%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Coulaud, P. J.
%A Sagaon Teyssier, Luis
%A Mimi, M.
%A Maradan, G.
%A Mora, M.
%A Bourrelly, M.
%A Keita, B. D.
%A Keita, A. A.
%A Anoma, C.
%A Yoro, S. A. B.
%A Dah, E. T. T.
%A Coulibaly, C.
%A Mensah, E.
%A Agbomadji, S.
%A Palvadeau, P.
%A Bernier, A.
%A Castro, D. R.
%A Couderc, C.
%A Laurent, Christian
%A Spire, B.
%A CohMSM Study Group,
%T Changes in risky sexual behaviours among West African MSM enrolled in a quarterly HIV testing and counselling prevention programme (CohMSM ANRS 12324-Expertise France)
%D 2020
%L fdi:010078005
%G ENG
%J Sexually Transmitted Infections
%@ 1368-4973
%K MALI ; COTE D'IVOIRE ; BURKINA FASO ; TOGO ; BAMAKO ; ABIDJAN ; OUAGADOUGOU ; LOME
%M ISI:000518230100009
%N 2
%P 115-120
%R 10.1136/sextrans-2018-053892
%U https://www.documentation.ird.fr/hor/fdi:010078005
%> https://www.documentation.ird.fr/intranet/publi/2020/03/010078005.pdf
%V 96
%W Horizon (IRD)
%X Objectives Whether 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. Methods Data 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. Results Two 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. Conclusions Quarterly 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.
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