Led by an international team and coordinated in Switzerland by Swiss AIDS Federation, this project brought together organizations and community members to give everyone a voice. In this blog, we'll highlight the key findings for Switzerland and what they mean for our community.

The full report (English) can be accessed and downloaded here: 

Recruitment and Demographics

Switzerland had one of the highest participation rates, with 1'509 MSM and TSM aged 15–65 taking part. 

The group surveyed closely matched Switzerland’s overall population. The median age was 44, which corresponds to the national median (43). About 28% of participants were born outside Switzerland, mostly from Germany, France, and Italy; similar to national statistics. The languages spoken were also similar to the general population, with most speaking German, then French and Italian, and a smaller number using English or other languages.

Most participants (72%) said they were open about their sexual orientation, putting Switzerland among the top European countries for “outness.” 

Morbidities

Depression, Anxiety, Alcohol Dependency

Swiss participants in the study had the lowest levels of severe depression or anxiety compared to other European countries, with only 5% reporting these issues. 

Problems with alcohol were about average; less common than in Austria, Germany, and France, but more frequent than in Italy. Zurich, in particular, stood out for higher rates of potential alcohol dependency (24.5%).

HIV and other STIs

About 10% of the people surveyed in Switzerland said they had been diagnosed with HIV, which puts Switzerland in the lower to middle range among European countries. New HIV diagnoses were very rare, with just two people reporting a recent diagnosis (0.1%).

Bacterial STIs such as syphilis and symptomatic gonorrhea were reported more often, affecting 6% and 5% of respondents, respectively. Altogether, 22% reported having some kind of bacterial STI in the last 12 months. 

Of those diagnosed with gonorrhea, 37.4% said they got tested because they had symptoms. For chlamydia, 27.5% were symptomatic.

Zurich was noted as a hotspot, but overall, mpox rates in Switzerland were still lower than in other Western European countries.

Risk and Precaution Behaviour

This section presents what participants actually reported doing, focusing on behaviors that influence health risks and protection.

Switzerland stands out for its high use of PrEP (32%), though France and the UK have even higher rates. Consistent condom use was relatively low, showing the expected inverse relationship between PrEP use and condom use: countries with higher PrEP uptake generally reported lower condom use, and vice versa. About 10% of Swiss participants said they took risks that could increase their chance of getting HIV.

Using antibiotics to prevent sexually transmitted infections (e.g. DoxyPEP) was fairly common (8%), and about half the time, people took these antibiotics without checking with a doctor. This happened most among those living with HIV or who use PrEP, especially in French- and Italian-speaking areas. 

Most MSM in Switzerland reported having sex while sober. Participation in Chemsex was reported by 6%, which is above the European average but less common than in Belgium, the Netherlands, or Spain. The top drugs used were GHB/GBL and synthetic stimulants, with new types of stimulants becoming more popular. 

Needs

A central research objective of EMIS was to identify sexual health needs that are commonly unmet across the population of gbMSM, and transgender and non-binary people to prioritise those needs for intervention.

Knowledge about Safer Sex is very high in Switzerland. Nearly everyone knows that condoms can prevent HIV (96%), most people have heard of PrEP (84%), and many understand that someone with an undetectable HIV level cannot pass it on (86%). Awareness of the mpox vaccine is also high (81%), making Switzerland one of the top countries in Europe for this knowledge. However, fewer people know about the HPV vaccine (66%), especially in the German-speaking areas, even though it’s free up to age 27.

People in Switzerland reported very low levels of negative feelings about being gay (internalized homonegativity), showing strong community support. Reports of physical violence within the previous 12 months were rare (< 5 %), placing Switzerland among the safest countries, with rates substantially below those observed in Russia (16 %) or Albania (25 %). Experiences of rape were also rare (< 2 %), though rates in the Region Lemanique were higher (3.5 %) and similar to those observed in neighbouring France.

Reports of homo- or trans-negative discrimination in healthcare settings were uncommon (< 2 %), while in several other countries, such as Israel and Kazakhstan, rates reached up to 13 %.

Interventions

Within EMIS, relevant interventions are the actions of others that either support or undermine the health promotion needs. Interventions may be positive (addressing needs) or negative (undermining needs and creating unmet need).

Switzerland recorded the highest proportion of MSM-specific information exposure in Europe. Between 86 % and 95 % of respondents had seen MSM- or trans-specific HIV/STI information. Hepatitis A and B vaccination uptake was also among the highest, consistent with previous EMIS waves. It was high across all regions, though substantially lower in Ticino, likely due to small sample numbers. While mpox and HPV vaccination rates lagged behind hepatitis A/B, they remained relatively high, with over 50 % HPV vaccination coverage among eligible age groups. HPV vaccination coverage overall was around 20 %, above the European average but below the levels reported in Denmark, Italy, and the United Kingdom (32–34 %), Ireland (40 %), and Israel (43 %). 

Mpox vaccination uptake ranked fourth in Europe (33 %), alongside Israel, following France (43 %), Denmark (38 %), and the United Kingdom (34 %). 

Switzerland had the second-highest proportion of respondents tested for HIV at a community health service (42 %), after the Netherlands (53 %).

Respondents consistently reported greater satisfaction with information and support during their last HIV test when tested in community health settings. HCV testing was nearly as frequent as HIV testing among Swiss PrEP users. EMIS-2024 data also document a massive expansion of immediate or early ART initiation over time, particularly after 2015.

Trans Community

Transgender and non-binary people usually have worse mental health than cisgender people. They are more likely to feel psychological distress and to be diagnosed with issues like depression or anxiety. They also face a higher risk of thinking about suicide compared to the general population. Even though the number of transgender and non-binary participants in Switzerland was small (n = 113), these patterns were still seen in the EMIS-2024 survey.

Health Inequalities

MSM who identify as gay or bisexual (gbMSM) are strongly affected by infections, more than all other sexual or gender identity groups. Other MSM, trans, and non-binary individuals experience predominantly mental health challenges, including sexual unhappiness. In contrast, MSM with diagnosed HIV are strongly affected by infections, but less than other MSM by mental health issues or sexual unhappiness. However, among those diagnosed with HIV, levels of chemsex and drug injection are particularly high.

Sex workers, both MSW and TSW, have high rates of STIs and hepatitis. While they are less likely to report being unhappy with their sex lives, they often face more mental health problems. Fewer than half always use protection, showing a need for better support. 

Overall, sex workers and people living with HIV are among those who need the most health and social support. Surveyed migrants to Switzerland exhibit smaller-than-expected inequalities in needs.