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)

2020

Article référencé dans le Web of Science WOS:000587802600009

Eubanks A., Keita B. D., Anoma C., Dah T. T. E., Mensah E., Maradan G., Bourrelly M., Mora M., Riegel L., Castro D. R., Yaya Issifou, Spire B., Laurent Christian, Sagaon Teyssier Luis, CohMSM-PrEP Study Group

JAIDS : Journal of Acquired Immune Deficiency Syndromes, 2020, 85 (3), p. 292-301 ISSN 1525-4135

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.

Entomologie médicale / Parasitologie / Virologie [052] ; Santé : aspects socioculturels, économiques et politiques [056]

AFRIQUE DE L'OUEST ; MALI ; COTE D'IVOIRE ; BURKINA FASO ; TOGO ; AFRIQUE SUBSAHARIENNE

Fonds IRD [F B010079988]

fdi:010079988