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1. Factors associated with ART interruption during the COVID-19 crisis in Burundi (the EPIC community-based research program)

Author: Annabelle Niyongabo, Virginie Villes, Rokhaya Diagne, Juliana Castro Avila, Jean-Michel Mutima, Dévote Gakima, Pélagie Nimbona, Evangéline Niyoncuti, Elvis Rwamuco, Martin Manirakiza, Lucas Riegel, Nicolas Lorente, Rosemary M. Delabre, and Daniela Rojas Castro
Subjects: Medicine, Science
Abstract: Abstract With a national prevalence of 0.9%, Burundi is close to achieving UNAIDS’ 2025 targets. Despite this, different types of crises periodically disrupt its HIV health services. The community-based program EPIC measured the impact of the COVID-19 health crisis on people living with HIV (PLHIV) in Burundi in 2021. Specifically, it assessed ART interruption and associated factors since the beginning of the pandemic. The study questionnaire was administered to PLHIV in three cities between October and November 2021. Participants were recruited using convenience sampling. Logistic regression models helped identify factors associated with ART interruption. Of the 317 respondents, 37 (11.7%) reported interruption. The majority (79.2%) self-identified as belonging to key populations. Interruption was significantly associated with: fewer HIV medical follow-up visits (adjusted Odds Ratio, aOR = 7.80, p = 0.001) and forced HIV status disclosure (aOR = 4.10, p = 0.004). It was inversely associated with multi-month ART dispensing (aOR = 0.36, p = 0.017) since the beginning of the pandemic and the perception of not having been sufficiently informed by the HIV medical team about the risk of COVID-19 infection (aOR = 0.11, p
Published: 2024
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2. Trabalhadoras sexuais no marco pandêmico brasileiro: efeitos em e relações com a saúde

Author: Amanda de Mello Calabria, Nicolas Lorente, Michel de Oliveira Furquim dos Santos, Ana Carolina Braga Azevedo, Paula Galdino Cardin de Carvalho, Daniel Dutra de Barros, Gizelle Aparecida Oliveira, Océane Apffel Font, Silvana de Souza Nascimento, Maria Amelia de Sousa Mascena Veras, Daniela Rojas Castro, and José Miguel Nieto Olivar
Subjects: Pandemia por COVID-19, Redes Comunitárias, Profissionais do Sexo, Ativismo Social, Cuidado Humanizado, Medicine, Public aspects of medicine, RA1-1270
Abstract: Resumo: Este trabalho apresenta os resultados do estudo Eu Quero é Mais! A Vida de Profissionais do Sexo Durante a Pandemia da COVID-19, integrante do programa de investigação comunitária EPIC. O estudo analisou os efeitos da pandemia nas vidas de trabalhadoras sexuais cis, trans e travestis em nove Unidades da Federação e 11 cidades brasileiras ao longo de 2020 e 2021. O artigo tem como foco o componente qualitativo do estudo baseado em entrevistas semiestruturadas realizadas de forma presencial e remota com 43 trabalhadoras sexuais, e seu cotejamento com o componente quantitativo. Os efeitos são analisados em relação com o marco pandêmico brasileiro, considerando as dimensões sociais, econômicas e políticas do vírus da COVID-19. Entre as temáticas chaves da análise, se destacam: casos de adoecimento, práticas localizadas de isolamento social, práticas de prevenção e gerenciamento de cuidado, vacinação individual e estratégias coletivas de vacinação. Compartilhamos também as respostas cotidianas e ativistas traçadas por trabalhadoras sexuais numa agenda política que se contrapõe à lógica individualista, familiarista, doméstica e neoliberal de isolamento, por meio de perspectivas comunitárias de cuidado, o que se desenhou como a única linha de ação em saúde para a categoria durante a pandemia. As ações coletivas reposicionam o trabalho sexual na interface entre a saúde pública e os direitos humanos e tomam como princípio os conhecimentos das ruas, desde os ativismos, e o poder de decisão delas próprias sobre seus corpos.
Published: 2024
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3. How Community-Based Organizations Responded to the Covid-19 Crisis to Maintain HIV Services Among Vulnerable Populations in Burundi, Mauritania, and Lebanon: Qualitative Results From the Multicountry EPIC Program

Author: Marion Di Ciaccio PhD, Othmane Bourhaba PhD, Cécile Khoury MS, Ayman Assi MD, Sara Abu Zaki MS, Nicolas Lorente PhD, Juliana Castro Avila MS, Annabelle Niyongabo MD, Dévote Gakima MD, Aminata Diouh MS, Lucas Riegel MS, Amal Ben Moussa PhD, Gabriel Girard PhD, Mehdi Karkouri MD, Rosemary M. Delabre PhD, and Daniela Rojas Castro PhD
Subjects: Diseases of the genitourinary system. Urology, RC870-923
Abstract: Little is known about the adaption of community-based organizations (CBOs) during the COVID-19 crisis. This study aimed to study how HIV CBOs and their community health workers (CHWs) faced the COVID-19 outbreak. Semi-structured interviews (n = 53) were conducted among CHWs in Burundi, Mauritania, and Lebanon in 2021. A thematic content analysis was performed. Results showed that CBOs had succeeded in maintaining HIV services and integrated COVID-19 prevention and awareness in their activities. COVID-19 led to innovation in terms of HIV services (eg, telemedicine and online psychosocial support) and to opportunities to try new modalities of antiretroviral therapy dispensation. Field workers (a specific group among CHWs) were negatively impacted by the COVID-19 crisis and showed resilience in their adaptation to ensure the continuity of their activities. Considering the essential role of field workers during the crisis, their status and the sustainability of their activities should be clearly supported by health policies and programs.
Published: 2024
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4. Barriers to Oral PrEP: A Qualitative Study of Female Sex Workers, PrEP Prescribers, Policymakers, and Community Advocates in Morocco

Author: Amal Ben Moussa PhD, Abdallah M Badahdah PhD, Khadija Hidous BS, Rime Barakad BS, Fodié Diallo MD, Mariam Traoré MD, Niloufer Khodabocus MD, Annette Ebsen Treebhoobun BS, Rosemary Delabre PhD, Daniela Rojas Castro PhD, Lahoucine Ouarsas MD, and Mehdi Karkouri PhD
Subjects: Diseases of the genitourinary system. Urology, RC870-923
Abstract: In 2017, Morocco became the first Arab country to incorporate pre-exposure prophylaxis (PrEP) in its HIV-prevention program. Yet no research has been published on PrEP from Morocco. Although female sex workers are one of the target populations of PrEP in Morocco, their enrollment in PrEP is lower than men who have sex with men. In this study, we conducted 38 semi-structured interviews with female sex workers, physicians who prescribe PrEP, policymakers, and community advocates to identify problems associated with access to and use of PrEP. We also investigated preferences for daily oral, vaginal ring, and long-acting injectable PrEP. A reflexive thematic analysis revealed seven themes: PrEP stigma; stigmatization and criminalization of sex work; one size doesn’t fit all; knowledge and misconceptions about PrEP; economic burden; inconvenience of PrEP pills; and preferred PrEP modalities. This paper discusses the implications of the findings for increasing access and use of PrEP in Morocco.
Published: 2024
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5. Resilience outcomes and associated factors among workers in community-based HIV care centres during the Covid-19 pandemic: A multi-country analysis from the EPIC program

Author: Marion Di Ciaccio, Nicolas Lorente, Virginie Villes, Axel Akpaka Maxence, Claudia Marcela Vargas Pelaez, José Rafael Guillen, Ingrid Castillo, Cinta Folch, Rokhaya Diagne, Lucas Riegel, Rosemary M. Delabre, and Daniela Rojas Castro
Subjects: CHW, COVID-19 crisis, Mental health, Resilience, HIV, Public aspects of medicine, RA1-1270
Abstract: Introduction: Community health workers (CHW) were integral in the COVID-19 response, particularly concerning services for populations vulnerable to HIV. Little is known regarding the mental health of CHW during the COVID-19 crisis. The objective of this study was to study resilience of CHW working in HIV non-governmental organizations. Methods: An anonymous online, cross-sectional questionnaire was implemented during 2021 among CHW in Benin, Colombia, Guatemala, and Spain. Three scales were used to assess mental health: the 6-item Brief-Resilience Scale, the 9-item Patient Scale Questionnaire and the 7‐item Generalized-Anxiety-Disorder scale. Logistic regression models were used to identify factors associated with “low” resilience vs “normal” or “high” resilience. Results: Among 295 respondents, the median standardized resilience score was 58.33 (IQR = [50.0–75.0], n = 267), 18.52 (IQR = [7.4–33.3], n = 282) for standardized depression score and 19.05 (IQR = [4.8–33.3], n = 274) for standardized anxiety score. Standardized resilience score was negatively correlated with standardized anxiety score (rho = -0.49, p
Published: 2023
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6. Impact of the COVID-19 Health Crisis on Key Populations at Higher Risk for, or Living With, HIV or Hepatitis C Virus and People Working With These Populations: Multicountry Community-Based Research Study Protocol (EPIC Program)

Author: Rosemary M Delabre, Marion Di Ciaccio, Nicolas Lorente, Virginie Villes, Juliana Castro Avila, Adam Yattassaye, César Bonifaz, Amal Ben Moussa, Ingrid-Zaïre Sikitu, Niloufer Khodabocus, Rosa Freitas, Bruno Spire, Maria Amélia Veras, Luis Sagaon-Teyssier, Gabriel Girard, Perrine Roux, Annie Velter, Valérie Delpech, Jade Ghosn, Lucas Riegel, and Daniela Rojas Castro
Subjects: Medicine, Computer applications to medicine. Medical informatics, R858-859.7
Abstract: BackgroundInformation concerning the impact of the COVID-19 health crisis on populations most affected by HIV and hepatitis C virus (HCV; or key populations [KP]), and those working with these populations in community settings, is limited. Community-based organizations working in the field of HIV and viral hepatitis are well placed to identify and meet the new needs of KP owing to the health crisis. ObjectiveThis study aims to describe the development and implementation of an exploratory and descriptive multicountry, community-based research program, EPIC (Enquêtes Pour évaluer l’Impact de la crise sanitaire covid en milieu Communautaire), within an international network of community-based organizations involved in the response to HIV and viral hepatitis. The EPIC program aimed to study the impact of the COVID-19 health crisis on KP or people living with HIV or HCV and people working with these populations at the community level (community health workers [CHWs]) and to identify the key innovations and adaptations in HIV and HCV services. MethodsA general protocol and study documents were developed and shared within the Coalition PLUS network. The protocol had a built-in flexibility that allowed participating organizations to adapt the study to local needs in terms of the target population and specific themes of interest. Data were collected using surveys or interviews. ResultsFrom July 2020 to May 2022, a total of 79 organizations participated in the EPIC program. Across 32 countries, 118 studies were conducted: 66 quantitative (n=12,060 among KP or people living with HIV or people living with HCV and n=811 among CHWs) and 52 qualitative (n=766 among KP or people living with HIV or people living with HCV and n=136 among CHWs). ConclusionsThe results of the EPIC program will provide data to describe the impact of the health crisis on KP and CHWs and identify their emerging needs. Documentation of innovative solutions that were put into place in this context may help improve the provision of services after COVID-19 and for future health crises. International Registered Report Identifier (IRRID)DERR1-10.2196/45204
Published: 2023
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7. Socio-behavioral correlates of pre-exposure prophylaxis use and correct adherence in men who have sex with men in West Africa

Author: August Eubanks, Bakary Coulibaly, Bintou Dembélé Keita, Camille Anoma, Ter Tiero Elias Dah, Ephrem Mensah, Sékou Kaba, Kpassou Julien Lokrou, Faïçal Rodrigue Ouedraogo, Alèda M. Fidèle Badjassim, Gwenaëlle Maradan, Michel Bourrelly, Marion Mora, Lucas Riegel, Daniela Rojas Castro, Issifou Yaya, Bruno Spire, Christian Laurent, Luis Sagaon-Teyssier, and on behalf of the CohMSM-PrEP Study Group
Subjects: MSM, HIV, PrEP, Community-based research, West Africa, Public aspects of medicine, RA1-1270
Abstract: Abstract Background Multiple barriers compromise pre-exposure prophylaxis (PrEP) engagement (i.e., use and adherence) in men who have sex with men (MSM). In low/middle-income countries, little is known about PrEP engagement in this population. In West Africa, the CohMSM-PrEP study was one of the rare interventions providing PrEP to MSM. We estimated PrEP use and correct adherence rates in CohMSM-PrEP, together with associated factors over time. Methods CohMSM-PrEP recruited MSM in four community-based clinics in Mali, Côte d’Ivoire, Burkina Faso, and Togo. Quarterly follow-up included collecting socio-behavioral data, and providing a comprehensive HIV prevention package, PrEP (daily or event-driven), and peer educator (PE)-led counselling. Using repeated measures, multivariate generalized estimating equations models were used to identify factors associated with self-reported i) PrEP use and ii) correct PrEP adherence during participants’ most recent anal intercourse (defined as four pills/week for daily users and 2 + 1 + 1 for event-driven users). Results Five hundred twenty participants were included with a median follow-up time of 12 months (IQR 6–21). Of the 2839 intercourses declared over the follow-up period, PrEP use was self-reported for 1996 (70%), and correct PrEP adherence for 1461 (73%) of the latter. PrEP use was higher in participants who also attended participating clinics outside of scheduled visits (adjusted odds ratio (aOR) [95% Confidence Interval, CI], p-value; 1.32[1.01–1.71], 0.040), and in those who practiced condomless anal sex (1.86[1.54–2.24],
Published: 2022
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8. Interaction and conflict between outreach workers and research officers in implementing collaborative action research in the field of harm reduction: a qualitative study

Author: Nicolas Khatmi, David Michels, Daniela Rojas Castro, and Perrine Roux
Subjects: Hepatitis C, Drug injection, Collaborative action research, Focus group, Outreach workers, Public aspects of medicine, RA1-1270
Abstract: Abstract Background The effectiveness of collaborative approaches in health interventions is underlined in the literature. Given the serious challenges to adequately managing the HCV epidemic in people who inject drugs (PWID), and the need to improve existing harm reduction (HR) interventions in this population, it seems important to investigate how collaboration between stakeholders is ensured in action research interventions. The present study aimed to explore interactions between outreach workers and research officers collaborating in the implementation of an action research project for PWID entitled OUTSIDER. Methods Using three focus groups, we studied the views of 24 outreach workers involved in the implementation and evaluation of a harm reduction educational intervention to help PWID inject more safely in off-site settings. Results The analysis of participants’ discourses highlighted the mixed perceptions they had about OUTSIDER. Several limitations to collaboration emerged. Epistemological (theoretical vs. practical knowledge), methodological (science vs. intervention), axiological (standardised vs. adapted approach), and material (mobilised vs. available resources) issues all placed a burden on the outreach worker–research officer relationship. Outreach workers’ acceptance of the project’s intervention dimension but rejection of its scientific dimension highlights a lack of contractualisation between the stakeholders involved, and a more general problematisation of the role of outreach workers in implementing action research in HR. How collaboration was perceived and practised by outreach workers participating in OUTSIDER can be considered a reflection of the current challenges to implementing action research in HR. Conclusion This study of the interaction between the research and implementation dimensions of an action research project explored the tensions between different intervention stakeholders that must work together. Equitable participation and integration of the expertise, practices, and knowledge of all stakeholders involved is essential for successful action research. Given current HCV epidemiological challenges, new forms of cooperation are needed when developing healthcare services and when strengthening collaborative approaches.
Published: 2021
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9. Adherence to quarterly HIV prevention services and its impact on HIV incidence in men who have sex with men in West Africa (CohMSM ANRS 12324 – Expertise France)

Author: Ter Tiero Elias Dah, Issifou Yaya, Luis Sagaon-Teyssier, Alou Coulibaly, Malan Jean-Baptiste Kouamé, Mawuényégan Kouamivi Agboyibor, Kader Maiga, Issa Traoré, Marion Mora, Paméla Palvadeau, Daniela Rojas-Castro, Fodié Diallo, Ephrem Mensah, Camille Anoma, Bintou Dembélé Keita, Bruno Spire, Christian Laurent, and on behalf of the CohMSM Study Group
Subjects: HIV, Prevention, Incidence, MSM, Africa, Public aspects of medicine, RA1-1270
Abstract: Abstract Background Access to tailored HIV prevention services remains limited for West African MSM. We assessed adherence to quarterly HIV prevention services and its impact on HIV incidence in MSM followed up in four cities in Burkina Faso, Côte d’Ivoire, Mali, and Togo. Methods We performed a prospective cohort study between 2015 and 2018. HIV-negative MSM aged over 18 benefited from quarterly medical visits which included a clinical examination, HIV testing, screening and treatment for other sexually transmitted infections, peer-led counselling and support, and the provision of condoms and lubricants. Determinants of adherence to quarterly follow-up visits and incident HIV infections were identified using generalized estimating equation models and Cox proportional hazard models, respectively. Results 618 MSM were followed up for a median time of 20.0 months (interquartile range 15.2–26.3). Overall adherence to quarterly follow-up visits was 76.5% (95% confidence interval [CI] 75.1–77.8), ranging from 66.8% in Abidjan to 87.3% in Lomé (p
Published: 2021
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10. Determinants and effects or consequences of internal HIV-related stigma among people living with HIV in Morocco

Author: Amal Ben Moussa, Rosemary M. Delabre, Virginie Villes, Mohammed Elkhammas, Aziza Bennani, Lahoucine Ouarsas, Hind Filali, Kamal Alami, Mehdi Karkouri, and Daniela Rojas Castro
Subjects: HIV, Stigma, Vulnerable populations, Healthcare disparities, Morocco, Public aspects of medicine, RA1-1270
Abstract: Abstract Background HIV-related stigma and discrimination constitute a barrier to different intervention programs. Unlike external stigma, internal stigma is not well explored in in the Middle East and North African countries, while grasping this particular form of stigma is essential to limit its effects. The present study aims to measure internal stigma effects and to identify factors associated with this kind of stigma not yet documented among people living with HIV (PLHIV) in Morocco. Methods The PLHIV Stigma Index questionnaire (adapted and translated into French and Moroccan Arabic dialect “darija”) was used to collect information regarding the stigma and discrimination experienced by PLHIV across 8 cities in Morocco (September–October 2016). A randomly drawn cluster of 10 PLHIV, consisting of 5 men and 5 women, was drawn at each participating medical care center to achieve a nationally representative sample of PLHIV. Fifteen interviewers living with HIV and five supervisors were selected and trained to administer the questionnaire. An internal stigma score (range: 0–7), was calculated based on seven negative feelings/ beliefs. Negative binomial regression was used to identify characteristics associated with the internal stigma score. Results Among 626 PLHIV, internal stigma was reported by 88.2%. The median [IQR] internal stigma score was 4 [2–5]. Regarding internal stigma, 51% avoided going to the local clinic when needed and 44% chose not to attend social gatherings. Belonging to at least one key population (aIRR [95%CI] = 1.15 [1.03; 1.28]), experiencing discriminatory reactions from family following HIV status disclosure (1.28 [1.11; 1.49]), avoiding HIV services for fear of stigmatization by staff (1.16 [1.05; 1.28]) and being denied health services because of HIV status (1.16 [1.03;1.32]), are among the factors significantly associated with an increase of the internal stigma score. Conclusions Internal stigma is high among Moroccan PLHIV and significantly impacting their life decisions and their healthcare access. Multi-level interventions are needed to address internal stigma experienced by PLHIV in Morocco.
Published: 2021
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11. Individual and structural correlates of willingness for intravenous buprenorphine treatment among people who inject sublingual buprenorphine in France

Author: Salim Mezaache, Patrizia Carrieri, Laélia Briand-Madrid, Virginie Laporte, Alain Morel, Daniela Rojas Castro, and Perrine Roux
Subjects: Opioid-related disorders, Opiate substitution treatment, Intravenous substance abuse, Harm reduction, Public aspects of medicine, RA1-1270
Abstract: Abstract Background Some people do not benefit from oral administration of opioid agonist treatment, and an intravenous (IV) formulation may be more suitable. Our objective was to evaluate the willingness of people who regularly inject sublingual buprenorphine to receive IV buprenorphine as a prescribed treatment, and to examine related correlates. Methods We performed a secondary analysis of data from the cross-sectional study PrebupIV, conducted in France in 2015 among 557 people who inject opioids. The study comprised questionnaires completed either face to face or online and community-based workshops. We only included participants who reported buprenorphine as their main injected drug (n = 209). Willingness to receive IV buprenorphine treatment was measured on a scale from 0 to 10. Ordinal logistic regression identified correlates of willingness. Artworks and testimonies from participants in the workshops were also used to illustrate correlates of willingness. Results Among the 209 participants, the mean score (SD) for willingness to receive IV buprenorphine was 8.0 (2.8). Multivariate analysis showed that participants who reported using non-prescribed buprenorphine (AOR = 4.82, p = 0.019), a higher daily dosage of buprenorphine (AOR (for 1 mg) = 1.05, p = 0.043), and a higher number of complications due to injection (AOR = 2.28, p = 0.037), were more willing to receive IV buprenorphine treatment. Conclusions Willingness to initiate IV buprenorphine treatment was high among people who regularly inject sublingual buprenorphine. A prescribed IV formulation could attract and retain more people into care and reduce harms associated with the injection of buprenorphine tablets.
Published: 2021
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12. Can we talk about price with patients when choosing antiretroviral therapy? A survey with people living with HIV and prescribers in France

Author: Yazdan Yazdanpanah, Philippe Morlat, Marie Préau, Cécile Goujard, Nikos Kalampalikis, Gilles Peytavin, Elisabeth Bouvet, Emmanuelle Papot, Marjolaine Doumergue, Fabrice Pilorgé, Guillemette Quatremère, Philippe Arnaud, Claire Auger, Franck Barbier, Gaele Bruneaux, Katia Bourdic, Agnès Certain, Charlotte Charpentier, Véronique Doré, Sophia Guessous, Anne-Claire Haye, Roland Landman, Sylvie LeGac, Françoise Louni, David Michels, Dorothée Obach, Laurence Pochat, Daniela Rojas Castro, and Patrick Yéni
Subjects: Medicine
Abstract: Objective The aim of this study was to evaluate people living with HIV (PLWH) and HIV specialist prescribers’ perception of discussing antiretroviral therapy (ART) price in PLWH’s care and the acceptability of choosing or switching to various types of less expensive ARTs.Design Cross-sectional surveys (one in a convenience sample of PLWH and one in a voluntary response sample of HIV specialist prescribers).Setting and participants The surveys were conducted among PLHW attending an HIV clinic in the North of Paris (cohort of 4922 PLWH in 2016), and HIV specialists working in French HIV clinics (210 across 12 districts/28), between January and June 2016.Method Self-administered questionnaires were constructed using data collected during focus groups with PLWH and prescribers. Pretests were carried out to select the questions and items. Descriptive analyses of the 129 complete questionnaires of PLWH and 79 of prescribers are presented.Results Among PLWH, 128/129 were on ART and 54% (69/128) gave a fair estimation of the price of their current regimen. Among prescribers, 24% (19/79) thought that their patients knew this price. Taking into account the price of ART was not perceived as a negative step in the history of French response to HIV epidemic for 53% (68/129) of PLWH and 82% (65/79) of prescribers. Seventy-seven PLWH (60%) would agree to switch to less expensive antiretroviral regimens (as effective and with similar adverse events) if pills were bigger; 42 (33%) if there were more daily doses, and 37 (29%) if there were more pills per dose; prescribers were more circumspect.Conclusion A high proportion of PLWH gave a fair estimate of their ART price and this seemed unexpected by HIV specialists. Consideration of drug prices when choosing ART was perceived as conceivable by PLWH and prescribers if effectiveness and tolerance were also considered.
Published: 2021
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13. Correction to: Individual and structural correlates of willingness for intravenous buprenorphine treatment among people who inject sublingual buprenorphine in France

Author: Salim Mezaache, Patrizia Carrieri, Laelia Briand‑Madrid, Virginie Laporte, Alain Morel, Daniela Rojas Castro, and Perrine Roux
Subjects: Public aspects of medicine, RA1-1270
Abstract: An amendment to this paper has been published and can be accessed via the original article.
Published: 2021
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14. Loss to Follow-Up from HIV Pre-Exposure Prophylaxis Care in Men Who Have Sex with Men in West Africa

Author: August Eubanks, Bakary Coulibaly, Bintou Dembélé Keita, Camille Anoma, Ter Tiero Elias Dah, Ephrem Mensah, Gwenaëlle Maradan, Michel Bourrelly, Marion Mora, Lucas Riegel, Daniela Rojas Castro, Issifou Yaya, Bruno Spire, Christian Laurent, Luis Sagaon-Teyssier, and the CohMSM-PrEP Study Group
Subjects: HIV/AIDS, key populations, MSM, pre-exposure prophylaxis, PrEP, West Africa, Microbiology, QR1-502
Abstract: Loss to follow-up (LTFU) from HIV pre-exposure prophylaxis (PrEP) care compromises the goal of HIV elimination. We investigated the proportion of LTFU and associated risk factors among men who have sex with men (MSM) enrolled in a PrEP demonstration project in Burkina Faso, Côte d’Ivoire, Mali, and Togo. CohMSM-PrEP, a prospective cohort study, was conducted between November 2017 and June 2021 in community-based clinics. MSM aged 18 years or older at substantial risk of HIV infection received a comprehensive prevention package, including PrEP and peer education. LTFU was defined as not returning to the clinic for six months. Associated risk factors were investigated using a time-varying Cox’s model. Of 647 participants followed up for a median time of 15 months, 372 were LTFU (57.5%). LTFU was associated with younger age (adjusted hazard ratio [95% Confidence Interval]; 1.50 [1.17–1.94]), unemployment (1.33 [1.03–1.71]), depression (1.63 [1.12–2.38]), and perceiving no HIV risk with stable male partners (1.61 [1.23–2.10]). Contacting peer educators outside of scheduled visits was protective (0.74 [0.56–0.97]). Our findings show that LTFU from PrEP care in West African MSM is a major challenge to achieving HIV elimination, but that the involvement of peer educators in PrEP delivery helps to limit LTFU by providing users with adequate support.
Published: 2022
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15. 'Yes, I'm interested in taking PrEP!': PrEP interest among women respondents to the European community-based survey 'Flash! PrEP in Europe'.

Author: Rosemary M Delabre, Adeline Bernier, Flor Sánchez, Antoine Vilotitch, Sophocles Chanos, Maria Luisa Cosmaro, Harriet Langanke, Coline Mey, Cary James, Sascha B Duken, Vincent Schlegel, Richard Stranz, Kai J Jonas, Bruno Spire, and Daniela Rojas Castro
Subjects: Medicine, Science
Abstract: The World Health Organization recommends pre-exposure prophylaxis (PrEP) for all populations at substantial risk of HIV infection, including women. However, data regarding PrEP interest among women is lacking, particularly in Europe. Factors associated with interest in using PrEP were assessed among women respondents to the Flash! PrEP in Europe (FPIE) survey. This community-based cross-sectional study, conducted in 12 European countries, aimed to assess PrEP knowledge and interest. "High objective risk" (HOR) was assessed using established risk criteria following EACS and CDC guidelines. Factors associated with interest in using PrEP were assessed in univariable and multivariable logistic regression models. Among 678 women, 12.5% (n = 85) were considered at HOR, 46.8% (n = 317) indicated prior PrEP knowledge and 18.0% (n = 122) reported interest in using PrEP. Among women at HOR, 40.0% (n = 34) were interested in PrEP. Factors significantly associated with PrEP interest in the final multivariable model were: younger age (18-29 years) (aOR 1.91[95CI: 1.07; 3.41]), bad self-perceived financial status (1.84[1.09; 3.11]), migrant status (south to north) (2.87[1.05; 7.89]), single or dating relationship status (1.93[1.23; 3.03]), sexual abuse history (1.86[1.17; 2.97]), "rather high"/ "high" self-perceived HIV risk (3.21[1.32; 7.81]), and HOR (2.49[1.42; 4.35]). These results show that women at HOR and those who perceived themselves to be at high risk are interested in using PrEP. There is a critical need for targeted information and improved access to PrEP to increase uptake of this HIV prevention tool to meet PrEP interest among women.
Published: 2021
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16. Assessment of mental health outcomes and associated factors among workers in community-based HIV care centers in the early stage of the COVID-19 outbreak in Mali

Author: Luis Sagaon-Teyssier, Aliou Kamissoko, Adam Yattassaye, Fodié Diallo, Daniela Rojas Castro, Rosemary Delabre, Fabrice Pouradier, Gwenaëlle Maradan, Michel Bourrelly, Mamadou Cissé, Laurent Vidal, Bintou Dembélé Keïta, and Bruno Spire
Subjects: Mali, COVID-19, Mental health, Healthcare workers, HIV, Public aspects of medicine, RA1-1270
Abstract: Background and objectives: In Mali, the non-governmental association (NGO) ARCAD Santé PLUS launched the CovidPrev program in response to the COVID-19 outbreak to ensure continuity of HIV care-related activities. This study aimed to identify individual and structural factors associated with mental health disorders (MHD) in the NGO’s healthcare workers (HCW) in the early stage of the outbreak. Methods: Data were collected between April 6 and 11, 2020 for 135 HCW in ARCAD Santé PLUS’s 18 community-based HIV care centers. Outcomes corresponded to the PHQ-9, GAD-7 and ISI instruments for depression, anxiety and insomnia, respectively. A general mixture model with a negative binomial distribution was implemented. Results: Most HCW were men (60.7%) and median age was 40 years IQR[33-46]. Symptoms of depression, anxiety and insomnia were declared by 71.9, 73.3, and 77% participants, respectively. Women were at greater risk of MHD. A lack of personal protection equipment and human resources, especially nurses, was associated with a high risk of MHD. Conclusions: Health policy must place non-front line HCW, including those in NGOs, at the core of the healthcare system response to the COVID-19 outbreak, as they ensure continuity of care for many diseases including HIV. The efficacy of public health strategies depends on the capacity of HCW to fully with and competently perform their duties.
Published: 2020
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17. Impact on renal function of daily and on-demand HIV pre-exposure prophylaxis in the ANRS-PREVENIR study

Author: Geoffroy Liegeon, Lambert Assoumou, Jade Ghosn, Mayssam El Mouhebb, Romain Palich, Christia Palacios, Laurence Slama, Laure Surgers, Michèle Genin, Lydie Beniguel, Lauriane Goldwirt, Claudine Duvivier, Daniela Rojas Castro, Dominique Costagliola, and Jean-Michel Molina
Subjects: Male, Adult, Pharmacology, Microbiology (medical), Anti-HIV Agents, HIV Infections, Kidney, Sexual and Gender Minorities, Infectious Diseases, Humans, Emtricitabine, Pre-Exposure Prophylaxis, Pharmacology (medical), Homosexuality, Male, Retrospective Studies
Abstract: Objectives To assess the impact on the estimated glomerular filtration rate (eGFR) of different tenofovir disoproxil/emtricitabine dosing regimens for HIV pre-exposure prophylaxis (PrEP). Patients and methods We included in the study individuals with baseline eGFR > 50 mL/min/1.73 m2 who initiated PrEP in the ongoing ANRS-PREVENIR PrEP cohort. We retrospectively classified PrEP users in three groups: ‘on-demand’ (reported at ≥75% of study visits), ‘daily’ (≥75% of study visits) or ‘switches’. We compared the area under curve (AUC) of the eGFR variation from baseline (ΔeGFR) between groups using analysis of covariance, and assessed factors associated with a negative AUC of ΔeGFR. Results From May 2017 to October 2020, 1253 PrEP-naïve participants (98% of MSM) were included in the study with a median follow-up of 22 months. 499 (40%), 494 (39%) and 260 (21%) users were in the group daily, on-demand and switches, respectively, for a median number of pills taken per week of 6, 1.7 and 4. The mean AUC of the ΔeGFR was −1.09 mL/min/1.73 m2 in the daily PrEP group, −0.69 mL/min/1.73 m2 in the switches group and +0.18 mL/min/1.73 m2 with on-demand PrEP. In a model adjusted on baseline age and eGFR, the AUC of the ΔeGFR was significantly higher with on-demand PrEP compared to daily PrEP (P = 0.037). Independent factors associated with a negative AUC of ΔeGFR were a daily PrEP regimen, a switches regimen, an age > 40 years and a baseline eGFR≥90 mL/min/1.73 m². Conclusions On-demand PrEP dosing had a smaller impact on eGFR evolution than daily PrEP, but the difference was not clinically relevant.
Published: 2022
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18. Willingness to receive intravenous buprenorphine treatment in opioid-dependent people refractory to oral opioid maintenance treatment: results from a community-based survey in France

Author: Perrine Roux, Daniela Rojas Castro, Khadim Ndiaye, Laélia Briand Madrid, Virginie Laporte, Marion Mora, Gwenaelle Maradan, Stéphane Morel, Bruno Spire, and Patrizia Carrieri
Subjects: Willingness, Intravenous buprenorphine, Opioid dependence, Cutaneous complications, Community-based research, Public aspects of medicine, RA1-1270, Social pathology. Social and public welfare. Criminology, HV1-9960
Abstract: Abstract Background Injectable opioids are an interesting option for people who inject drugs (PWID) that do not respond to oral Opioid Maintenance Treatment (OMT). To date, intravenous (IV) buprenorphine - a safer drug than full-opioid agonists in terms of overdose risk - has never been tested in a clinical trial on opioid dependence. We designed a survey to better understand the profile of PWID eligible for IV buprenorphine, and their willingness to receive it. Methods This cross-sectional community-based national survey was conducted through face-to-face interviews (in low-threshold and addiction care services) and online questionnaires (on https://psychoactif.org and other websites). Among the 557 participants, we selected those who were eligible for IV buprenorphine treatment (history of oral OMT, regular opioid injection) (n = 371). We used regression models to study factors associated with willingness to receive IV buprenorphine treatment among those with data on willingness (n = 353). In those who were willing (n = 294), we subsequently studied their willingness to receive daily supervised IV buprenorphine treatment. Results Among the selected 353 participants, 59% mainly injected buprenorphine, 15% heroin, 16% morphine sulfate and 10% other opioids. Eighty-three percent of the sample reported willingness to receive IV buprenorphine treatment. Factors associated with willingness were: more than 5 injection-related complications, regular buprenorphine injection, no lifetime overdose, and completion of the questionnaire online. Factors associated with unwillingness to receive daily supervised treatment were younger age (OR[IC95%]=1.04[1.01; 1.07]) and stable housing (OR[IC95%]=0.61[0.37;1.01]) while regular heroin injectors were more willing to receive daily supervision (OR[IC95%]=2.94 [1.42; 6.10]). Conclusions PWID were very willing to receive intravenous buprenorphine as a treatment, especially those with multiple injection-related complications. In addition, our findings show that IV buprenorphine may be less acceptable to PWID who inject morphine sulfate. Young PWID and those with stable housing were unwilling to receive IV buprenorphine if daily supervision were required. This preliminary study provides useful information for the development of a clinical trial on IV buprenorphine treatment.
Published: 2017
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19. Pleasure and PrEP: Pleasure-Seeking Plays a Role in Prevention Choices and Could Lead to PrEP Initiation

Author: Xavier Mabire, Costanza Puppo, Stéphane Morel, Marion Mora, Daniela Rojas Castro, Julie Chas, Eric Cua, Claire Pintado, Marie Suzan-Monti, Bruno Spire, Jean-Michel Molina, and Marie Préau
Subjects: Medicine
Abstract: Pleasure-seeking plays a role in prevention (means choices and use), and in the sexual quality of life of men who have sex with men (MSM). Since HIV is a major threat to MSM health, new means of prevention, like pre-exposure prophylaxis (PrEP), must meet the needs of MSM to be fully efficient. Using a psychosocial approach, we examined how pleasure-seeking plays a role in participation of MSM in “ANRS-IPERGAY,” a community-based trial on sexual health which included sexual on-demand PrEP. Thirteen semistructured collective interviews were conducted with 45 participants. First, we analyzed participants’ search for new prevention means due to previous failures in condom use. We found that participants perceived condoms as a barrier—both materially and symbolically—to pleasure and desire, causing anxiety and stress considering sexual intercourse. Second, we explored representations and attitudes concerning pleasure within the context of PrEP. We found that PrEP allowed participants to freely choose their desired sexual positions and to better enjoy intimacy. Third, we studied the sexual quality of life for PrEP users in ANRS-IPERGAY and found an improvement. Thanks to the community-based design of the trial, this new prevention tool became a means to develop agency and empowerment for participants, not only in negotiating individual prevention but also in opposing the normative and stigmatizing discourse on sexuality and HIV. In conclusion, pleasure-seeking appears to be an essential element of sexual fulfillment that needs to be integrated as a positive notion in the study of HIV prevention.
Published: 2019
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20. La recherche communautaire en temps de pandémie : retour sur l’étude multi-pays EPIC

Author: Lucas Riegel, Marion Di Ciaccio, Amal Ben Moussa, Annie Velter, Maria Elena Acosta, Virginie Villes, Juliana Castro Avila, Nicolas Lorente, Teresa Cerveau, Ingrid Sikitu, Adam Yattassaye, Niloufer Khodabocus, David Michels, María Amelia Veras, Valérie Delpech, Bruno Spire, Rosemary M. Delabre, null Le groupe de travail EPIC, and Daniela Rojas Castro
Subjects: Public Health, Environmental and Occupational Health
Published: 2022
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21. HIV pre-exposure prophylaxis for men who have sex with men in west Africa: a multicountry demonstration study

Author: Christian Laurent, Bintou Dembélé Keita, Issifou Yaya, Gwenvael Le Guicher, Luis Sagaon-Teyssier, Mawuényégan K Agboyibor, Alou Coulibaly, Issa Traoré, Jean-Baptiste Malan, Irith De Baetselier, August Eubanks, Lucas Riegel, Daniela Rojas Castro, Hortense Fayé-Ketté, Amadou Koné, Souba Diandé, Claver A Dagnra, Laetitia Serrano, Fodié Diallo, Ephrem Mensah, Ter Tiero E Dah, Camille Anoma, Bea Vuylsteke, Bruno Spire, Sayouba Ouedraogo, Bruno Granouillac, Martine Peeters, Clotilde Couderc, Marion Mora, Gwenaëlle Maradan, Michel Bourrelly, Mohamed Mimi, Cyril Berenger, Sylvie Boyer, Paméla Palvadeau, Thijs Reyniers, Alassane Kader Maïga, Drissa Camara, Mahamadou Diarra, Aly Ouologuem, Naboh Sangaré, Abdoul Aziz Keita, Oumar Cissé, Fodé Traoré, Bréhima Abdrahamane Ouary, Ibrahima Kanta, Rachelle Kotchi, Niamkey Thomas Aka, Kpassou Julien Lokrou, Noufo Hamed Coulibaly, Ekissi Jean Armel Koffi, Dibi Frédéric N'guessan, Stéphane-Alain Babo Yoro, Adama Cissé, Ter Tiero Elias Dah, Camille Rajaonarivelo, Fayçal Rodrique Ouedraogo, Joseph Ouedraogo, Christian Coulibaly, Mamadou Ouedraogo, Ousseni Ilboudo, Abdoulazziz Traoré, Honoré Comsiambo, Mawuényégan Kouamivi Agboyibor, Anani Attisso, Anouwarsadat Kokouba, Aléda Mawuli Badjassim, Kouakou Kokouvi Selom Agbomadji, Messan Attiogbe, Kossi Jeff Yaka, Agbégnigan Lorette Ekon, Julien Bimba, Claver Anoumou Dagnra, Kokou Dominique Tegueni, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), ARCAD Santé PLUS [Bamako, Mali], Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Espoir Vie Togo [Lomé, Togo], Association African Solidarité [Ouagadougou, Burkina Faso], Espace Confiance [Abidjan, Côte d’Ivoire], Institute of Tropical Medicine [Antwerp] (ITM), Coalition PLUS [Pantin, France], Institut Pasteur de Côte d'Ivoire, Réseau International des Instituts Pasteur (RIIP), Université des sciences, des techniques et des technologies de Bamako (USTTB), Laboratoire National de Référence de la Tuberculose [Ouagadougou, Burkina Faso] (LNRT), Laboratoire National de Référence de la tuberculose [Lomé, Togo] (LNRT/CHU Lomé), CohMSM-PrEP Study Group: Christian Laurent, Issifou Yaya, Sayouba Ouedraogo, Bruno Granouillac, Gwenvael Le Guicher, Laetitia Serrano, Martine Peeters, Clotilde Couderc, Bruno Spire, Luis Sagaon-Teyssier, Marion Mora, Gwenaëlle Maradan, Michel Bourrelly, Mohamed Mimi, Cyril Berenger, Sylvie Boyer, Daniela Rojas Castro, Lucas Riegel, Paméla Palvadeau, Bea Vuylsteke, Irith De Baetselier, Thijs Reyniers, Bintou Dembélé Keita, Fodié Diallo, Alou Coulibaly, Alassane Kader Maïga, Drissa Camara, Mahamadou Diarra, Aly Ouologuem, Naboh Sangaré, Abdoul Aziz Keita, Oumar Cissé, Fodé Traoré, Bréhima Abdrahamane Ouary, Ibrahima Kanta, Camille Anoma, Jean-Baptiste Malan, Rachelle Kotchi, Niamkey Thomas Aka, Kpassou Julien Lokrou, Noufo Hamed Coulibaly, Ekissi Jean Armel Koffi, Dibi Frédéric N'guessan, Stéphane-Alain Babo Yoro, Adama Cissé, Ter Tiero Elias Dah, Issa Traoré, Camille Rajaonarivelo, Fayçal Rodrique Ouedraogo, Joseph Ouedraogo, Christian Coulibaly, Mamadou Ouedraogo, Ousseni Ilboudo, Abdoulazziz Traoré, Honoré Comsiambo, Ephrem Mensah, Mawuényégan Kouamivi Agboyibor, Anani Attisso, Anouwarsadat Kokouba, Aléda Mawuli Badjassim, Kouakou Kokouvi Selom Agbomadji, Messan Attiogbe, Kossi Jeff Yaka, Agbégnigan Lorette Ekon, Julien Bimba, Claver Anoumou Dagnra, Kokou Dominique Tegueni, Malbec, Odile, Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), and Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI)
Subjects: Adult, Male, 0301 basic medicine, Anti-HIV Agents, Epidemiology, Sexual Behavior, [SDV]Life Sciences [q-bio], Immunology, HIV Infections, Pilot Projects, Emtricitabine, Men who have sex with men, West africa, Young Adult, 03 medical and health sciences, Pre-exposure prophylaxis, 0302 clinical medicine, Virology, parasitic diseases, Humans, Medicine, Prospective Studies, 030212 general & internal medicine, Dosing, Homosexuality, Male, Tenofovir, Prospective cohort study, business.industry, 1. No poverty, 030112 virology, 3. Good health, [SDV] Life Sciences [q-bio], Africa, Western, Regimen, Infectious Diseases, Cohort, Pre-Exposure Prophylaxis, business, Demography, medicine.drug
Abstract: International audience; Background HIV pre-exposure prophylaxis (PrEP) data in men who have sex with men (MSM) in west Africa are essential to guide its large-scale implementation. We assessed the uptake of event-driven and daily PrEP, HIV incidence, and changes over time in sexual behaviours and prevalence of bacterial sexually transmitted infections (STIs) in MSM in Burkina Faso, Côte d'Ivoire, Mali, and Togo. Methods We did a prospective cohort study from Nov 20, 2017, to April 14, 2020, in four community-based clinics in Abidjan (Côte d'Ivoire), Bamako (Mali), Lomé (Togo), and Ouagadougou (Burkina Faso). Participants were MSM aged 18 years or older at substantial risk of HIV infection. Participants could choose between event-driven (2+1+1 dosing) and daily oral PrEP (tenofovir disoproxil fumarate 300 mg plus emtricitabine 200 mg), switch regimen, and discontinue or restart PrEP. We compared HIV incidence in this study with that of the same cohort before the availability of PrEP (CohMSM). Statistical analysis included the Kaplan-Meier method and mixed-effects regression models. This study is registered with ClinicalTrials.gov, NCT03459157. Findings We followed up 598 participants for a total of 743•6 person-years. At enrolment, 445 (74%) of 598 participants chose event-driven PrEP and 153 (26%) of 598 chose daily PrEP. 60 (13%) of 445 and 65 (42%) of 153 partici pants switched PrEP regimen at least once (p
Published: 2021
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22. Titre de séjour pour raisons médicales : un observatoire pour objectiver les pratiques et défendre un droit

Author: Clémentine Bonifay‑Besson, Cécile Chaussignand, Daniela Rojas‑Castro, and Adeline Toullier
Subjects: HIV, AIDS, migrants, residence permit for medical reasons, “sick foreigners” Observatory, Social Sciences
Abstract: En 1996, les antirétroviraux (ARV) sont accessibles en France, contrairement aux pays en développement. L’année suivante, une loi est votée pour interdire les expulsions d’étrangers malades résidant en France et n’ayant pas la garantie de bénéficier d’ARV dans leur pays d’origine. L’année d’après, en 1998, une nouvelle loi introduit un droit au séjour pour soins pour ces mêmes personnes. Mais dans la pratique, ces dispositifs sont malmenés, surtout depuis la restriction légale de juin 2011 et le défaut de pilotage ministériel survenu à l’automne 2012.Pour compenser les carences de données officielles, l’association AIDES a mis en place l’observatoire « étrangers malades » fin 2010 : il s’agit d’un outil informatique de recueil de données quantitatives et qualitatives, alimenté par les personnes concernées et les différents acteurs qui les accompagnent, militants de AIDES, travailleurs sociaux, partenaires associatifs, etc. Des rubriques d’aide, intégrées à la grille de recueil, facilitent l’accompagnement social et juridique : elles sont régulièrement actualisées et enrichies, notamment dans le cadre d’un partenariat avec le COMEDE.Cet observatoire recense les difficultés administratives ainsi que leur impact sur la santé et la vie quotidienne des personnes étrangères touchées par le VIH et/ou une hépatite virale, résidant en France et qui ne peuvent se soigner dans leur pays d’origine. Pour cette seconde édition, entre octobre 2010 et juin 2013, 437 situations ont été renseignées (43,3 % hommes, 3,2 % transsexuels), 95,1 % de PVVIH (personnes vivant avec le VIH) mono-infectées, 4,2 % de PVVHC (personnes vivant avec le virus de l’hépatite C) et 3,5 % VHB (virus de l’hépatite B), de plus de 50 nationalités.Les résultats montrent la persistance des piètres conditions d’accueil et d’instruction en préfecture : attente au guichet supérieure à 5 heures (19,58 % des cas), refus ou report d’enregistrement de la demande de titre de séjour sans motif légal. Le délai d’instruction dépasse 6 mois dans 20,7 % des cas. Aucun récépissé n’est remis au cours de l’instruction dans 47,8 % des cas.Sur le plan médical, la situation s’est fortement dégradée depuis l’automne 2012. Certains préfets interviennent dans l’évaluation médicale (ingérence directe dans le dossier médical dans 10,6 % des cas). En 2012, le taux d’accord a chuté de 11 %, à la suite d’avis négatifs du médecin de l’ARS pour la grande majorité des cas.Aux différents stades de la procédure, ces dysfonctionnements induisent fatigue et découragement et impactent les ressources et la santé des intéressés.Ces données objectivent la nature et l’ampleur des pratiques, leurs conséquences sur la vie et le projet de soins des étrangers malades. Compte tenu des enjeux en cause, AIDES formule une série de recommandations détaillées en faveur de l’effectivité des droits des personnes étrangères gravement malades et de leur qualité de vie, que cela soit en matière de droit au séjour, de protection contre l’éloignement, d’accès aux droits sociaux et à la couverture santé ou encore en faveur de l’accès universel aux soins à l’échelle internationale.
Published: 2016
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23. Heterogeneity in the Prevalence of High-Risk Human Papillomavirus Infection in Human Immunodeficiency Virus-Negative and Human Immunodeficiency Virus-Positive Men Who Have Sex With Men in West Africa

Author: Issifou, Yaya, Véronique, Boyer, Phyllis Amivi, Ehlan, Alou, Coulibaly, Mawuényégan Kouamivi, Agboyibor, Issa, Traoré, Malan Jean-Baptiste, Kouamé, Alassane Kader, Maiga, Ochoh Rachelle, Kotchi, Yawo Tufa, Nyasenu, Gwenaëlle, Maradan, Daniela, Rojas-Castro, Fodié, Diallo, Camille, Anoma, Ter Tiero Elias, Dah, Ephrem, Mensah, Bintou, Dembélé Keita, Bruno, Spire, Claver Anoumou, Dagnra, Christian, Laurent, Kokou Dominique, Tegueni, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Université de Lomé [Togo], ARCAD Santé PLUS [Bamako, Mali], Espoir Vie Togo [Lomé, Togo], Association African Solidarité [Ouagadougou, Burkina Faso], Espace Confiance [Abidjan, Côte d’Ivoire], Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Coalition PLUS [Pantin, France], CohMSM Study Group: Christian Laurent, Issifou Yaya, Sayouba Ouedraogo, Bruno Granouillac, Gwenvael Le Guicher, Laetitia Serrano, Martine Peeters, Clotilde Couderc, Bruno Spire, Luis Sagaon-Teyssier, Marion Mora, Gwenaëlle Maradan, Michel Bourrelly, Mohamed Mimi, Cyril Berenger, Sylvie Boyer, Daniela Rojas Castro, Lucas Riegel, Paméla Palvadeau, Bintou Dembélé Keita, Fodié Diallo, Alou Coulibaly, Alassane Kader Maïga, Drissa Camara, Mahamadou Diarra, Aly Ouologuem, Naboh Sangaré, Abdoul Aziz Keita, Oumar Cissé, Fodé Traoré, Bréhima Abdrahamane Ouary, Ibrahima Kanta, Camille Anoma, Malan Jean-Baptiste Kouamé, Ochoh Rachelle Kotchi, Niamkey Thomas Aka, Kpassou Julien Lokrou, Noufo Hamed Coulibaly, Jean Armel Ekessi Koffi, Frédéric Dibi N'guessan, Stéphane-Alain Babo Yoro, Adama Cissé, Ter Tiero Elias Dah, Issa Traoré, Camille Rajaonarivelo, Fayçal Rodrique Ouedraogo, Joseph Ouedraogo, Christian Coulibaly, Mamadou Ouedraogo, Ousseni Ilboudo, Abdoulazziz Traoré, Honoré Comsiambo, Ephrem Mensah, Richard Mawuényégan Kouamivi Agboyibor, Anani Attisso, Anouwarsadat Kokouba, Aléda Mawuli Badjassim, Kouakou Kokouvi Selom Agbomadji, Messan Attiogbe, Kossi Jeff Yaka, Agbégnigan Lorette Ekon, Julien Bimba, Claver Anoumou Yaotsè Dagnra, Phyllis Amivi Ehlan, Xavier Yawo Tufa Nyasenu, Kokou Dominique Tegueni., Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), and Dupuis, Christine
Subjects: Male, Microbiology (medical), HPV, Multivariate analysis, Adolescent, [SDV]Life Sciences [q-bio], MSM, Human immunodeficiency virus (HIV), Anal Canal, HIV Infections, Logistic regression, medicine.disease_cause, Men who have sex with men, Sexual and Gender Minorities, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Burkina Faso, Prevalence, medicine, Humans, 030212 general & internal medicine, Homosexuality, Male, Papillomaviridae, business.industry, Papillomavirus Infections, HPV infection, HIV, virus diseases, Odds ratio, medicine.disease, Confidence interval, [SDV] Life Sciences [q-bio], Vaccination, Cross-Sectional Studies, Infectious Diseases, 030220 oncology & carcinogenesis, Africa, Female, business, Demography
Abstract: Background Men who have sex with men (MSM) are at high risk of human papillomavirus (HPV) infection. We assessed (i) the prevalence of high-risk HPV (HR-HPV) infection and associated factors, and (ii) the prevalence of vaccine-preventable HPV infections in MSM in Burkina Faso, Côte d’Ivoire, Mali, and Togo. Methods A cross-sectional study was conducted in 2017–2018 among MSM ≥18 years old followed in community-based clinics. HPV infection was investigated in oral and anal samples using the e-BRID system. Factors associated with HR-HPV infection were identified using multivariate logistic regressions. Results Among 631 participants, 425 were HIV-negative and 206 HIV-positive. HR-HPV prevalence ranged from 9.2% to 34.8% in the former, and 33.3% to 71.0% in the latter, according to the study country. In multivariate analysis, HIV infection (adjusted odds ratio (aOR) 3.61, 95% confidence interval (CI) 2.48–5.27) and study country (4.73, 2.66–8.43 for Mali; 3.12, 1.68–5.80 for Burkina Faso; 3.51, 1.92–6.42 for Togo) were associated with HR-HPV infection. Other associated factors were low educational level, self-defined homosexual identity, and condomless anal sex. The prevalence of infections which can be prevented with bivalent, quadrivalent, and nonavalent vaccines was 5.9, 27.1, and 34.6% in HIV-negative participants, and 18.9, 43.7, and 54.9% in HIV-positive participants, respectively. Conclusions HR-HPV prevalence was very heterogeneous between the study countries in both HIV-negative and HIV-positive MSM. Vaccine-preventable HPV infections predominated. Vaccination should be proposed to young MSM to reduce the burden of HPV infection in this vulnerable population and their female partners in West Africa.
Published: 2021
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24. How are women living with HIV in France coping with their perceived side effects of antiretroviral therapy? Results from the EVE study.

Author: Guillemette Quatremère, Marguerite Guiguet, Patricia Girardi, Marie-Noëlle Liaud, Coline Mey, Cynthia Benkhoucha, Franck Barbier, Graciela Cattaneo, Anne Simon, and Daniela Rojas Castro
Subjects: Medicine, Science
Abstract: OBJECTIVE:Side effects of antiretroviral therapy (ART) can have a negative impact on health-related quality of life threatening long-term retention in HIV care and adherence to ART. The aim of the French community-based survey EVE was to document personal experiences with side effects, the related physician-patient communication, and solutions found to deal with them. DESIGN:Cross-sectional study of women between September 2013 to September 2014. METHODS:An anonymous online questionnaire included the HIV Symptom Distress Module, which explores 20 symptoms. RESULTS:In all, 301 women on ART participated in the study (median age: 49 years; median duration of ART: 14 years). They reported having experienced a median of 12 symptoms (Q1-Q3: 9-15) during the previous 12 months. Overall, 56% of them reported having found at least a partial solution to dealing with their symptoms. Women reporting financial difficulties were twice less likely to have found solutions to coping with their side effects (AOR: 0.5; 95% CI: 0.3-0.8). Feeling supported by the health-care provider (AOR: 2.1; 95% CI: 1.1-3.9) and being in contact with HIV/AIDS organisations (AOR: 1.9; 95% CI: 1.2-3.2) were positively associated with coping. Seventeen percent reported having modified their ART regimen to improve tolerance, with only 2 in 3 informing their physician afterwards. Reporting financial difficulties and living with more bothersome symptoms increased the risk of ART regimen modification without health-care provider consultation. CONCLUSION:The EVE study has called attention to the large number of side effects experienced by WLWHIV, only half of whom have found self-care strategies to manage their symptoms. Modification of ART regimen by the women themselves was not uncommon.
Published: 2017
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25. PrEP in the Context of Other HIV Risk Reduction Strategies Among Men Who Have Sex with Men: Results from the Flash! PrEP in Europe Survey

Author: Marion Di Ciaccio, Rosemary M. Delabre, Antoine Vilotitch, Giulio Maria Corbelli, Virginie Villes, Alejandro Ros Sánchez, Paul Zantkuijl, Holger Sweers, Flor Sanchez, Michael Meulbroek, Gus Cairns, Adeline Bernier, Jade Ghosn, Luìs Miguel Carvalho Rocha, Maria Luisa Cosmaro, Sascha Béla Duken, Monica Dan, Vincent Schlegel, Richard Stranz, Kai J. Jonas, Bruno Spire, Daniela Rojas Castro, Coalition PLUS [Pantin, France] (Community Research Laboratory Pantin), Groupe de Recherche en Psychologie Sociale (GRePS), Université Lumière - Lyon 2 (UL2), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des sciences de la santé publique [Marseille] (ISSPAM), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Plus [Rome, Italy], Soa Aids Nederland [Amsterdam, The Netherlands], Deutsche AIDS-Hilfe E.V. [Berlin, Germany], Universidad Autónoma de Madrid (UAM), Projecte dels NOMS - Hispanosida, NAM [London, UK], Services de Maladies Infectieuses et Tropicales [CHU Bichat], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Grupo de Ativistas em Tratamentos [Lisbon, Portugal] (GAT), Universidade Nova de Lisboa = NOVA University Lisbon (NOVA), Fondazione LILA Milano [Milan, Italy] (FLM), University of Amsterdam [Amsterdam] (UvA), Romanian Association Against AIDS [Bucharest, Romania] (ARAS), AIDES [Pantin, France] (Mission Innovation Recherche Expérimentation), Maastricht University [Maastricht], Klinische Psychologie (Psychologie, FMG), RS: FPN WSP II, and Section Applied Social Psychology
Subjects: Male, MESH: Sexual Behavior, Anti-HIV Agents, Sexual Behavior, [SDV]Life Sciences [q-bio], HIV prevention, HIV Infections, BEHAVIORS, Condoms, MESH: Homosexuality, Male, Sexual and Gender Minorities, MESH: Condoms, Arts and Humanities (miscellaneous), Community-based research, PREVENTION TASP, Humans, MESH: Sexual Partners, MSM, Homosexuality, Male, MESH: Anti-HIV Agents, General Psychology, POSTEXPOSURE PROPHYLAXIS, MESH: Humans, MESH: HIV Infections, PrEP, MESH: Male, Europe, MESH: Sexual and Gender Minorities, GAY, Sexual Partners, ACCEPTABILITY, MESH: Risk Reduction Behavior, PATTERNS, Sexual orientation, MESH: Europe, Risk Reduction Behavior, PREEXPOSURE PROPHYLAXIS
Abstract: International audience; Combination HIV prevention covers a range of biomedical, behavioral, and socio-structural interventions. Despite the growing availability of pre-exposure prophylaxis (PrEP), it is not always accessible in European Centre for Disease Prevention and Control reporting countries and may not meet the needs of all at-risk populations. Based on the Flash! PrEP in Europe data, multiple correspondence analysis and hierarchical clustering were used to identify patterns in HIV prevention strategies among 9980 men who have sex with men (MSM). PrEP interest was evaluated among four identified clusters: (A) "high condom use, sometimes Treatment as Prevention (TasP)"; (B) "mix of methods, infrequent condom use"; (C) "high condom use, tendency to choose partners based on serological status" and (D) "moderate use of condoms mixed with other prevention strategies". Clusters B and D had higher PrEP interest. These results suggest that MSM use a range of behavioral and biomedical risk reduction strategies that are often combined. On-demand PrEP may meet the needs of MSM who infrequently use condoms and other prevention methods.
Published: 2022
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26. Increased Uptake of HCV Testing through a Community-Based Educational Intervention in Difficult-to-Reach People Who Inject Drugs: Results from the ANRS-AERLI Study.

Author: Perrine Roux, Daniela Rojas Castro, Khadim Ndiaye, Marie Debrus, Camélia Protopopescu, Jean-Marie Le Gall, Aurélie Haas, Marion Mora, Bruno Spire, Marie Suzan-Monti, and Patrizia Carrieri
Subjects: Medicine, Science
Abstract: AIMS:The community-based AERLI intervention provided training and education to people who inject drugs (PWID) about HIV and HCV transmission risk reduction, with a focus on drug injecting practices, other injection-related complications, and access to HIV and HCV testing and care. We hypothesized that in such a population where HCV prevalence is very high and where few know their HCV serostatus, AERLI would lead to increased HCV testing. METHODS:The national multisite intervention study ANRS-AERLI consisted in assessing the impact of an injection-centered face-to-face educational session offered in volunteer harm reduction (HR) centers ("with intervention") compared with standard HR centers ("without intervention"). The study included 271 PWID interviewed on three occasions: enrolment, 6 and 12 months. Participants in the intervention group received at least one face-to-face educational session during the first 6 months. MEASUREMENTS:The primary outcome of this analysis was reporting to have been tested for HCV during the previous 6 months. Statistical analyses used a two-step Heckman approach to account for bias arising from the non-randomized clustering design. This approach identified factors associated with HCV testing during the previous 6 months. FINDINGS:Of the 271 participants, 127 and 144 were enrolled in the control and intervention groups, respectively. Of the latter, 113 received at least one educational session. For the present analysis, we selected 114 and 88 participants eligible for HCV testing in the control and intervention groups, respectively. In the intervention group, 44% of participants reported having being tested for HCV during the previous 6 months at enrolment and 85% at 6 months or 12 months. In the control group, these percentages were 51% at enrolment and 78% at 12 months. Multivariable analyses showed that participants who received at least one educational session during follow-up were more likely to report HCV testing, compared with those who did not receive any intervention (95%[CI] = 4.13[1.03;16.60]). CONCLUSION:The educational intervention AERLI had already shown efficiency in reducing HCV at-risk practices and associated cutaneous complications and also seems to have a positive impact in increasing HCV testing in PWID.
Published: 2016
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27. Impact of the COVID-19 Health Crisis on Trans Women and Cis Men Sex Workers in Spain

Author: Juan M. Leyva-Moral, Juliana Castro Ávila, Marta Villar, Beti López, Héctor Adell, Mercè Meroño, Kevin Santander, Laia Ferrer, Jocelyn Mesías-Gazmuri, Rocío Astudillo Alonso, Daniela Rojas Castro, Jordi Casabona, and Cinta Folch
Subjects: Trans women, Arts and Humanities (miscellaneous), Qualitative research, Transgender, COVID-19, Determinants of health, Sex work, General Psychology
Abstract: The objective of the study was to describe the impact of the COVID-19 pandemic on sex workers in accessing health and social services. A qualitative study was conducted using semi-structured interviews with 29 participants in Barcelona, Spain. Data were analyzed using thematic analysis. Four themes were identified: (1) impact of COVID-19 on physical/mental health, (2) barriers and facilitators to health/social service access, (3) health decision-making, and (4) suggestions for future pandemic situations. Barriers to accessing health services were structural. Non-governmental organization support was the main facilitating factor. A person-centered, intersectional approach is suggested for future practice, considering co-occurring syndemic factors.
Published: 2022

28. A syndemic examination of injecting drug use, incarceration and multiple drug-related harms in French opioid users

Author: Salim Mezaache, Laélia Briand-Madrid, Virginie Laporte, Daniela Rojas Castro, Patrizia Carrieri, Perrine Roux, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des sciences de la santé publique [Marseille] (ISSPAM), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), AIDES [Pantin, France], Coalition PLUS [Pantin, France], and Malbec, Odile
Subjects: [SDV]Life Sciences [q-bio], Prison, HIV, HIV Infections, Health Professions (miscellaneous), Syndemic, Analgesics, Opioid, [SDV] Life Sciences [q-bio], Cross-Sectional Studies, Pharmaceutical Preparations, Bacterial infections, Injection drug use, HCV, Overdoses, Humans, Substance Abuse, Intravenous
Abstract: Purpose People who inject drugs (PWID) face multiple health problems, including infectious diseases and drug overdoses. Applying syndemic and risk environment frameworks, this paper aims to examine the co-occurrence and clustering of drug-related harms and their association with incarceration experience with or without in-prison drug injection. Design/methodology/approach The authors used data from a cross-sectional survey conducted in 2015 among 557 active opioid injectors. Self-reported data were collected through face-to-face or online questionnaires. They distinguished three harm categories, namely, viral infections, bacterial infections and overdoses, and built an index variable by summing the number of harm categories experienced, yielding a score from 0 to 3. Association between incarceration experience and co-occurrence of harms was modelled using a multinomial logistic regression. Findings Of the 557 participants, 30% reported lifetime experience of drug-related viral infection, 46% bacterial infection and 22% drug overdose. Multinomial logistic models showed that those who injected drugs during incarceration were more likely to report two (aOR = 2.35, 95% CI: 1.03–5.36) and three (aOR = 9.72, 95% CI: 3.23–29.22) harm categories than those who had never been incarcerated. They were also more likely to report three harm categories than formerly incarcerated respondents who did not inject drugs in prison (aOR = 5.14, 95% CI: 1.71–15.48). Originality/value This study provides insights of the syndemic nature of drug-related harms and highlights that drug injection during incarceration is associated with co-occurring harms. Public health interventions and policy changes are needed to limit the deleterious impact of prison on PWID.
Published: 2021
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29. Daily and on-demand HIV pre-exposure prophylaxis with emtricitabine and tenofovir disoproxil (ANRS PREVENIR): a prospective observational cohort study

Author: Jean-Michel Molina, Jade Ghosn, Lambert Assoumou, Constance Delaugerre, Michèle Algarte-Genin, Gilles Pialoux, Christine Katlama, Laurence Slama, Geoffroy Liegeon, Lydie Beniguel, Michel Ohayon, Hanane Mouhim, Lauriane Goldwirt, Bruno Spire, Bénédicte Loze, Laure Surgers, Juliette Pavie, Jérémy Lourenco, Mohamed Ben-Mechlia, Soizic Le Mestre, Daniela Rojas-Castro, Dominique Costagliola, Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Génomes, biologie cellulaire et thérapeutiques (GenCellDi (U944 / UMR7212)), Collège de France (CdF (institution))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Pitié-Salpêtrière [AP-HP], Hôtel-Dieu, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Saint-Antoine [AP-HP], Centre d'infectiologie Necker-Pasteur [CHU Necker], Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), ANRS France Recherche Nord & sud Sida-hiv hépatites, and AIDES [Pantin, France]
Subjects: Adult, Male, Adolescent, Epidemiology, Anti-HIV Agents, [SDV]Life Sciences [q-bio], Immunology, HIV Infections, Medication Adherence, MESH: HIV-1, MESH: Homosexuality, Male, Sexual and Gender Minorities, MESH: Tenofovir, Virology, MESH: Emtricitabine, Emtricitabine, Humans, Prospective Studies, MESH: Anti-HIV Agents, Homosexuality, Male, Tenofovir, MESH: Adolescent, MESH: Humans, MESH: Adult, MESH: HIV Infections, MESH: Medication Adherence, MESH: Prospective Studies, MESH: Male, MESH: Sexual and Gender Minorities, Infectious Diseases, HIV-1, Female, Pre-Exposure Prophylaxis, MESH: Female, MESH: Pre-Exposure Prophylaxis
Abstract: International audience; BackgroundThere are few data available regarding the use of on-demand pre-exposure prophylaxis (PrEP) for HIV prevention. We aimed to assess PrEP effectiveness, adherence, and safety in adults using daily or on-demand PrEP.MethodsWe conducted a prospective observational cohort study (ANRS PREVENIR) at 26 sites in the Paris region, France. We enrolled HIV-negative adults (aged ≥18 years) at high risk of HIV infection who were starting or continuing PrEP. PrEP was prescribed as a fixed-dose combination of tenofovir disoproxil and emtricitabine (245 mg and 200 mg, respectively, per pill). PrEP could be prescribed as a daily regimen with one pill per day or, in men who have sex with men (MSM) or in transgender women who have sex with men, as an on-demand regimen following the IPERGAY dosing recommendation. At enrolment and every 3 months thereafter, participants were tested for HIV and provided information regarding the PrEP dosing regimen used. Adherence to PrEP was assessed by self-report and by tenofovir diphosphate concentrations in dried blood spots. The primary outcome of HIV-1 incidence was assessed using Poisson regression among participants who started PrEP. This study is registered with ClinicalTrials.gov, NCT03113123, and EudraCT, 2016A0157744.FindingsBetween May 3, 2017, and May 2, 2019, 3082 people were assessed for eligibility and 3065 participants were enrolled. 3056 (99·7%) of 3065 participants reported using PrEP and were included in the analyses. The median age was 36 years (IQR 29–43), 1344 (44·0%) of 3056 participants were PrEP-naive, and 3016 (98·7%) were MSM. At enrolment, 1540 (50·5%) of 3049 participants opted for daily PrEP dosing and 1509 (49·5%) opted for on-demand PrEP dosing; these proportions remained stable during follow-up. Median follow-up was 22·1 months (IQR 15·9–29·7) and incidence of study discontinuation was 17·6 participants (95% CI 16·5–18·7) per 100 person-years. At the data cutoff on Sept 30, 2020, there had been six HIV-1 seroconversions (three participants using daily PrEP and three using on-demand PrEP; all were MSM) over 5623 person-years. Overall HIV-1 incidence was 1·1 cases (95% CI 0·4–2·3) per 1000 person-years, and did not differ between participants using daily PrEP and those using on-demand PrEP (incidence rate ratio 1·00, 95% CI 0·13–7·49; p=0·99). Four participants (two using daily PrEP and two using on-demand PrEP) discontinued PrEP due to treatment-related adverse events (nausea [n=2], vomiting and diarrhoea [n=1], and lumbar pain [n=1]).InterpretationIn this study, which enrolled mainly MSM, HIV-1 incidence on PrEP was low and did not differ between participants using daily PrEP and those using on-demand PrEP. On-demand PrEP therefore represents a valid alternative to daily PrEP for MSM, providing greater choice in HIV prevention.FundingANRS/Maladies Infectieuses Emergentes, Gilead Sciences, SIDACTION, and Région Ile de France.TranslationFor the French translation of the abstract see Supplementary Materials section.; ANRS/Maladies Infectieuses Emergentes, Gilead Sciences, SIDACTION, and Région Ile de France.
Published: 2021
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30. Can we talk about price with patients when choosing antiretroviral therapy? A survey with people living with HIV and prescribers in France

Author: Philippe Morlat, Cécile Goujard, Nikos Kalampalikis, Gilles Peytavin, Elisabeth Bouvet, Emmanuelle Papot, Marjolaine Doumergue, Fabrice Pilorgé, Guillemette Quatremère, Philippe Arnaud, Claire Auger, Franck Barbier, Gaele Bruneaux, Katia Bourdic, Agnès Certain, Charlotte Charpentier, Véronique Doré, Sophia Guessous, Anne-Claire Haye, Roland Landman, Sylvie LeGac, Françoise Louni, Dorothée Obach, Laurence Pochat, Daniela Rojas Castro, and Patrick Yéni
Subjects: Medicine
Published: 2021

31. Impact of the early 2020 COVID-19 crisis and lockdown on PrEP use among men who have sex with men (MSM) in France

Author: Marion Di Ciaccio, Virginie Villes, David Michels, Stéphane Morel, Rosemary M Delabre, Daniela Rojas Castro, and Annie Velter
Subjects: Male, Sexual and Gender Minorities, Psychotropic Drugs, Infectious Diseases, Cross-Sectional Studies, Sexual Behavior, Communicable Disease Control, Humans, COVID-19, HIV Infections, Pre-Exposure Prophylaxis, Dermatology, Homosexuality, Male
Abstract: ObjectiveTo describe changes in pre-exposure prophylaxis (PrEP) use during and following the COVID-19 lockdown in France (March–May 2020) and identify the factors associated with PrEP discontinuation among men who have sex with men (MSM) after the lockdown.MethodsData from the, an anonymous, cross-sectional internet survey among MSM in July 2020, were analysed. Among respondents who were using PrEP prior to the lockdown, a binary logistic regression model was used to compare participants who were still taking PrEP (current PrEP users) with those who were not taking PrEP at the time of the survey (former PrEP users).ResultsAmong 8345 respondents, 946 were PrEP users before the lockdown, of whom 58.8% (n=556) reported stopping PrEP during the lockdown and 15.4% (n=146) were not using PrEP at the time of the survey. Among the 556 who stopped PrEP during lockdown, 86.5% (n=481) reported no sexual activity; 76.8% (n=427) restarted PrEP after lockdown. Former PrEP users were more likely to be younger, not living with a stable male sexual partner, report moderate anxiety, report increased psychoactive drug use during the lockdown, and report not having tested for HIV or STI since the end of the lockdown because they did not know where to go, preferred to wait or for another reason. Reporting fewer male sexual partners in the last 6 months was also significantly associated with being a former PrEP user.ConclusionsMSM adapted PrEP use to their sexual activity during and after the French lockdown. After the lockdown, discontinued PrEP occurred more often among MSM who had fewer sexual partners and had mental health vulnerabilities. These factors could also be predictive of PrEP discontinuation in a more general context. PrEP users should be informed on how to safely stop/start PrEP and on the use of other prevention tools to reduce potential risk exposure during PrEP discontinuation.
Published: 2021

32. Becoming adherent to a preventive treatment for HIV: a qualitative approach

Author: Claire Pintado, Eric Cua, Julie Chas, Costanza Puppo, Bruno Spire, Marie Suzan-Monti, Vanessa Laguette, Jean-Michel Molina, Xavier Mabire, Daniela Rojas Castro, Marie Préau, Stéphane Morel, Hôpital l'Archet, Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Groupe de Recherche en Psychologie Sociale (GRePS), Université Lumière - Lyon 2 (UL2), AIDES Association [France], Centre de Recherche en Psychologie : Cognition, Psychisme et Organisations - UR UPJV 7273 (CRP-CPO), Université de Picardie Jules Verne (UPJV), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Coalition PLUS [Pantin, France], CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Universitaire de Nice (CHU Nice), Service de maladies infectieuses et tropicales [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], ANRS (France Recherche Nord & Sud Sida-HIV Hépatites) and funded by the ANRS and the Fonds de dotation Pierre Bergé pour la Prévention – SIDACTION, Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], and HAL AMU, Administrateur
Subjects: Adult, Male, medicine.medical_specialty, Anti-HIV Agents, Human immunodeficiency virus (HIV), HIV Infections, coping strategies, medicine.disease_cause, Medication Adherence, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, prevention, stigmatization, On demand, medicine, Humans, adherence, 030212 general & internal medicine, PrEP intake, Qualitative Research, ComputingMilieux_MISCELLANEOUS, Applied Psychology, 030505 public health, business.industry, HIV, Focus Groups, 3. Good health, Clinical trial, Psychiatry and Mental health, Clinical Psychology, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Family medicine, Pre-Exposure Prophylaxis, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 0305 other medical science, business, qualitative methods, Qualitative research
Abstract: The clinical trial ANRS-IPERGAY investigated the efficacy of sexual activity-based (i.e. on demand) HIV pre-exposure prophylaxis (PrEP). Using a qualitative method, we analysed the role of adherence as one of the main elements for PrEP effectiveness and its associated determinants. Data were collected in various French ANRS-IPERGAY sites during the double-blind (2012-2014) and open-label study (2015-2016) phases, through two individual interviews per participant, collective interviews and focus groups. A total of 83 participants participated in the present study. Our analysis included 32 individual interviews (with 16 participants), 13 collective interviews (
Published: 2019
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33. Low Seroprevalence of Hepatitis C Among Men Who Have Sex With Men in West Africa

Author: Mahamadou Diarra, Oumar Cissé, Mamadou Ouedraogo, Niamkey Thomas Aka, Kossi Jeff Yaka, Ter Tiero Elias Dah, Stéphane-Alain Babo Yoro, Honoré Comsiambo, Martine Peeters, Kpassou Julien Lokrou, Daniela Rojas Castro, Bréhima Abdrahamane Ouary, Cyril Berenger, Kokou Dominique Tegueni, Michel Bourrelly, Frédéric Dibi N’guessan, Bintou Dembélé Keita, Ousseni Ilboudo, Adama Cissé, Naboh Sangaré, Aly Ouologuem, Fodié Diallo, Marion Mora, Aléda Mawuli Badjassim, Julien Bimba, Kouakou Kokouvi Selom Agbomadji, Ibrahima Kanta, Gwenvael Le Guicher, Camille Rajaonarivelo, Camille Anoma, Laetitia Serrano, Messan Attiogbe, Luis Sagaon-Teyssier, Alassane Kader Maïga, Clotilde Couderc, Gwenaëlle Maradan, Abdoulazziz Traoré, Issifou Yaya, Bruno Granouillac, Drissa Camara, Anani Attisso, Alou Coulibaly, Jean Armel Ekessi Koffi, Phyllis Amivi Ehlan, Claver Anoumou Yaotsè Dagnra, Anouwarsadat Kokouba, Sayouba Ouedraogo, Malan Jean-Baptiste Kouamé, Ochoh Rachelle Kotchi, Joseph Ouedraogo, Agbégnigan Lorette Ekon, Fodé Traoré, Christian Coulibaly, Abdoul Aziz Keita, Richard Mawuényégan Kouamivi Agboyibor, Ephrem Mensah, Lucas Riegel, Mohamed Mimi, Paméla Palvadeau, Noufo Hamed Coulibaly, Christian Laurent, Fayçal Rodrique Ouedraogo, Issa Traoré, Bruno Spire, Sylvie Boyer, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), ARCAD Santé PLUS [Bamako, Mali], Espace Confiance [Abidjan, Côte d’Ivoire], Association African Solidarité [Ouagadougou, Burkina Faso], Centre Muraz [Bobo-Dioulasso, Burkina Faso], Espoir Vie Togo [Lomé, Togo], Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), CohMSM Study Group: Christian Laurent, Issifou Yaya, Sayouba Ouedraogo, Bruno Granouillac, Gwenvael Le Guicher, Laetitia Serrano, Martine Peeters, Clotilde Couderc, Bruno Spire, Luis Sagaon-Teyssier, Marion Mora, Gwenaëlle Maradan, Michel Bourrelly, Mohamed Mimi, Cyril Berenger, Sylvie Boyer, Daniela Rojas Castro, Lucas Riegel, Paméla Palvadeau, Bintou Dembélé Keita, Fodié Diallo, Alou Coulibaly, Alassane Kader Maïga, Drissa Camara, Mahamadou Diarra, Aly Ouologuem, Naboh Sangaré, Abdoul Aziz Keita, Oumar Cissé, Fodé Traoré, Bréhima Abdrahamane Ouary, Ibrahima Kanta, Camille Anoma, Malan Jean-Baptiste Kouamé, Ochoh Rachelle Kotchi, Niamkey Thomas Aka, Kpassou Julien Lokrou, Noufo Hamed Coulibaly, Jean Armel Ekessi Koffi, Frédéric Dibi N'guessan, Stéphane-Alain Babo Yoro, Adama Cissé, Ter Tiero Elias Dah, Issa Traoré, Camille Rajaonarivelo, Fayçal Rodrique Ouedraogo, Joseph Ouedraogo, Christian Coulibaly, Mamadou Ouedraogo, Ousseni Ilboudo, Abdoulazziz Traoré, Honoré Comsiambo, Ephrem Mensah, Richard Mawuényégan Kouamivi Agboyibor, Anani Attisso, Anouwarsadat Kokouba, Aléda Mawuli Badjassim, Kouakou Kokouvi Selom Agbomadji, Messan Attiogbe, Kossi Jeff Yaka, Agbégnigan Lorette Ekon, Julien Bimba, Claver Anoumou Yaotsè Dagnra, Phyllis Amivi Ehlan, Kokou Dominique Tegueni, Malbec, Odile, and Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI)
Subjects: Male, Microbiology (medical), [SDV]Life Sciences [q-bio], MEDLINE, West africa, Men who have sex with men, MESH: Homosexuality, Male, Sexual and Gender Minorities, Seroepidemiologic Studies, MESH: Africa, Western, medicine, Humans, Seroprevalence, Homosexuality, Male, Online Only Articles, ComputingMilieux_MISCELLANEOUS, MESH: Hepatitis C, MESH: Humans, MESH: Seroepidemiologic Studies, business.industry, virus diseases, Hepatitis C, medicine.disease, MESH: Male, MESH: Sexual and Gender Minorities, [SDV] Life Sciences [q-bio], Africa, Western, Infectious Diseases, business, Demography
Abstract: BACKGROUND: Sexual transmission of hepatitis C virus (HCV) is uncommon, yet documented among men who have sex with men (MSM), primarily among those with human immunodeficiency virus (HIV). METHODS: In the HIV Prevention Trials Network 078 study (HPTN 078), which assessed an integrated strategy to achieve HIV viral suppression, 1305 MSM were screened across 4 geographically diverse US cities. At screening, demographic/behavioral/psychosocial questionnaires were completed, along with HIV and HCV testing. Multivariable logistic regression was used to evaluate associations with HCV antibody positivity. RESULTS: Among the 1287 (99%) of the MSM with HCV antibody results, the median age was 41, 69% were black, 85% had a high school education or more, 35% were employed, 70% had HIV, and 21% had undergone substance use counseling. The median lifetime number of male sexual partners was 17 (interquartile range, 6–50), and 246 (19%) were HCV antibody positive. HCV antibody positivity was high in MSM with HIV (20%) and MSM without HIV (17%) (P = .12) and was higher in those receiving substance use counseling (36%) than in those who had not (15%) (P ≤ .01). Substance use counseling (odds ratio, 2.51; 95% confidence interval, 1.80–3.51) and unstable housing (2.16; 1.40–3.33) were associated with HCV antibody positivity. CONCLUSIONS: Nearly 1 in 5 MSM screened for HPTN 078 have been infected with HCV. The prevalence is high regardless of HIV status and is high even in those who did not undergo substance use counseling. In HIV burden networks, high HCV infection prevalence may occur in MSM without HIV. As implementation of preexposure prophylaxis expands and condom use declines, routine HCV counseling and screening among MSM are important.
Published: 2021
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34. Impact of HIV risk perception on both pre-exposure prophylaxis and condom use

Author: Claire Pintado, Mohamed Mimi, Laurence Meyer, Bruno Spire, Jean-Michel Molina, Daniela Rojas Castro, Luis Sagaon-Teyssier, Marie Suzan-Monti, Christel Protière, Marie Préau, Marion Di Ciaccio, Gilles Pialoux, Groupe de Recherche en Psychologie Sociale (GRePS), Université Lumière - Lyon 2 (UL2), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de maladies infectieuses et tropicales [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service des maladies infectieuses et tropicales [CHU Tenon], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], HAL AMU, Administrateur, Service de Maladies infectieuses et tropicales [CHU Tenon], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Male, media_common.quotation_subject, Human immunodeficiency virus (HIV), men who have sex with men, HIV Infections, condom use, medicine.disease_cause, Hiv risk, law.invention, Men who have sex with men, Condoms, Sexual and Gender Minorities, 03 medical and health sciences, Pre-exposure prophylaxis, 0302 clinical medicine, Condom, law, risk perception, Perception, medicine, Humans, trajectories, adherence, 030212 general & internal medicine, Homosexuality, Male, pre-exposure prophylaxis, Applied Psychology, Reproductive health, media_common, 030505 public health, business.industry, HIV, Risk perception, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, pre-exposure prophylaxis adherence, Pre-Exposure Prophylaxis, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 0305 other medical science, business, Demography
Abstract: Risk perception is one of the several important factors impacting sexual health behaviours. This study investigated the evolution of HIV risk perception on pre-exposure prophylaxis adherence and condom use in men who have sex with men at high risk of HIV and associated factors. Group-based trajectory modelling helped in identifying patterns of risk perception, pre-exposure prophylaxis adherence and condom use over time. The association between the former and the latter two dimensions was then investigated. An estimated 61 per cent ( p
Published: 2021
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35. 'Yes, I'm interested in taking PrEP!': PrEP interest among women respondents to the European community-based survey 'Flash! PrEP in Europe'

Author: Daniela Rojas Castro, Flor Sánchez, Antoine Vilotitch, Cary James, Coline Mey, Kai J. Jonas, Vincent Schlegel, Rosemary M. Delabre, Sascha B. Duken, Sophocles Chanos, Harriet Langanke, Adeline Bernier, Richard Stranz, Bruno Spire, Maria Luisa Cosmaro, Coalition PLUS [Pantin, France], Universidad Autónoma de Madrid (UAM), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Ath & Thess Checkpoints [Athens, Greece] (ATC), Fondazione LILA Milano [Milan, Italy] (FLM), Gemeinnützige Stiftung Sexualität und Gesundheit [Cologne, Germany] (GSSG), AIDES [Pantin, France], Terrence Higgins Trust [London, UK] (THT), University of Amsterdam [Amsterdam] (UvA), Maastricht University [Maastricht], Malbec, Odile, RS: FPN WSP II, Section Applied Social Psychology, UAM. Departamento de Psicología Social y Metodología, Klinische Psychologie (Psychologie, FMG), and Psychology Other Research (FMG)
Subjects: RNA viruses, Health Knowledge, Attitudes, Practice, US WOMEN, Younger age, Epidemiology, [SDV]Life Sciences [q-bio], Human immunodeficiency virus (HIV), HIV Infections, Surveys, medicine.disease_cause, Logistic regression, Pathology and Laboratory Medicine, Geographical Locations, Pre-exposure prophylaxis, Immunodeficiency Viruses, INFECTION, Medicine and Health Sciences, Public and Occupational Health, Multidisciplinary, ANTIRETROVIRAL PROPHYLAXIS, ORAL PREEXPOSURE PROPHYLAXIS, HIV diagnosis and management, MEN, Europe, [SDV] Life Sciences [q-bio], Medical Microbiology, Research Design, Viral Pathogens, Viruses, Infectious diseases, Medicine, Female, women, Pathogens, GENDER-BASED VIOLENCE, Research Article, Adult, Medical conditions, European community, Adolescent, TRANSMISSION, Science, Viral diseases, Hiv risk, Research and Analysis Methods, Microbiology, World health, Young Adult, Retroviruses, medicine, RISK SCORING TOOL, Humans, survey, European Union, FEMALE SEX WORKERS, Microbial Pathogens, pre-exposure prophylaxis, PERCEPTION, Survey Research, business.industry, Prophylaxis, Lentivirus, Organisms, Biology and Life Sciences, HIV, HIV PREVENTION, Patient Acceptance of Health Care, HIV infection, Health Surveys, PREVENTION, Diagnostic medicine, Sexual abuse, Medical Risk Factors, People and Places, Pre-Exposure Prophylaxis, Preventive Medicine, business, Sociología, HIV PREEXPOSURE PROPHYLAXIS, Demography
Abstract: The World Health Organization recommends pre-exposure prophylaxis (PrEP) for all populations at substantial risk of HIV infection, including women. However, data regarding PrEP interest among women is lacking, particularly in Europe. Factors associated with interest in using PrEP were assessed among women respondents to the Flash! PrEP in Europe (FPIE) survey. This community-based cross-sectional study, conducted in 12 European countries, aimed to assess PrEP knowledge and interest. “High objective risk” (HOR) was assessed using established risk criteria following EACS and CDC guidelines. Factors associated with interest in using PrEP were assessed in univariable and multivariable logistic regression models. Among 678 women, 12.5% (n = 85) were considered at HOR, 46.8% (n = 317) indicated prior PrEP knowledge and 18.0% (n = 122) reported interest in using PrEP. Among women at HOR, 40.0% (n = 34) were interested in PrEP. Factors significantly associated with PrEP interest in the final multivariable model were: younger age (18–29 years) (aOR 1.91[95CI: 1.07; 3.41]), bad self-perceived financial status (1.84[1.09; 3.11]), migrant status (south to north) (2.87[1.05; 7.89]), single or dating relationship status (1.93[1.23; 3.03]), sexual abuse history (1.86[1.17; 2.97]), “rather high”/ “high” self-perceived HIV risk (3.21[1.32; 7.81]), and HOR (2.49[1.42; 4.35]). These results show that women at HOR and those who perceived themselves to be at high risk are interested in using PrEP. There is a critical need for targeted information and improved access to PrEP to increase uptake of this HIV prevention tool to meet PrEP interest among women, KJJ received a grant from Dutch AIDS Fonds (Grant P-11302)
Published: 2021
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36. Homonegativity, sexual violence and condom use with women in men who have sex with men and women in West Africa (CohMSM)

Author: Bintou Dembélé Keita, Lucas Riegel, Michel Bourrelly, Luis Sagaon-Teyssier, Clotilde Couderc, August Eubanks, Issifou Yaya, Pierre-Julien Coulaud, Marion Fiorentino, Ephrem Mensah, Christian Laurent, Gwenaëlle Maradan, Elias Ter Tiero Dah, Bruno Spire, Daniela Rojas-Castro, Camille Anoma, Dupuis, Christine, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), ARCAD-SIDA [Bamako, Mali], Espace Confiance [Abidjan, Côte d’Ivoire], Association African Solidarité [Ouagadougou, Burkina Faso], Centre Muraz [Bobo-Dioulasso, Burkina Faso], Espoir Vie Togo [Lomé, Togo], Coalition PLUS [Pantin, France] (Community Research Laboratory Pantin), CohMSM Study Group, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), and Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1)
Subjects: Male, 0301 basic medicine, MESH: Sexual Behavior, [SDV]Life Sciences [q-bio], HIV Infections, West africa, law.invention, Men who have sex with men, Condoms, Sexual and Gender Minorities, 0302 clinical medicine, 5. Gender equality, law, Immunology and Allergy, Medicine, MESH: Sexual Partners, 030212 general & internal medicine, Sexual violence, MESH: HIV Infections, 3. Good health, [SDV] Life Sciences [q-bio], MESH: Sexual and Gender Minorities, Sexual Partners, Infectious Diseases, Sexual behavior, Togo, Cohort, Female, France, Design support, Psychosocial, MESH: Sex Offenses, MESH: Cote d'Ivoire, Sexual Behavior, Immunology, MESH: Homosexuality, Male, 03 medical and health sciences, MESH: Condoms, Condom, Burkina Faso, Humans, MESH: Burkina Faso, Homosexuality, Male, MESH: Humans, business.industry, Sex Offenses, MESH: Male, MESH: France, Cote d'Ivoire, 030104 developmental biology, MESH: Togo, business, MESH: Female, Demography
Abstract: International audience; Objective: The study aimed to explore longitudinal interactions between homonegativity and sexual behaviors with female partners among HIV-negative West African men who have sex with men and women (MSMW).Design and method: The community-based cohort CohMSM ANRS 12324 - Expertise France enrolled MSM in Togo, Burkina Faso, Côte d'Ivoire and Mali. Sociobehavioral data were collected every 6 months. Using 30-month follow-up data, a multiprobit analysis was performed to investigate the relationship between psychosocial and behavioral variables ex-ante (t - 1) and ex-post (t).Results: MSMW (n = 326) accounted for half of all participants in CohMSM. They reported inconsistent condom use with women in 39% of visits. Perceived and internalized homonegativity at t - 1 tended to lead to sexual violence toward women at t (P < 0.1), which was associated with inconsistent condom use with them at t (P < 0.05).Conclusion: Given the high HIV prevalence in West African MSM, widespread condom-less sex with women in MSMW, and the aggravating effect of social and internalized homonegativity, more research in the MSMW subpopulation is needed to assess the risk of HIV bridging to women and to design support activities.
Published: 2021
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37. Assessment of mental health outcomes and associated factors among workers in community-based HIV care centers in the early stage of the COVID-19 outbreak in Mali

Author: Bintou Dembélé Keita, Gwenaëlle Maradan, Michel Bourrelly, Luis Sagaon-Teyssier, Aliou Kamissoko, Mamadou Cisse, Fabrice Pouradier, Fodié Diallo, Rosemary M. Delabre, Bruno Spire, Adam Yattassaye, Laurent Vidal, Daniela Rojas Castro, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), ARCAD Santé PLUS [Bamako, Mali], Coalition PLUS [Pantin, France] (Community Research Laboratory Pantin), Hôpital Simone Veil [Eaubonne], Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), and Dupuis, Christine
Subjects: medicine.medical_specialty, [SDV]Life Sciences [q-bio], education, MEDLINE, Mali, Article, 03 medical and health sciences, 0302 clinical medicine, Health care, Medicine, Healthcare workers, 030212 general & internal medicine, Health policy, Depression (differential diagnoses), business.industry, Public health, Outbreak, COVID-19, HIV, Mental health, 3. Good health, [SDV] Life Sciences [q-bio], Family medicine, Anxiety, medicine.symptom, Public aspects of medicine, RA1-1270, business, 030217 neurology & neurosurgery
Abstract: International audience; Background and objectives: In Mali, the non-governmental association (NGO) ARCAD Santé PLUS launched the CovidPrev program in response to the COVID-19 outbreak to ensure continuity of HIV care-related activities. This study aimed to identify individual and structural factors associated with mental health disorders (MHD) in the NGO's healthcare workers (HCW) in the early stage of the outbreak.Methods: Data were collected between April 6 and 11, 2020 for 135 HCW in ARCAD Santé PLUS's 18 community-based HIV care centers. Outcomes corresponded to the PHQ-9, GAD-7 and ISI instruments for depression, anxiety and insomnia, respectively. A general mixture model with a negative binomial distribution was implemented.Results: Most HCW were men (60.7%) and median age was 40 years IQR[33-46]. Symptoms of depression, anxiety and insomnia were declared by 71.9, 73.3, and 77% participants, respectively. Women were at greater risk of MHD. A lack of personal protection equipment and human resources, especially nurses, was associated with a high risk of MHD.Conclusions: Health policy must place non-front line HCW, including those in NGOs, at the core of the healthcare system response to the COVID-19 outbreak, as they ensure continuity of care for many diseases including HIV. The efficacy of public health strategies depends on the capacity of HCW to fully with and competently perform their duties.
Published: 2020
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38. Changes in Sexual Behaviors in Men Who Have Sex with Men: A Comparison Between the Double-Blind and Open-Label Extension Phases of the ANRS-IPERGAY Trial

Author: Cécile Tremblay, Marie Suzan-Monti, Christian Chidiac, Jean-Michel Molina, Daniela Rojas Castro, Christel Protière, Mohamed Mimi, Laurence Meyer, Bruno Spire, Marion Di Ciaccio, Catherine Capitant, Luis Sagaon-Teyssier, Marie Préau, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupe de Recherche en Psychologie Sociale (GRePS), Université Lumière - Lyon 2 (UL2), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), AIDES [Pantin, France], Coalition Internationale Sida [Pantin, France] (Programme Recherche Communautaire), Essais Thérapeutiques et Maladies Infectieuses, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CR CHUM), Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal (UdeM)-Université de Montréal (UdeM), Service de Maladies Infectieuses et Tropicales [Hôpital de la Croix-Rousse - HCL], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service des Maladies Infectieuses et Tropicales [CHU Saint Louis], Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), ANRS IPERGAY Study Group: J-M Molina, C Capitant, B Spire, G Pialoux, L Cotte, I Charreau, C Tremblay, J-M Le Gall, E Cua, A Pasquet, F Raffi, C Pintado, C Chidiac, J Chas, P Charbonneau, C Delaugerre, M Suzan-Monti, B Loze, J Fonsart, G Peytavin, A Cheret, J Timsit, G Girard, N Lorente, M Préau, J F Rooney, M A Wainberg, D Thompson, W Rozenbaum, V Doré, L Marchand, M-C Simon, N Etien, J-P Aboulker, L Meyer, J-F Delfraissy, C Pintado, B Loze, C Delaugerre, P Charbonneau, C Gatey, D Ponscarme, P Penot, L Niedbalski, R Veron, J Delgado, E Dalle, S Parlier, I Madelaine, J Fonsart, M Danet, N Mahjoub, N Mezreb, K Moudachirou, S Morel, G Conort, F Lorho, M Meunier, W Rozenbaum, J M Molina, J Chas, C Monfort, J Foucoin, B Boissavy, S Cousseau, S Huon, M Danet, A Djessima, V Berrebi, A Adda, S le Nagat, L Zarka, J Berdougo, G Pialoux, C Chidiac, N Mzoughi, F Clement, A Decouty, C Chapolard, M Godinot, C Adouard-Groslafeige, J Koffi, A Pansu, A Becker, S Pailhes, F Bonnet, F Jeanblanc, C Brochier, X Teruin, S Rouby, L Gilly, L Cotte, C Beauvais, P Arlotto, C Fortin, A Talbot, A Chamberland, A McKenzie, M Blanchette, R Rousseau, K Montheuth, D Thompson, M Morin, M Wainberg, C Tremblay, C Etienne, F Tolonin, S Breaud, V Péchenot, S Bagge, T Cepitelli, P M Roger, E Rosenthal, E Cua, A Cheret, P Cornavin, S Vandamme, J Lambec, N Dumon, O Leclanche, T Huleux, R Biekre, O Robineau, H Melliez, H Bazus, A Pasquet, C Bernaud, M Besnier, B Bonnet, N Hall, M Cavellec, H Hue, L Larmet, M Colas, R Choquet, F Raffi, Dupuis, Christine, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Sud - Paris 11 (UP11)
Subjects: Male, Safe Sex, MESH: Sexual Behavior, [SDV]Life Sciences [q-bio], HIV Infections, Gee, law.invention, Men who have sex with men, 0302 clinical medicine, law, Medicine, MESH: Sexual Partners, MESH: Double-Blind Method, 030212 general & internal medicine, MESH: Anti-HIV Agents, Generalized estimating equation, MESH: Middle Aged, MESH: HIV Infections, Middle Aged, PrEP, 3. Good health, [SDV] Life Sciences [q-bio], Sexual Partners, Infectious Diseases, Sexual behavior, MESH: Risk-Taking, MESH: Young Adult, MESH: Risk Reduction Behavior, France, Open label, 0305 other medical science, Adult, Canada, Social Psychology, Anti-HIV Agents, ANRS-IPERGAY trial, Sexual Behavior, MESH: Safe Sex, Double blind, MESH: Homosexuality, Male, Young Adult, 03 medical and health sciences, Risk-Taking, Double-Blind Method, Condom, MESH: Canada, Humans, MSM, Homosexuality, Male, 030505 public health, MESH: Humans, business.industry, Public Health, Environmental and Occupational Health, HIV risk management, MESH: Adult, Odds ratio, MESH: Male, MESH: France, Behaviors, Pre-Exposure Prophylaxis, business, Risk Reduction Behavior, Demography, MESH: Pre-Exposure Prophylaxis
Abstract: International audience; Pre-Exposure Prophylaxis (PrEP) is changing the landscape of HIV prevention, and may bring changes in sexual behaviors. The double-blind phase (DBP) and open-label extension (OLE) study of the ANRS-IPERGAY trial allowed us to assess changes in sexual behavior of men who have sex with men (MSM) taking sexual activity-based (i.e., on-demand) PrEP. Generalized Estimating Equation (GEE) models found a significant decrease in the number of sexual partners (Coefficient [CI95%], p value; - 0.37[- 0.70 to - 0.04], p = 0.03) between the DBP and OLE as well as in the number of sexual relations (- 0.25 [- 0.49 to 0.00], 0.04). GEE estimates also showed that respondents' most recent sexual relation was less likely to have been with an unknown casual partner during the OLE than during the DBP (Odds Ratio [CI95%], p value: 0.75[0.62-0.92], 0.005). Furthermore, they showed an increase in the proportion of condomless anal sex in the OLE (1.32[1.04-1.67], 0.02), a decrease in the proportion of 'suboptimal PrEP adherence' over time (0.75[0.58-0.97], p = 0.03), a decrease in PrEP only use (0.73[0.55-0.96], 0.03) and in both PrEP and condom use over time (0.70[0.51-0.95], 0.02) and finally, a decrease in alcohol consumption between the DBP and OLE (0.74[0.61-0.90], 0.002). We observed both protective and risky behaviors in terms of HIV and STI risk after on-demand PrEP uptake in the OLE phase. Our findings are consistent with results from previous PrEP trials.
Published: 2020
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39. Are PrEP services in France reaching all those exposed to HIV who want to take PrEP? MSM respondents who are eligible but not using PrEP (EMIS 2017)

Author: Stéphane Morel, Annie Velter, David Michels, Virginie Villes, Rosemary M. Delabre, Margot Annequin, Tristan Alain, Axel J. Schmidt, Daniela Rojas Castro, Coalition PLUS [Pantin, France] (Community Research Laboratory Pantin), AIDES [Pantin, France], London School of Hygiene and Tropical Medicine (LSHTM), Santé publique France - French National Public Health Agency [Saint-Maurice, France], Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Dupuis, Christine
Subjects: Male, Health Knowledge, Attitudes, Practice, MESH: Sexual Behavior, Health (social science), pre-exposure prophylaxis (PrEP), [SDV]Life Sciences [q-bio], MESH: Health Knowledge, Attitudes, Practice, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Health Services Accessibility, Condoms, Health insurance system, 0302 clinical medicine, Surveys and Questionnaires, Medicine, 030212 general & internal medicine, MESH: Anti-HIV Agents, MESH: Health Services Accessibility, MESH: Patient Acceptance of Health Care, MESH: HIV Infections, 3. Good health, [SDV] Life Sciences [q-bio], PrEP delivery, France, 0305 other medical science, Adult, medicine.medical_specialty, Social Psychology, Anti-HIV Agents, Sexual Behavior, PrEP access, PrEP eligibility, MESH: Homosexuality, Male, 03 medical and health sciences, MESH: Condoms, MESH: Cross-Sectional Studies, Humans, MSM, Homosexuality, Male, MESH: Surveys and Questionnaires, 030505 public health, MESH: Humans, business.industry, Public Health, Environmental and Occupational Health, MESH: Adult, Patient Acceptance of Health Care, MESH: Male, MESH: France, Cross-Sectional Studies, Family medicine, Pre-Exposure Prophylaxis, business, MESH: Pre-Exposure Prophylaxis
Abstract: International audience; Pre-exposure prophylaxis (PrEP) is fully reimbursed by the French health insurance system since 2016. However, uptake of PrEP is slower than expected and little is known about men who have sex with men (MSM) who are eligible for PrEP according to French guidelines, but not using it. This study aims to (1) assess and describe MSM that are eligible to PrEP but not using it, and (2) identify potential individual and structural barriers of PrEP uptake among eligible MSM who are aware and intend to take PrEP. Data from EMIS-2017, a cross-sectional internet survey among gay, bisexual, and other MSM, were used. Among 7965 respondents without diagnosed HIV, 9.2% were PrEP users. Among 7231 non-PrEP users, 35.2% were eligible to PrEP and 15.2% were eligible, aware and intended to take PrEP. Eligible MSM who are not using PrEP are mostly younger, students, less "out", living in small cities, using condoms more frequently but still with low self-efficacy regarding safe sex and more distant from preventive health care and information than PrEP users. Despite free PrEP availability in France, results suggest that PrEP is not fully accessible and that there is a need to increase PrEP demand and decentralize PrEP delivery.
Published: 2020
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40. Correlates of Self-Reported Cotton Fever Experience among People Who Inject Opioids

Author: Patrizia Carrieri, Salim Mezaache, Daniela Rojas Castro, Laélia Briand-Madrid, Virginie Laporte, Perrine Roux, Marion Mora, Khafil Moudachirou, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), AIDES [Pantin, France], Coalition PLUS [Pantin, France], Groupe de Recherche en Psychologie Sociale (GRePS), Université Lumière - Lyon 2 (UL2), and Dupuis, Christine
Subjects: Pediatrics, medicine.medical_specialty, Health (social science), Fever, [SDV]Life Sciences [q-bio], 030508 substance abuse, Medicine (miscellaneous), cotton fever, Cotton fever, Febrile syndrome, 03 medical and health sciences, 0302 clinical medicine, Medicine, Humans, 030212 general & internal medicine, harm reduction, Crack cocaine, Substance Abuse, Intravenous, poussiere, crack cocaine, Harm reduction, Intravenous drug, business.industry, Public Health, Environmental and Occupational Health, medicine.disease, 3. Good health, [SDV] Life Sciences [q-bio], Analgesics, Opioid, Psychiatry and Mental health, Cross-Sectional Studies, Injecting drug use, France, Self Report, Presentation (obstetrics), 0305 other medical science, business
Abstract: International audience; Background: Cotton fever is a febrile syndrome occurring after intravenous drug injection. Although its clinical presentation is well described in the literature, data regarding prevention is lacking. We aimed to assess proportion and correlates of cotton fever experience among people who inject opioids. Methods: We performed a cross-sectional study using data from the community-based survey PrebupIV conducted in France in 2015 among 557 people who regularly injected opioids. Self-reported sociodemographic data, together with data on substance use, injecting practices and occurrence of cotton fever were all collected through face-to-face (n = 398) or online (n = 159) questionnaires. Factors associated with cotton fever experience were assessed using logistic regression model. Results: Over half of the participants (54%) reported cotton fever experience. In the multivariable logistic regression, crack cocaine injection (adjusted Odds Ratio (aOR) = 1.96, 95% Confidence Interval (CI) = 1.03-3.63), longer duration of opioid use (for 1 year of use: aOR = 1.05, 95%CI = 1.02-1.09), and filtering mainly with cotton filters (compared with membrane filters, aOR = 1.86, 95%CI = 1.24-2.78) were all associated with cotton fever experience. Conclusions: Our findings highlight that cotton fever is a frequent complication of injecting drug use. Avoiding the use and reuse of cotton balls to filter injected solutions, and promoting membrane filters use could reduce the risk of the condition occurring.
Published: 2020
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41. Reaching a Different Population of MSM in West Africa With the Integration of PrEP Into a Comprehensive Prevention Package (CohMSM-PrEP ANRS 12369—Expertise France)

Author: Camille Anoma, Daniela Rojas Castro, Luis Sagaon-Teyssier, Gwenaëlle Maradan, Bintou Dembélé Keita, Michel Bourrelly, August Eubanks, Marion Mora, Ephrem Mensah, Issifou Yaya, Ter Tiero Elias Dah, Bruno Spire, Christian Laurent, Lucas Riegel, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), ARCAD-SIDA [Bamako, Mali], Espace Confiance [Abidjan, Côte d’Ivoire], Association African Solidarité [Ouagadougou, Burkina Faso], Centre Muraz [Bobo-Dioulasso, Burkina Faso], Espoir Vie Togo [Lomé, Togo], Coalition PLUS [Pantin, France] (Community Research Laboratory Pantin), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), CohMSM-PrEP Study Group, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), and Dupuis, Christine
Subjects: Male, medicine.medical_specialty, Anti-HIV Agents, media_common.quotation_subject, [SDV]Life Sciences [q-bio], Population, Psychological intervention, HIV Infections, 030312 virology, Men who have sex with men, 03 medical and health sciences, Pre-exposure prophylaxis, Risk Factors, Odds Ratio, Medicine, Humans, Pharmacology (medical), Homosexuality, Homosexuality, Male, 10. No inequality, education, media_common, 0303 health sciences, education.field_of_study, Unsafe Sex, business.industry, 1. No poverty, virus diseases, 16. Peace & justice, 3. Good health, [SDV] Life Sciences [q-bio], Outreach, Africa, Western, Infectious Diseases, Family medicine, Cohort, Pre-Exposure Prophylaxis, business, Peer education
Abstract: International audience; Background: In West Africa, few HIV services target men who have sex with men (MSM). In 2015, the interventional cohort CohMSM started offering a community-based prevention package for MSM. Participants expressed interest in pre-exposure prophylaxis (PrEP) and their eligibility was demonstrated. In 2017, PrEP was added to services already offered as part of a new program, CohMSM-PrEP, which recruited CohMSM participants and new participants. We aimed to determine whether the introduction of PrEP as an additional prevention tool influenced the type of participant signing up for CohMSM-PrEP.Methods: CohMSM-PrEP recruited HIV-negative MSM in community-based clinics in Mali, Cote d'Ivoire, Burkina Faso, and Togo. Quarterly follow-up included free clinical examinations, PrEP, HIV/sexually transmitted infection screening, peer education, condoms, and lubricants. Sociobehavioral data were collected every 3 months using face-to-face questionnaires. Our outcome was participant type: new participants vs CohMSM participants. Logistic regression was performed to identify the factors associated with being a new participant.Results: Of the 524 MSM included in CohMSM-PrEP, 41% were new participants. After adjustment, multivariate analysis showed they were more socioeconomically disadvantaged with financial insecurity, social isolation-including isolation within the MSM community-and riskier sexual practices.Conclusion: The introduction of PrEP as an additional prevention tool and the use of peer-based outreach services over time influenced the type of participant signing up for a community-based HIV prevention cohort in West Africa. Adding these elements to existing interventions in Sub-Saharan Africa could be the key to reaching MSM marginalized from HIV prevention and care programs.
Published: 2020
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42. Changes in risky sexual behaviours among West African MSM enrolled in a quarterly HIV testing and counselling prevention programme (CohMSM ANRS 12324 - Expertise France)

Author: Camille Anoma, Marion Mora, Abdoul Aziz Keita, Bintou Dembélé Keita, Mohamed Mimi, Stéphane-Alain Babo Yoro, Daniela Rojas Castro, Pierre-Julien Coulaud, Michel Bourrelly, Paméla Palvadeau, Adeline Bernier, Ephrem Mensah, Bruno Spire, Selom Agbomadji, Christian Coulibaly, Clotilde Couderc, Elias Ter Tiero Dah, Christian Laurent, Gwenaëlle Maradan, Luis Sagaon-Teyssier, Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Muraz [Bobo-Dioulasso, Burkina Faso], Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Recherche pour le Développement (IRD), Espace Confiance [Abidjan, Côte d’Ivoire], Association African Solidarité [Ouagadougou, Burkina Faso], Espoir Vie Togo [Lomé, Togo], Coalition PLUS, Recherches Translationnelles sur le VIH et les maladies infectieuses (TransVIHMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Recherche pour le Développement (IRD)-Université Montpellier 1 (UM1)-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Universtié Yaoundé 1 [Cameroun]-Université de Montpellier (UM), Institut de Recherche pour le Développement (IRD [France-Sud]), Université de Montpellier (UM), and Aiello, Mélisande
Subjects: Counseling, Male, [SDV]Life Sciences [q-bio], Social Stigma, Intimate Partner Violence, HIV Infections, hiv, 030312 virology, Mali, Men who have sex with men, law.invention, Cohort Studies, Condoms, Health Risk Behaviors, Sexual and Gender Minorities, 0302 clinical medicine, prevention, law, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Medicine, 030212 general & internal medicine, Depression (differential diagnoses), 0303 health sciences, Depression, Risk of infection, Age Factors, sexual behaviour, Gender Identity, virus diseases, 3. Good health, Infectious Diseases, Togo, Cohort, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Bisexuality, Adult, Sexual Behavior, Sexually Transmitted Diseases, Dermatology, Hiv testing, Young Adult, 03 medical and health sciences, Condom, Burkina Faso, West Africa, Humans, MSM, Unsafe Sex, business.industry, Sex Work, Mental health, Self Concept, Cote d'Ivoire, Logistic Models, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Harassment, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Risk Reduction Behavior, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Demography
Abstract: ObjectivesWhether regular HIV testing and counselling reduce risky sexual behaviours in African men who have sex with men (MSM) is still a matter for debate. We aimed to identify behavioural trajectories based on HIV risk exposure (HRE) and factors affecting their evolution.MethodsData were collected from 621 HIV-negative West African MSM (Mali, Cote d'Ivoire, Burkina Faso and Togo) included in a community-based cohort providing quarterly HIV testing and counselling. Sociobehavioural data were collected every 6 months. HRE was defined as reporting inconsistent condom use during receptive anal sex with male partners of unknown HIV status in the previous 6 months. Using 18-month follow-up data, group-based trajectory modelling helped identify behavioural trajectories and determine the factors associated with their evolution. HIV seroconversions (n=67) were specified in each group trajectory.ResultsTwo distinct group trajectories were identified: medium-risk exposure MSM (ME-MSM) (61%, 6.4% of whom having seroconverted) and high-risk exposure MSM (HE-MSM) (39%, 17.5% of whom having seroconverted). A significant declining trend in the probability of reporting HRE over time ((95% CI)) was observed for HE-MSM (from 0.59 (0.48 to 0.70) at M0 to 0.31 (0.22 to 0.41) at M18), while it remained constant for ME-MSM (0.034 (0.0 to 0.079)). This can be explained by a progressive use of risk reduction strategies (less receptive anal sex, better knowledge of their partners’ status and increasing condom use). Being younger, living in Burkina Faso, self-considering both a man and a woman and reporting a higher level of depression were all associated with HE membership. Among HE-MSM, HRE was higher in those practising transactional or group sex and those experiencing psychological harassment.ConclusionsQuarterly HIV testing and counselling seem to reduce risky sexual behaviours in HIV-negative MSM at greatest risk of infection. Specific support for young MSM, focusing on identity and mental health, is needed to strengthen HIV prevention in West African MSM.
Published: 2020
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43. What are the situational and behavioral factors associated with condomless anal sex without pre-exposure prophylaxis in MSM?

Author: Christian Chidiac, Mohamed Mimi, Marie Préau, Christel Protière, Catherine Capitant, Luis Sagaon-Teyssier, Jean-Michel Molina, Daniela Rojas Castro, Laurence Meyer, Cécile Tremblay, Marion Di Ciaccio, Bruno Spire, Marie Suzan-Monti, Dupuis, Christine, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupe de Recherche en Psychologie Sociale (GRePS), Université Lumière - Lyon 2 (UL2), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), AIDES [Pantin, France] (Mission Innovation Recherche Expérimentation), Coalition Internationale Sida [Pantin, France] (Programme Recherche Communautaire), Essais Thérapeutiques et Maladies Infectieuses, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal (UdeM), Service de Maladies Infectieuses et Tropicales [Hôpital de la Croix-Rousse - HCL], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service de maladies infectieuses et tropicales [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Department of Infectious Diseases [Paris], Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Sud - Paris 11 (UP11), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université de Paris (UP)
Subjects: Male, Safe Sex, 0301 basic medicine, Sexual partner, MESH: Sexual Behavior, [SDV]Life Sciences [q-bio], HIV Infections, Gee, law.invention, Condoms, Pre-exposure prophylaxis, 0302 clinical medicine, law, Immunology and Allergy, Medicine, MESH: Sexual Partners, 030212 general & internal medicine, MESH: Anti-HIV Agents, Generalized estimating equation, MESH: Middle Aged, MESH: HIV Infections, Middle Aged, 3. Good health, [SDV] Life Sciences [q-bio], Sexual Partners, Infectious Diseases, MESH: Risk-Taking, MESH: Young Adult, Viral load, Adult, Anti-HIV Agents, MESH: Unsafe Sex, Sexual Behavior, Immunology, MESH: Safe Sex, MESH: Homosexuality, Male, Young Adult, 03 medical and health sciences, MESH: Condoms, Risk-Taking, Condom, Humans, Homosexuality, Male, MESH: Humans, Unsafe Sex, business.industry, MESH: Adult, MESH: Male, Sexual intercourse, 030104 developmental biology, Attributable risk, Pre-Exposure Prophylaxis, business, Demography, MESH: Pre-Exposure Prophylaxis
Abstract: International audience; Objective: This study aimed to identify situational and behavioral factors associated with condomless anal sex without on-demand PrEP in the open-label extension (OLE) study of the ANRS-IPERGAY trial.Methods: Univariable and multivariable modified Poisson regressions with a generalized estimating equation (GEE) were used. The attributable risk percentage for each explanatory variable and for condomless anal sex without PrEP was calculated.Results: In the OLE, 19% of anal intercourses were unprotected (i.e. no PrEP or condom). Of these, 85% were attributable to sexual intercourse with main partners and 47% with HIV-negative partners. The following factors were positively associated with condomless anal sex without PrEP: a depressive episode in the previous 12 months [aR (95% CI), P-value: 1.49 (1.02--2.17), 0.039], a higher number of sexual intercourses during the previous 4 weeks [1.01 [1.002--1.02], 0.014], and sexual intercourses under the influence of alcohol [1.45 (1.10--1.92), 0.008]. By contrast, condomless anal sex without PrEP was less frequent during sexual intercourses with known casual, unknown casual and multiple partners [0.20 (0.14--0.30)
Published: 2020
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44. De la recherche communautaire à la transformation sociale : l’exemple du projet ANRS-AERLI sur l’accompagnement et l’éducation aux risques liés à l’injection

Author: Marie Suzan-Monti, Daniela Rojas Castro, Fred Bladou, Patrizia Carrieri, Elisabeth Avril, Perrine Roux, and Marie Debrus
Subjects: 03 medical and health sciences, Psychiatry and Mental health, Clinical Psychology, 0302 clinical medicine, Political science, 030508 substance abuse, 030212 general & internal medicine, 0305 other medical science, Humanities, Cosmos
Abstract: La situation epidemiologique des usagers de drogue (UD), et tout particulierement des UD par voie intraveineuse (UDVI), vis-a-vis du virus de l’hepatite C et du VIH appelle aujourd’hui a de nouveaux moyens de prevention et de soins. L’intervention d’Accompagnement et d’Education aux Risques LIes a l’injection (AERLI) issue des pratiques des acteurs de terrain en direction des UDVI a fait l’objet d’une evaluation a travers le projet de recherche communautaire ANRS-AERLI mene en partenariat etroit avec l’Inserm, Medecins du Monde et AIDES. Cette intervention communautaire consiste en une session educative en face a face, basee sur une observation des pratiques d’injection permettant une reponse individualisee. Cette etude longitudinale ayant compare un groupe d’UDVI expose a AERLI et un groupe controle non expose a permis de mettre en evidence l’efficacite d’AERLI non seulement en termes de diminution des pratiques a risque de transmission du VHC et des complications cutanees, mais aussi a travers une amelioration de l’acces au depistage VHC. L’intervention AERLI apparait donc comme un outil supplementaire a la politique de reduction des risques et un moyen d’inciter les UDVI au depistage VHC a l’heure de l’acces universel aux traitements du VHC. C’est ainsi que deux changements majeurs ont ete possibles grâce aux resultats de cette recherche communautaire, l’inclusion de cet outil pedagogique dans la loi de sante et sa visibilite dans le dernier rapport Dhumeaux sur les hepatites comme moyen d’ameliorer l’acces au depistage VHC.
Published: 2017
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45. Strengthening HCV elimination policies through community-based research

Author: Chase Perfect, Maria Donatelli Klinger, Rosemary Delabre, and Daniela Rojas Castro
Subjects: Hepatology
Published: 2020
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46. Give PrEP a chance: moving on from the 'risk compensation' concept

Author: Rosemary M. Delabre, Jean-Michel Molina, Daniela Rojas Castro, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Coalition PLUS [Pantin, France], Service de maladies infectieuses et tropicales [Saint-Louis], Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Génétique et Ecologie des Virus, Génétique des Virus et Pathogénèse des Maladies Virales, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7), ANRS (France Recherche Nord&Sud Sida‐hiv Hépatites), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), and HAL AMU, Administrateur
Subjects: Male, Debate, Anti-HIV Agents, Sexual Behavior, Psychological intervention, Context (language use), HIV Infections, Developmental psychology, risk compensation, 03 medical and health sciences, Sexual and Gender Minorities, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), Argument, Medicine, Humans, 030212 general & internal medicine, Homosexuality, Male, sexually transmitted infections, Reproductive health, 030505 public health, business.industry, bio‐behavioural prevention, Public Health, Environmental and Occupational Health, sexual behaviour, HIV, medicine.disease, PrEP, 3. Good health, Risk compensation, Identification (information), Infectious Diseases, Sexual Partners, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Pre-Exposure Prophylaxis, Risk Adjustment, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 0305 other medical science, business, Social control
Abstract: International audience; Introduction: While bio-behavioural interventions (BIs) for sexually transmitted infections (STIs) and HIV prevention have shown their effectiveness (e.g. treatment for syphilis, HPV vaccination or pre-exposure prophylaxis [PrEP]), they have also aroused major concerns regarding behavioural changes that could counteract their benefit. Risk compensation (RC) fears concerning BIs in the HIV/STIs prevention field are intimately linked to representations, judgements and social control on sexual behaviour. With an increasing number of PrEP studies describing a rise in STIs due to RC, this paper argues for a shift away from the focus on RC and proposes a more constructive approach to respond to the needs of people living with HIV and populations most at risk. Discussion: The concept of RC, stemming from road safety and derived from economic theory, relies on rational theoretical models of human behaviour. Although widely applied in several contexts its use has been reasonably questioned. Major methodological issues regarding RC have been raised within HIV/AIDS literature. Although behavioural changes (e.g. condomless sex and number of sexual partners) are often erroneously assimilated with RC, there is no evidence that behavioural changes have undermined the effectiveness of previous and current BIs. Still, PrEP has not escaped RC concerns. Increases in condomless sex within the context of growing uptake of PrEP signals a continued need for integrated and innovative HIV and STI prevention strategies and a comprehensive sexual health approach. Routine HIV/STI testing, peer-led counselling, and identification of sexual health needs within the PrEP model of care could become a gold standard in the sexual health field for all populations. Conclusions: RC remains a frequent argument against the availability and provision of prevention methods for vulnerable populations. Individuals should be able to benefit from the full panel of BIs options available, to find and adapt methods according to their needs. Current, past and future PrEP users, with other stakeholders, may provide valuable insight into innovative solutions and programmes to control HIV and other STIs.
Published: 2019
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47. Community-Based Care in the ANRS-IPERGAY Trial: The Challenges of Combination Prevention

Author: Eric Cua, Costanza Puppo, Marie Préau, Laurent Cotte, François Raffi, Xavier Mabire, Armelle Pasquet, Bruno Spire, Gilles Pialoux, Marie Suzan Monti, Jean-Michel Molina, Daniela Rojas Castro, Groupe de Recherche en Psychologie Sociale (GRePS), Université Lumière - Lyon 2 (UL2), Service de Maladies Infectieuses et Tropicales [Hôpital de la Croix-Rousse - HCL], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Coalition PLUS [Pantin, France], Hôpital l'Archet, Service des maladies infectieuses et tropicales [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service des Maladies Infectieuses et Tropicales [Hôpital Gustave Dron, Tourcoing], Centre Hospitalier Gustave Dron [Tourcoing], Centre hospitalier universitaire de Nantes (CHU Nantes), Service de maladies infectieuses et tropicales [Saint-Louis], Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), HAL AMU, Administrateur, Service de Maladies infectieuses et tropicales [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Male, Gerontology, Health (social science), HIV Infections, law.invention, 0302 clinical medicine, Randomized controlled trial, law, negotiation, Transgender, 030212 general & internal medicine, Empowerment, Community-based care, Qualitative Research, Randomized Controlled Trials as Topic, media_common, Community Health Workers, education.field_of_study, Middle Aged, PrEP, 3. Good health, Negotiation, Infectious Diseases, France Read More: https://guilfordjournals.com/doi/10.1521/aeap.2019.31.3.259, Feeling, Pill, Female, 0305 other medical science, Psychology, Adult, Community-Based Participatory Research, Anti-HIV Agents, Sexual Behavior, media_common.quotation_subject, Population, Transgender Persons, Interviews as Topic, 03 medical and health sciences, ANRS-IPERGAY, Double-Blind Method, Humans, Homosexuality, Male, education, community-based care, 030505 public health, Public Health, Environmental and Occupational Health, HIV, empowerment, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Pre-Exposure Prophylaxis, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
Abstract: International audience; ANRS-IPERGAY was a community-based randomized trial investigating the efficacy of sexual activity-based HIV pre-exposure prophylaxis (PrEP) in a population of males and transgender females who had sex with men and were at high risk of HIV infection. We qualitatively analyzed the support provided to participants by community-based health workers (CBHW) throughout the trial's double-blind and open-label extension phases. In particular, we showed that the relationship between participants and CBHW strongly influenced self-managed pill intake. The delicate construction of this relationship, balanced between trust and dependence, played an important role in PrEP adherence. CBHW had to deal with various issues surrounding participants' feelings of empowerment regarding their role in the trial, as well as related tensions between various logics and rationalities. They were essential to participants' continued involvement.
Published: 2019
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48. On-demand pre-exposure prophylaxis with tenofovir disoproxil fumarate plus emtricitabine among men who have sex with men with less frequent sexual intercourse: a post-hoc analysis of the ANRS IPERGAY trial

Author: Laurence Meyer, Julie Chas, Jean-Guy Baril, Véronique Doré, Michel Morin, Jean-Pierre Aboulker, Marine Saouzanet, Isabelle Durant-Zaleski, Marie Suzan-Monti, Emmanuelle Netzer, Françoise Euphrasie, Nathalie Bajos, Séverine Gibowski, Soizic Le Mestre, Gilles Peytavin, Jean-François Delfraissy, Constance Delaugerre, David Thompson, Brigitte Guillon, Gilles Pialoux, Alpha Diallo, Nicolas Etien, Christian Chidiac, Michel Besnier, Isabelle Charreau, Benoit Trottier, Baptiste Demoulin, Julie Timsit, Bruno Spire, Joanne Otis, Laurent Cotte, Julien Fonsart, W. Rozenbaum, Mark A. Wainberg, Gabriel Girard, Eric Cua, Guillemette Antoni, Daniela Rojas Castro, Catherine Capitant, Luis Sagaon-Teyssier, Antoine Cheret, Marie-Christine Simon, Cécile Tremblay, Nicolas Leturque, Johan Binesse, Diane Carette, Valérie Foubert, Anaïs Mennecier, Grégoire Cattin, Jean-Michel Molina, Yacine Saïdi, Nicolas Lorente, Elias Choucair, François Raffi, Cecile Rabian, Armelle Pasquet, Marie Préau, Thomas Huleux, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Essais Thérapeutiques et Maladies Infectieuses, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CR CHUM), Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal (UdeM)-Université de Montréal (UdeM), Génomes, biologie cellulaire et thérapeutiques (GenCellDi (UMR_S_944)), Collège de France (CdF (institution))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Hôpital Archet 2 [Nice] (CHU), Coalition PLUS [Pantin, France] (Community Research Laboratory Pantin), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Gustave Dron [Tourcoing], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), ANRS (France Recherche Nord and Sud Sida-HIV Hépatites), the Canadian HIV Trials Network, Fonds Pierre Bergé (Sidaction), Gilead Sciences, and the Bill & Melinda Gates Foundation., ANRS IPERGAY study group: Jean-Pierre Aboulker, Nathalie Bajos, Jean-Guy Baril, Michel Besnier, Johan Binesse, Diane Carette, Grégoire Cattin, Antoine Chéret, Christian Chidiac, Elias Choucair, Jean-François Delfraissy, Baptiste Demoulin, Alpha Diallo, Isabelle Durant-Zaleski, Véronique Doré, Nicolas Etien, Françoise Euphrasie, Julien Fonsart, Valérie Foubert, Séverine Gibowski, Gabriel Girard, Brigitte Guillon, Soizic Le Mestre, France Lert, Nicolas Leturque, Nicolas Lorente, Anaïs Mennecier, Michel Morin, Emmanuelle Netzer, Joanne Otis, Armelle Pasquet, Gilles Peytavin, Gilles Pialoux, Marie Préau, Cécile Rabian, Willy Rozenbaum, Luis Sagaon-Teyssier, Yacine Saïdi, Marine Saouzanet, Marie-Christine Simon, Marie Suzan-Monti, David Thompson, Julie Timsit, Benoît Trottier, Mark Wainberg, Dupuis, Christine, Génomes, biologie cellulaire et thérapeutiques (GenCellDi (U944 / UMR7212)), Collège de France (CdF (institution))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: 0301 basic medicine, Male, MESH: Sexual Behavior, Epidemiology, [SDV]Life Sciences [q-bio], HIV Infections, Men who have sex with men, MESH: HIV-1, Pre-exposure prophylaxis, Sexual and Gender Minorities, 0302 clinical medicine, MESH: Tenofovir, Medicine, MESH: Double-Blind Method, 030212 general & internal medicine, MESH: Incidence, MESH: Anti-HIV Agents, education.field_of_study, Incidence (epidemiology), Incidence, MESH: HIV Infections, 3. Good health, [SDV] Life Sciences [q-bio], MESH: Sexual and Gender Minorities, Infectious Diseases, Pill, France, medicine.drug, Adult, medicine.medical_specialty, Canada, Anti-HIV Agents, Sexual Behavior, Immunology, Population, Placebo, Emtricitabine, Medication Adherence, MESH: Homosexuality, Male, 03 medical and health sciences, Double-Blind Method, MESH: Canada, Virology, Internal medicine, Humans, Homosexuality, Male, education, Tenofovir, MESH: Humans, business.industry, MESH: Adult, MESH: Medication Adherence, 030112 virology, MESH: Male, MESH: France, Sexual intercourse, HIV-1, Pre-Exposure Prophylaxis, business, MESH: Pre-Exposure Prophylaxis
Abstract: Summary Background ANRS IPERGAY found that on-demand pre-exposure prophylaxis (PrEP) with oral tenofovir disoproxil fumarate plus emtricitabine was associated with an 86% relative reduction of HIV-1 incidence compared with placebo among men who have sex with men at high risk of HIV. We aimed to investigate whether on-demand PrEP was similarly effective among individuals with lower exposure to HIV risk. Methods Participants in the ANRS IPERGAY trial were randomly assigned to receive PrEP (fixed-dose combination of 300 mg tenofovir disoproxil fumarate and 200 mg emtricitabine per pill) or placebo. The primary endpoint was the diagnosis of HIV-1 infection. Pill uptake was assessed by counting returned pills at each follow-up and by estimating tenofovir concentration from frozen plasma samples. Participants were interviewed at each visit to assess the pattern of PrEP use. All participants enrolled in the modified intention-to-treat population of the double-blind phase of the ANRS IPERGAY trial were eligible for this post-hoc analysis. We calculated the total follow-up time for periods of less frequent sexual intercourse with high PrEP adherence (15 pills or fewer per month taken systematically or often during sexual intercourse). To estimate the time of HIV acquisition, fourth-generation HIV-1/2 ELISA assays, plasma HIV-1 RNA assays, and western blot analyses were done with use of frozen samples, and the stage of HIV infection was defined according to Fiebig staging. HIV incidence was compared between the two treatment groups among individuals who had less frequent sexual intercourse with high PrEP adherence. The ANRS IPERGAY trial is registered with ClinicalTrials.gov , NCT01473472 . Findings 400 participants who were randomly assigned to receive PrEP (n=199) or placebo (n=201) between Feb 22, 2012, and Oct 17, 2014, were included in this analysis. 270 participants had at least one period of less frequent sexual intercourse with high PrEP adherence during the study, representing 134 person-years of follow-up and 31% of the total study follow-up. During these periods, participants in both groups reported a median of 5·0 (IQR 2·0–10·0) episodes of sexual intercourse per month and used a median of 9·5 (6·0–13·0) pills per month. Six HIV-1 infections were diagnosed in the placebo group (HIV incidence of 9·2 per 100 person-years; 95% CI 3·4–20·1) and none were diagnosed in the tenofovir disoproxil fumarate plus emtricitabine arm (HIV incidence of 0 per 100 person-years; 0–5·4; p=0·013), with a relative reduction of HIV incidence of 100% (95% CI 39–100). Interpretation A choice between daily or on-demand PrEP regimens could be offered to men who have sex with men who have less frequent sexual intercourse. Funding ANRS (France Recherche Nord and Sud Sida-HIV Hepatites), the Canadian HIV Trials Network, Fonds Pierre Berge (Sidaction), Gilead Sciences, and the Bill & Melinda Gates Foundation.
Published: 2019
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49. Pleasure and PrEP: Pleasure-Seeking Plays a Role in Prevention Choices and Could Lead to PrEP Initiation

Author: Bruno Spire, Costanza Puppo, Marie Suzan-Monti, Marie Préau, Claire Pintado, Eric Cua, Xavier Mabire, Jean-Michel Molina, Daniela Rojas Castro, Marion Mora, Stéphane Morel, Julie Chas, Groupe de Recherche en Psychologie Sociale (GRePS), Université Lumière - Lyon 2 (UL2), AIDES, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital l'Archet, Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Adult, Male, Pleasure, Health (social science), media_common.quotation_subject, Sexual Behavior, sexual health, lcsh:Medicine, Context (language use), Human sexuality, HIV Infections, physiological and endocrine disorders, Men who have sex with men, law.invention, Interviews as Topic, 03 medical and health sciences, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), Condom, law, medicine, Humans, 030212 general & internal medicine, Homosexuality, Male, media_common, Reproductive health, Aged, health-care issues, 030505 public health, business.industry, lcsh:R, Public Health, Environmental and Occupational Health, Middle Aged, medicine.disease, 3. Good health, sexuality, Sexual intercourse, Bisexuality, HIV/AIDS, Original Article, Pre-Exposure Prophylaxis, health promotion and disease prevention, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 0305 other medical science, business, Psychology, Social psychology
Abstract: International audience; Pleasure-seeking plays a role in prevention (means choices and use), and in the sexual quality of life of men who have sex with men (MSM). Since HIV is a major threat to MSM health, new means of prevention, like pre-exposure prophylaxis (PrEP), must meet the needs of MSM to be fully efficient. Using a psychosocial approach, we examined how pleasure-seeking plays a role in participation of MSM in “ANRS-IPERGAY,” a community-based trial on sexual health which included sexual on-demand PrEP. Thirteen semistructured collective interviews were conducted with 45 participants. First, we analyzed participants’ search for new prevention means due to previous failures in condom use. We found that participants perceived condoms as a barrier—both materially and symbolically—to pleasure and desire, causing anxiety and stress considering sexual intercourse. Second, we explored representations and attitudes concerning pleasure within the context of PrEP. We found that PrEP allowed participants to freely choose their desired sexual positions and to better enjoy intimacy. Third, we studied the sexual quality of life for PrEP users in ANRS-IPERGAY and found an improvement. Thanks to the community-based design of the trial, this new prevention tool became a means to develop agency and empowerment for participants, not only in negotiating individual prevention but also in opposing the normative and stigmatizing discourse on sexuality and HIV. In conclusion, pleasure-seeking appears to be an essential element of sexual fulfillment that needs to be integrated as a positive notion in the study of HIV prevention.
Published: 2019
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50. Hepatitis B Virus Prevalence and Vaccination in Men Who Have Sex With Men in West Africa (CohMSM ANRS 12324—Expertise France)

Author: Ter Tiero Elias, Dah, Clotilde, Couderc, Alou, Coulibaly, Malan Jean-Baptiste, Kouamé, Mawuényégan Kouamivi, Agboyibor, Issa, Traoré, Gwenaëlle, Maradan, Daniela, Rojas Castro, Ephrem, Mensah, Camille, Anoma, Bintou, Dembélé Keita, Bruno, Spire, Christian, Laurent, Claver Anoumou Yaotsé, Dagnra, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), Institut de Recherche pour le Développement (IRD [France-Sud]), Centre Muraz [Bobo-Dioulasso, Burkina Faso], Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Aiello, Mélisande, Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), and Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI)
Subjects: HBsAg, 030231 tropical medicine, prevalence, men who have sex with men, medicine.disease_cause, Logistic regression, Men who have sex with men, 03 medical and health sciences, 0302 clinical medicine, [SDV.IMM.VAC] Life Sciences [q-bio]/Immunology/Vaccinology, parasitic diseases, medicine, Major Article, 030212 general & internal medicine, Hepatitis B virus, business.industry, virus diseases, Odds ratio, Hepatitis B, medicine.disease, vaccination, Confidence interval, 3. Good health, Vaccination, Infectious Diseases, Oncology, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Africa, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, hepatitis B, [SDV.IMM.VAC]Life Sciences [q-bio]/Immunology/Vaccinology, business, Demography
Abstract: BackgroundAlthough men who have sex with men (MSM) are at high risk of hepatitis B virus (HBV) infection, they do not have access to vaccination in West Africa, which is a highly endemic region. We investigated HBV prevalence and associated factors, as well as acceptability and difficulties of vaccination in MSM enrolled in an operational research program in Burkina Faso, Côte d’Ivoire, Mali, and Togo.MethodsWe followed up 779 MSM in 2015–2018. Participants who were negative for both hepatitis B surface antigen (HBsAg) and antibodies (anti-HBs) at enrollment were offered HBV vaccination. Factors associated with HBV infection were identified using logistic regression models.ResultsOverall, HBV prevalence was 11.2% (95% confidence interval [CI], 9.0%–13.6%). It was lower in Togo than in Côte d’Ivoire (2.7% vs 17.3%; adjusted odds ratio [aOR], 0.12; 95% CI, 0.02–0.28) and higher in participants with 6+ recent male sexual partners (21.0% vs 9.3%; aOR, 1.48; 95% CI, 1.12–1.97). Of 528 participants eligible for vaccination, 484 (91.7%) were willing to be vaccinated and received at least 1 dose (ranging from 68.2% in Abidjan to 96.4% in Bamako; P < .001). Of the latter, 390 (80.6%) received 3 or 4 doses. The proportion of participants for whom the minimum required time between each dose was respected ranged from 10.9% in Bamako to 88.6% in Lomé (P < .001).ConclusionsMSM in West Africa should be targeted more for HBV screening and vaccination. Although vaccination is well accepted by MSM, greater training of health care workers and education of MSM are required.
Published: 2019
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