@article{fdi:010078854,
  title = {{I}s {M}adagascar at the edge of a generalised {HIV} epidemic ? : situational analysis},
  author = {{R}aberahona, {M}. and {M}onge, {F}. and {A}ndrianiaina, {R}.{H}. and {R}andria, {M}.{J}.{D}.{D}. and {R}atefiharimanana, {A}. and {R}akatoarivelo, {R}.{A}. and {R}andrianary, {L}. and {R}andriamilahatra, {E}. and {R}akotobe, {L}. and {M}attern, {C}. and {A}ndriananja, {V}. and {R}ajaonarison, {H}. and {R}andrianarisoa, {M}. and {R}akotomanana, {E}. and {P}ourette, {D}olor{\`e}s and {A}ndriamahenina, {H}.{Z}. and {D}ez{\'e}, {C}. and {B}oukli, {N}. and {B}aril, {L}. and {V}all{\`e}s, {X}.},
  editor = {},
  language = {{ENG}},
  abstract = {{O}bjectives : {T}o describe the epidemiological situation of the {HIV}/{AIDS} epidemic and to identify the main drivers for vulnerability in {M}adagascar. {D}esign : {L}iterature review, qualitative research and situational analysis. {D}ata sources {S}earch of electronic bibliographic databases, national repositories of documentation from 1998 to 2018. {S}earch keywords included {M}adagascar, {HIV}, sexually transmitted infections, men who have sex with men ({MSM}), sex workers ({SW}s), transactional sex ({TS}), injecting drug users ({IDU}s), vulnerability and sexual behaviour. {Q}ualitative sources were interviews and focus group discussions. {R}eview methods : {S}tudies focused on {HIV} and/or vulnerability of {HIV} in {M}adagascar in general, and key populations ({KP}s) and {HIV}/{AIDS} response were taken into account.  {N}ational reports from key {HIV} response actors were included. {R}esults : {M}adagascar is characterised by a low {HIV}/{AIDS} epidemic profile in the general population ({GP}) (0.3%) combined with a high prevalence of {HIV} among {KP}s ({SW}s, {MSM} and {IDU}s). {A}n increase in {HIV} prevalence among {KP} has been observed during recent years. {H}ospital-based data suggest an increase in {HIV} prevalence among the {GP}. {T}he vulnerability traits are inconsistent use of condoms, multipartner relationships and other contextual factors like widespread {TS} and gender inequality. {A} high prevalence/incidence of sexually transmitted infections could indicate a high vulnerability to {HIV}/{AIDS}. {H}owever, there are no reports of {HIV} prevalence of >1% in antenatal consultation. {C}onclusion : {T}here is not enough evidence to make a conclusion about the {HIV} epidemiological situation in {M}adagascar due to the scarcity of the epidemiological data. {H}owever, {M}adagascar may be closer to a turning point towards a high-prevalence epidemic with severe consequences, particularly when taking into account its socioeconomical fragility and underlying vulnerabilities. {M}ore precise epidemiological data and improved {HIV}/ {AIDS} diagnosis and case management should be a public
health priority.},
  keywords = {{MADAGASCAR}},
  booktitle = {},
  journal = {{S}exually {T}ransmitted {I}nfections},
  volume = {[{P}ubl. online 18 mai 2020]},
  numero = {},
  pages = {en ligne [6 ]},
  ISSN = {1368-4973},
  year = {2020},
  DOI = {10.1136/sextrans-2019-054254},
  URL = {https://www.documentation.ird.fr/hor/fdi:010078854},
}