Sex and Travel

Vaccinations are currently available to protect against certain sexually transmitted infections (STIs). The Federal Office of Public Health (FOPH) recommends vaccination against hepatitis B and human papillomavirus (HPV) for the general population. For people at increased risk, vaccinations against hepatitis A and Mpox (formerly monkeypox) are also recommended.

It is important to know that the STI risk can vary from country to country. Vaccines that are not normally recommended in Switzerland may be beneficial when traveling to other countries. Contact a medical professional or a specialized center for travel medicine or sexual health for individual advice on vaccinations against STIs. This will ensure you get the right protection for your lifestyle and travel plans.

Here you will find information on the respective vaccinations:

• The hepatitis B vaccination is recommended for young children, adolescents aged 11 to 15 who have not yet been vaccinated, people over the age of 15 with multiple sexual partners and other people at increased risk, e.g. healthcare workers and people who inject or snort substances. The costs are covered by compulsory health insurance (OKP).
  
  
• The HPV vaccination is strongly recommended for adolescents and young adults. It is offered in cantonal programs for the target groups (until 26 years of age) completely free of charge (i.e. without a deductible or co-payment). Specifically, the FOPH recommends two doses for 11 to 14-year-olds and three doses for 15 to 26-year-olds. The best protection is achieved if you are vaccinated before you become sexually active. The vaccination protects against various HPV complications, including cervical and anal cancer, genital warts and penile cancer.
  
  
• Vaccination against hepatitis A is recommended for people at increased risk. This includes men, trans and non-binary people who have sex with men or trans/non-binary people, and people who inject substances. If you are unsure whether you fall into a risk category, you should consult a doctor. For people at increased risk, the costs are covered by OKP. Vaccination is also recommended for travelers. In this case, you will have to pay the costs yourself.
  
  
• Vaccination against Mpox is also recommended for men, trans and non-binary people who have frequent sexual contact with men, trans or non-binary people. The costs of the vaccination are also covered by the OKP for people at increased risk.

When used correctly, condoms are an important means of protection against HIV and unwanted pregnancy.

• They offer simple, inexpensive and reliable protection and are therefore recommended for anal or vaginal sex, especially if the HIV status of the partner is unknown.
• With multiple partners or when switching between different sexual activities, a new condom should be used for each person and each type of sex in order to maintain protection.
• Other sexually transmitted infections (STIs) such as chlamydia, herpes or HPV can be transmitted despite condoms. Regular STI tests are therefore advisable to maintain one’s sexual health.
• When traveling, it is recommended that you take your own condoms with you. This way you can ensure that you have access to high-quality products in the right size.
  
  

• Choose the right size (measured by the circumference) so that the condom does not slip or tear.
• Use condoms with a CE mark or the "OK" seal and with a valid expiration date.
• Condoms should be stored correctly, i.e. protected from sunlight and not in a wallet where they can be damaged. Only water-soluble or silicone-based lubricants should be used for latex condoms. Products containing oil can break down the latex, which can lead to tears. We recommend trying out whether the size fits before having sex.
• When traveling, it is advisable to bring your own tested condoms from Switzerland.

There are different types of condoms for different needs, including external condoms for the penis and vaginal condoms. There are also latex-free versions for people with latex allergies.

No condoms

In certain cases, it is possible to dispense of the use of condoms to protect against HIV. Couples in a monogamous relationship who have both tested HIV-negative, or people with HIV who are undergoing successful treatment, can have sex without condoms. People who use HIV pre-exposure prophylaxis (PrEP) as a preventive measure against HIV can also do without condoms. It is also important to know that successful HIV treatment is not visible in a partner, which is why open communication and regular testing are important.

Awareness of how sexually transmitted infections (STIs) are transmitted and suitable prevention measures are part of safer sex and can reduce the risk of infection.

• HIV is only transmitted during unprotected vaginal or anal sex, as well as blood contact. Oral sex, even without a condom, only poses a risk of HIV transmission when blood and injuries are present.
• Most bacterial STIs (chlamydia, gonorrhea and syphilis), as well as some viruses (HPV, herpes), can be transmitted through vaginal, anal, oral sex and kissing (so-called smear infection).
• Sharing sex toys can lead to infections through contact with contaminated objects. To protect yourself, you should clean sex toys thoroughly with soap and water before and after each use, especially before sharing them with others. Using condoms on sex toys and changing condoms when moving between different orifices or people further reduces the risk. Lubricants are also important to avoid skin lesions that can be entry points for pathogens.
• Anal douches pose a similar risk of infection if they are shared. They should therefore be cleaned thoroughly with soap and water before use and before passing them on to another person.
• When using substances, sharing syringes, needles and other utensils can significantly increase the risk of HIV and hepatitis infection. It is safest to use your own utensils and never share them with others.
• Make sure that sterile materials are used when getting tattoos and piercings, especially when traveling, and choose studios that adhere to high hygiene standards. Never use piercing or tattoo needles together, as non-sterile instruments can transmit HIV, hepatitis B and C.
• Personal hygiene is also important. Regular personal hygiene is recommended, but certain practices can increase the risk of certain infections. Shaving intimate regions can lead to small skin lesions that facilitate the transmission of some STIs. Excessive intimate hygiene, especially soaping the vulva or glans, can disrupt the natural bacterial balance of the mucous membranes and thus facilitate the spread of pathogens. It is recommended to clean the vulva and penis with water only and to avoid douching.

Despite safer sex and careful use of condoms, not all sexually transmitted infections (STIs) can be avoided. Regular testing can therefore be recommended for specific situations, for example the number of sexual contacts or people from groups with an increased risk of infection. Testing is also recommended for paid sex and other high-risk situations. The risk of certain STIs may be higher in other countries than in Switzerland, so testing after returning from a trip may be recommended. Testing allows STIs to be detected and treated early, which can prevent further transmission and complications.

STI symptoms can include itching/burning/discharge in the genital area, anus or oral cavity, skin rashes, joint pain, fever or swollen lymph nodes. However, many STIs can be asymptomatic, so routine testing may be recommended even in the absence of symptoms. It is advisable to get tested if you have been in a high-risk situation, e.g. if the condom was forgotten, slipped or broke during vaginal or anal sex, or if a sexual partner has tested positive for an STI.

Groups with an increased risk of STIs such as men who have sex with men should be tested regularly if they have changing sexual contacts. Sex workers and their clients should also be tested regularly. People who have unprotected sex in regions with a high incidence of HIV should be tested six weeks after possible exposure. Additionally regular testing is recommended for people who inject or snort substances, as there is a risk of HIV and hepatitis transmission through shared utensils.

Starting a new monogamous relationship is a good opportunity for both partners to get tested for HIV, syphilis, gonorrhea and chlamydia to ensure that you start your relationship without infections. Pregnant women are routinely tested for HIV, syphilis and hepatitis B, and can be tested for chlamydia and gonorrhea if necessary to protect their unborn child.

If you test positive for an STI, it is important to inform all sexual partners so that they can also be tested and treated. This can reduce the further spread of the disease in society.

Open communication with healthcare providers about your sexual history and STI testing is important. If you are uncomfortable talking about STIs with your regular healthcare provider, specialty clinics and sexual health checkpoints offer counseling and testing. When traveling, you will often find these under the term STI clinics.

HIV-PrEP

HIV pre-exposure prophylaxis (HIV-PrEP) is a prevention strategy for people at high risk of HIV infection. It is a prescription medication in tablet form that is taken before sex. If HIV-PrEP is taken correctly, it is highly effective, i.e. just as good as condoms. However, it only protects against HIV and not against other sexually transmitted infections (STIs), against which condoms and regular testing remain the best protection strategy.

Whether PrEPis necessary will be decided during a personal consultation. It is generally recommended for all people who have an increased risk of HIV (e.g. men and trans/non-binary people who have sex with men, people who have sexual contact in countries with a high HIV prevalence, and people who inject substances). An HIV test is carried out before starting PrEP, as PrEP is not a treatment for an existing HIV infection. Regular follow-up appointments are necessary to monitor health status and any side effects, as well as to test for HIV and other STIs. PrEP is part of a comprehensive HIV prevention strategy that includes condom use, regular STI testing and safe injection practices.

For specific groups with an increased risk of HIV infection, the costs of PrEP are covered by basic insurance.

HIV PEP

HIV post-exposure prophylaxis (PEP) is an emergency medical treatment to prevent HIV infection after a high-risk exposure, e.g. after a condom accident during vaginal or anal sex, if no condom was used or in the event of sexual assault. PEP should be started as soon as possible, ideally within 2 hours, but no later than 48 hours after exposure, as its effectiveness decreases rapidly over time.

If you believe that you have come into contact with HIV, contact a specialist sexual health clinic, a checkpoint, an infectious disease clinic or an emergency department immediately to find out whether PEP is an option for you. The earlier PEP is started, the better the chances of preventing HIV infection. Every hour counts! If more than 48 hours have passed since the possible exposure, it is still important to visit a testing or counseling center to discuss the risk of HIV infection and get tested. Until an HIV infection has been ruled out, you should continue to use condoms for all sexual contact to prevent possible transmission.

When traveling, it is best to contact a local medical facility. The situation varies depending on the country you are traveling to; in certain countries, access to PEP is more difficult. Under certain circumstances, a telemedicine service from your health insurance company, for example, may also be able to help you.

In addition to the condom, there are other hormonal and mechanical methods of contraception. When using hormonal contraception with the pill, there are some special features to consider with regard to time differences and traveler's diarrhea and vomiting. In general, the pill should be taken at the same time of day as at home, e.g. always at 7 a.m. at home and at the vacation destination. An exception to this is if the interval between two doses is extended to such an extent that safe contraception is no longer guaranteed. If the time interval is extended by 12 hours or more for the combined pill or by 3 hours or more for the mini pill, an "intermediate pill" should be taken once after approx. 12 hours. You can find more information on how to take the pill correctly if there is a time difference here (only in German). Contraception is no longer guaranteed in the event of vomiting and prolonged diarrhea, as can occur when traveling. If you have any doubts or questions, please contact your gynecologist before or during your trip.

In the event of a contraceptive failure, sexual assault or if a condom has not been used, the morning-after pill can prevent pregnancy within three to a maximum of five days. It is generally available over the counter in many countries and can usually be obtained from pharmacies, doctors or hospitals.

People of any age, gender or sexual orientation can become victims of sexual violence when traveling and should be aware of this risk. Possible preventative protection strategies can be:

• Inform a person you trust when you meet someone, where you are going and when you will be back.
• Only drink alcohol in quantities that allow you to make conscious decisions. Never leave your glass unattended.
• Be aware that drug use can increase susceptibility to sexual assault.
• Take the question of consent seriously: only yes means yes!
• Have important emergency numbers for your travel destination to hand.

It is also important to know the cultural and legal conditions in the country you are traveling to: Familiarize yourself with the local laws regarding sexuality and be aware of what is acceptable and what is not. This is especially important in religious or conservative countries where certain types of affectionate/sexual behavior may be prosecuted, fined or lead to deportation. In certain countries, sex outside of marriage is forbidden, homosexuality is punishable by law or physical contact in public is frowned upon. In some countries, some people depend on contact with tourists for their livelihood. Sometimes it's obviously about exchanging sex for money, sometimes it's more subtle and it's more about companionship and romance in exchange for donations in kind.