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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. 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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3. 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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4. 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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5. 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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6. 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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7. 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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8. 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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9. 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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10. 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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11. 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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12. Étude en méthodologie mixte des attentes des personnes vivant avec le VIH en 2013 : la difficulté dans le regard de l’autre

Author

Pierre Gantner, David Rey, Idalina Paupart, Béatrice Lindecker, Sophie Reinhart, Marialuisa Partisani, Erik De Mautort, Claudine Bernard-Henry, Christine Cheneau, Lucas Riegel, Michèle Priester, Sophie Revollon, and Marie-Laure Batard

Subjects
General Nursing
Abstract

Resume Introduction Avec la simplification des traitements antiretroviraux, faut-il penser que l’education therapeutique du patient (ETP) chez les patients vivant avec le virus de l’immunodeficience humaine (VIH) n’est plus une necessite ? L’ETP ne s’arrete pas a soutenir l’adhesion therapeutique mais a pour objectif de renforcer la qualite de vie des personnes en repondant a leurs besoins. Objectif Decrire les besoins des personnes vivant avec le VIH dans une approche centree sur la personne par une methodologie mixte. Methodes Etude francaise monocentrique qualitative sous forme d’entretiens semi-directifs ( n = 40) et quantitative par auto-questionnaires ( n = 200) aupres de patients suivis en consultation en 2013. Resultats Dans l’etude quantitative, 80 % des participants etaient des hommes de 46 ans d’âge median. Dans le contexte soignant, un patient sur deux souhaitait s’exprimer sur le vecu de sa maladie, sa vie affective, sa sexualite et ses projets de vie. Trois patients sur quatre avaient besoin d’informations sur les effets indesirables ou les complications liees au VIH, notamment « le risque cardiovasculaire ». Des sous-groupes de patients ont ete identifies : certains participants consideraient qu’on ne leur demandait jamais leur avis concernant les decisions medicales ( n = 13), se sentaient isoles ( n = 54) et d’autres n’avaient personne a qui parler en cas de probleme ( n = 43). Discussion Le « regard des autres » est une problematique du quotidien chez ces personnes qui souffrent principalement des stereotypes persistants sur l’infection par le VIH dans la societe francaise, notamment sur le mode de transmission. Perspectives Les personnes vivant avec le VIH ont encore de nombreux besoins d’accompagnement qui doivent etre au centre des interventions d’ETP.

Published
2015
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13. 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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