled via MSM screening clinics. Of 654 participants, 21 (3.2%) disclosed being HIV positive; 140 (21%) had unknown HIV status. In the preceding 12 months, 357 (55%) of 654 participants reported unprotected anal intercourse (UAI) and 321 (49%) of 654 participants reported UAI with partners of different/unknown HIV status. Not HIV serosorting was reported more frequently among HIV-positive individuals (76%, P < 0.001). Three hundred two participants (46%) were aware of HCV, awareness being higher among clinic than meeting area participants (49% vs. 33%, P = 0.04). One individual (of 654; 0.2%), with a negative HIV test result 18 months previously was newly diagnosed as being HCV positive on rapid testing. CONCLUSIONS: In this sample of predominantly HIV-negative MSM, half the participants were aware of HCV and HCV seroprevalence was low. However, high rates of UAI and of UAI without HIV serosorting were reported. Given the increasing incidence of HCV among HIV-positive men, we propose that HCV counseling should be offered to MSM regardless of HIV status, with testing offered to those at high risk.