Coulaud P. J. auteur aut IRD Sagaon Teyssier Luis auteur aut IRD Mimi M. auteur aut IRD Maradan G. auteur aut IRD Mora M. auteur aut IRD Bourrelly M. auteur aut IRD Keita B. D. auteur aut IRD Keita A. A. auteur aut IRD Anoma C. auteur aut IRD Yoro S. A. B. auteur aut IRD Dah E. T. T. auteur aut IRD Coulibaly C. auteur aut IRD Mensah E. auteur aut IRD Agbomadji S. auteur aut IRD Palvadeau P. auteur aut IRD Bernier A. auteur aut IRD Castro D. R. auteur aut IRD Couderc C. auteur aut IRD Laurent Christian auteur aut IRD Spire B. auteur aut IRD CohMSM Study Group auteur aut IRD text journalArticle eng text/pdf born digital access 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. specialized MALI COTE D'IVOIRE BURKINA FASO TOGO BAMAKO ABIDJAN OUAGADOUGOU LOME 056 052 96 2 115-120 2020 1368-4973 https://www.documentation.ird.fr/hor/fdi:010078005 10.1136/sextrans-2018-053892 1368-4973 [F B010078005] https://www.documentation.ird.fr/hor/fdi:010078005 https://www.documentation.ird.fr/intranet/publi/2020/03/010078005.pdf Accès réservé (Intranet de l'IRD) IRD - Base Horizon / Pleins textes 2020-05-18 2025-02-24 fdi:010078005 fre