%0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Becquet, Valentine %A Nouaman, M. %A Plazy, M. %A Masumbuko, J. M. %A Anoma, C. %A Kouame, S. %A Danel, C. %A Eholie, S. P. %A Larmarange, Joseph %A ANRS 12361 PrEP-CI Study Group %T Sexual health needs of female sex workers in Cote d'Ivoire : a mixed-methods study to prepare the future implementation of pre-exposure prophylaxis (PrEP) for HIV prevention %D 2020 %L fdi:010078925 %G ENG %J BMJ Open %@ 2044-6055 %K qualitative research ; HIV & AIDS ; public health ; demography ; epidemiology %K COTE D'IVOIRE %M ISI:000519306600185 %N 1 %P e028508 [12 p.] %R 10.1136/bmjopen-2018-028508 %U http://www.documentation.ird.fr/hor/fdi:010078925 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers20-04/010078925.pdf %V 10 %W Horizon (IRD) %X Objective To describe sexual and reproductive health (SRH) needs of female sex workers (FSWs) to inform the future implementation of pre-exposure prophylaxis (PrEP) for HIV prevention in this population. Design and setting The ANRS 12361 PrEP-CI cross-sectional and mixed-methods study was designed and implemented with two community-based organisations in Cote d'Ivoire. Participants A convenience sample of 1000 FSWs aged >= 18, not known as HIV-positive, completed a standardised questionnaire assessing sociodemographic characteristics, sexual practices, use of community health services and a priori acceptability of PrEP. Twenty-two indepth interviews and eight focus group discussions were also conducted to document FSWs' risky practices and sexual behaviours, experiences with violence and discrimination, attitudes regarding HIV and sexually transmitted infections (STIs), and barriers to SRH services. Results Although 87% described consistent condom use with clients, more than 22% declared accepting condomless sexual intercourse for a large sum of money. Furthermore, condom use with their steady partner and knowledge of their partner's HIV status were low despite their acknowledged concurrent sexual partnerships. While inconsistent condom use exposed FSWs to STIs and undesired pregnancies, the prevalence of contraceptive strategies other than condoms was low (39%) due to fear of contraception causing sterility. FSWs faced obstacles to accessing SRH care and preferred advice from their peers or self-medication. Conclusions Despite adoption of preventive behaviour in most cases, FSWs are still highly exposed to HIV. Furthermore, FSWs seem to face several barriers to accessing SRH. Implementing PrEP among FSWs in West Africa, such as in Cote d'Ivoire, constitutes an opportunity to consider the regular follow-up of HIV-negative FSWs. PrEP initiation should not condition access to SRH services; conversely, SRH services could be a way to attract FSWs into HIV prevention. Our results highlight the importance of developing a people-focused approach that integrates all SRH needs when transitioning from PrEP efficacy trials to implementation. %$ 056 ; 108 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Havlir, D. %A Lockman, S. %A Ayles, H. %A Larmarange, Joseph %A Chamie, G. %A Gaolathe, T. %A Iwuji, C. %A Fidler, S. %A Kamya, M. %A Floyd, S. %A Moore, J. %A Hayes, R. %A Petersen, M. %A Dabis, F. %A Universal Test Treat Trials UT3 Consortium %T What do the Universal Test and Treat trials tell us about the path to HIV epidemic control ? %D 2020 %L fdi:010078031 %G ENG %J Journal of the International AIDS Society %K HIV testing ; antiretroviral therapy ; HIV elimination ; HIV care continuum ; HIV prevention ; HIV care continuum ; public health ; universal access %K BOTSWANA ; ZAMBIE ; OUGANDA ; KENYA ; AFRIQUE DU SUD ; AFRIQUE SUBSAHARIENNE %M ISI:000518595100011 %N 2 %P e25455 [7 p.] %R 10.1002/jia2.25455 %U http://www.documentation.ird.fr/hor/fdi:010078031 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers20-04/010078031.pdf %V 23 %W Horizon (IRD) %X Introduction Achieving HIV epidemic control globally will require new strategies to accelerate reductions in HIV incidence and mortality. Universal test and treat (UTT) was evaluated in four randomized population-based trials (BCPP/Ya Tsie, HPTN 071/PopART, SEARCH, ANRS 12249/TasP) conducted in sub-Saharan Africa (SSA) during expanded antiretroviral treatment (ART) eligibility by World Health Organization guidelines and the UNAIDS 90-90-90 campaign. Discussion These three-year studies were conducted in Botswana, Zambia, Uganda, Kenya and South Africa in settings with baseline HIV prevalence from 4% to 30%. Key observations across studies were: (1) Universal testing (implemented via a variety of home and community-based testing approaches) achieved >90% coverage in all studies. (2) When coupled with robust linkage to HIV care, rapid ART start and patient-centred care, UTT achieved among the highest reported population levels of viral suppression in SSA. Significant gains in population-level viral suppression were made in regions with both low and high baseline population viral load; however, viral suppression gains were not uniform across all sub-populations and were lower among youth. (3) UTT resulted in marked reductions in community HIV incidence when universal testing and robust linkage were present. However, HIV elimination targets were not reached. In BCPP and HPTN 071, annualized HIV incidence was approximately 20% to 30% lower in the intervention (which included universal testing) compared to control arms (no universal testing). In SEARCH (where both arms had universal testing), incidence declined 32% over three years. (4) UTT reduced HIV associated mortality by 23% in the intervention versus control communities in SEARCH, a study in which mortality was comprehensively measured. Conclusions These trials provide strong evidence that UTT inclusive of universal testing increases population-level viral suppression and decreases HIV incidence and mortality faster than the status quo in SSA and should be adapted at a sub-country level as a public health strategy. However, more is needed, including integration of new prevention interventions into UTT, in order to reach UNAIDS HIV elimination targets. %$ 052 ; 050 ; 056 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Inghels, M. %A Kouassi, A. K. %A Niangoran, S. %A Bekelynck, A. %A Carillon, Severine %A Sika, L. %A Danel, C. %A Kone, M. %A Desgrées du Loû, Annabel %A Larmarange, Joseph %A Assoumou, N. %A Doumbia, M. %A Kone, M. %A Kouadio, A. %A Ouantchi, H. %A ANRS 12323 DOD-CI Study Group %T Cascade of provider-initiated human immunodeficiency virus testing and counselling at specific life events (Pregnancy, sexually transmitted infections, marriage) in Cote d'Ivoire %D 2020 %L fdi:010077495 %G ENG %J Sexually Transmitted Diseases %@ 0148-5717 %K COTE D'IVOIRE %M ISI:000503502900014 %N 1 %P 54-61 %R 10.1097/olq.0000000000001084 %U http://www.documentation.ird.fr/hor/fdi:010077495 %> http://www.documentation.ird.fr/intranet/publi/2020/01/010077495.pdf %V 47 %W Horizon (IRD) %X Background Despite the implementation of Provider Initiated Testing and Counselling (PITC) in 2009, PITC coverage remains low in Cote d'Ivoire. The purpose of this study is to determine whether an human immunodeficiency virus (HIV) test was offered and performed at specific life events where PITC is recommended by national guidelines. Methods In 2017, a cross-sectional telephone survey was conducted among a representative sample of 3,867 adults from the general population in Cote d'Ivoire. The occurrences of the following events over the past 5 years were documented: pregnancy (event A) or partner's pregnancy (event B) of the last child, sexually transmitted infection (event C) and marriage (event D). For each of these events, participants were asked (i) if they consulted a health care professional, (ii) if they were offered an HIV test during that consultation and (iii) if they accepted it. Results Consulting a health care provider was reported by 94.9%, 58.3%, 70.3% and 19.1% of those who reported events A, B, C and D respectively. In case of medical consultations following events A, B, C and D, respectively 70.1%, 33.1%, 28.1%, and 78.8% of individuals were offered an HIV test. The testing acceptance was high regardless of the event. Overall, testing coverage was 63.7%, 16.9%, 13.4% and 14.5% for events A, B, C and D respectively. Conclusions Increasing HIV testing coverage in Cote d'Ivoire requires (i) facilitating attendance to health services in case of sexually transmitted infections, marriage and pregnancy-for men-and (ii) strengthening routine testing offer on these occasions. %$ 056 ; 052 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Inghels, M. %A Kouassi, A. K. %A Niangoran, S. %A Bekelynck, A. %A Carillon, Séverine %A Sika, L. %A Danel, C. %A Kone, M. %A du Lo, A. D. %A Larmarange, Joseph %A ANRS Dod-Ci Study Group, %T Practices and obstacles to Provider-Initiated HIV Testing and Counseling (PITC) among healthcare providers in Cote d'Ivoire %D 2020 %L fdi:010078075 %G ENG %J Aids and Behavior %@ 1090-7165 %K Provider initiated testing and counselling ; HIV testing ; Cote d'Ivoire ; Health personnel ; Phone-based survey %K COTE D'IVOIRE %M ISI:000535163300001 %P [10 p.] %R 10.1007/s10461-020-02923-0 %U http://www.documentation.ird.fr/hor/fdi:010078075 %> http://www.documentation.ird.fr/intranet/publi/2020/06/010078075.pdf %V [Early access] %W Horizon (IRD) %X Practices of Provider-Initiated HIV Testing and Counseling (PITC) remains suboptimal in Cote d'Ivoire. The aim of this survey was to identify the practices and obstacles to PITC among healthcare professionals in Cote d'Ivoire. A nationally representative cross-sectional survey was conducted in 2018 by telephone among three separate samples of midwives, nurses and physicians practicing in Cote d'Ivoire. The number of HIV tests proposed during consultation in the month preceding the survey was collected for each professional. Factors associated with the number of proposed tests were identified through ordinal logistic regression models. A total of 298 midwives, 308 nurses and 289 physicians were interviewed. Midwives proposed the test more frequently, followed by nurses and physicians. Among midwives, a higher number of proposed tests was associated with the perception that HIV testing does not require specific consent compared to other diseases (aOR 4.00 [95% CI 1.37-14.29]). Among nurses, having received HIV training and the presence of community HIV counselors were associated with a higher number of proposed tests (aOR 2.01 [1.31-3.09] and aOR 1.75 [1.14-2.70], respectively). For physicians, the presence of a voluntary testing center was associated with a higher number of proposed tests (aOR 1.69 [1.01-2.86]). PITC practices and barriers differed across professions. Beyond improving environmental opportunities such as dedicated staff or services, strengthening the motivations and capabilities of healthcare professionals to propose testing could improve PITC coverage. %$ 056 ; 124 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Kouadio, B.A. %A Carillon, Séverine %A Bekelynck, A. %A Assi, A.N.A. %A Ouantchi, H. %A Doumbia, M. %A Koné, M. %A Larmarange, Joseph %A Equipe projet DOD-CI ANRS 12323 %T Dépistage du VIH hors les murs en Côte d'Ivoire : des prestataires communautaires sous pression %D 2020 %L fdi:010078851 %G FRE %J Santé Publique %@ 0995-3914 %K AFRIQUE SUBSAHARIENNE ; COTE D'IVOIRE %M ISI:000550020300010 %N 1 %P 103-111 %R 10.3917/spub.201.0103 %U http://www.documentation.ird.fr/hor/fdi:010078851 %> http://www.documentation.ird.fr/intranet/publi/depot/2020-08-11/010078851.pdf %V 32 %W Horizon (IRD) %X Contexte : Les stratégies de dépistage du virus de l'immunodéficience humaine (VIH) ' hors les murs ' ont fortement contribué à augmenter le nombre des personnes connaissant leur statut sérologique en Afrique subsaharienne. Cet article analyse l'articulation entre les exigences des bailleurs et les contraintes du terrain dans le cadre de la mise en oeuvre du dépistage hors les murs en Côte d'Ivoire. Méthodes : Une recherche qualitative a été menée dans trois districts sanitaires de Côte d'Ivoire (Man, Cocody-Bingerville et Aboisso) en 2015-2016. Les données étaient issues d'entretiens conduits auprès de prestataires communautaires d'organisations non gouvernementales (ONG) d'exécution, et de personnes dépistées, ainsi que par l'observation d'activités de dépistage du VIH hors les murs. Résultats : Les organisations d'exécution se sentent ' sous pression ' face aux objectifs des bailleurs jugés inatteignables et au déficit de formation et de financement. Dès lors, les prestataires n'observent pas systématiquement les règles en matière de conseil, consentement éclairé et confidentialité, dites des ' trois C ', et dépistent des personnes ' hors cibles ' (géographiques et populationnelles). Discussion : Deux types de contraintes pèsent sur les ONG d'exécution : celles issues du fonctionnement de l'aide internationale (financements inadéquats par rapport aux coûts réels, objectifs trop élevés, chaîne d'intermédiaires importante) et celles liées au contexte local (espaces non adaptés pour garantir la confidentialité et activité professionnelle des populations cibles). Conclusion : Les pressions que subissent à différents niveaux les ONG d'exécution se font au détriment de la qualité du dépistage. Il apparaît aujourd'hui essentiel de développer une approche plus qualitative dans la définition des stratégies et de ses critères d'évaluation. %$ 052 ; 056 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Assoumou, A.A. %A Bekelynck, A. %A Carillon, Severine %A Kouadio, B.A. %A Ouantchi, H. %A Doumbia, M. %A Larmarange, Joseph %A Koné, M. %T Organisation du financement du dépistage du VIH à base communautaire en Côte d'Ivoire : une recherche d'efficience potentiellement contre-productive ? %D 2019 %L fdi:010076848 %G FRE %J Médecine et Santé Tropicales %@ 2261-3684 %K COTE D'IVOIRE ; ABIDJAN %M ISI:000488876500011 %N 3 %P 287-293 [en ligne] %U http://www.documentation.ird.fr/hor/fdi:010076848 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers19-09/010076848.pdf %V 29 %W Horizon (IRD) %X Objectif : Depuis le début des années 2010, le President's Emergency Plan for AIDS Relief (Pepfar) et le Fonds mondial de lutte contre le VIH/ sida, la tuberculose et le paludisme ont accentué leurs stratégies de gestion axée sur les résultats (GAR). Les conditions de décaissements sont de plus en plus exigeantes pour les organisations non gouvernementales (ONG) financés (atteinte d'objectifs chiffrés, réalisation de compte rendu et de contrôles des activités fréquents) et leur rémunération dépend des résultats atteints. Cet article vise à analyser les effets de ce renforcement des politiques fondées sur le new public management sur la mise en oeuvre locale des activités, à travers l'exemple du dépistage du VIH à base communautaire. Méthodes : Dans trois districts sanitaires de la Côte d'Ivoire, nous avons réalisé, en 2015 et 2016, une cartographie des acteurs impliqués dans le dépistage communautaire et des entretiens semi-directifs auprès de membres des ONG dites "communautaires" (n = 18). Résultats : Le financement des organisations en charge du dépistage au niveau local transite par des organisations intermédiaires selon un système pyramidal complexe. Combiné à la lourdeur des comptes rendus d'activité et de la validation des données, cela génère des retards dans le décaissement des fonds et réduit fortement le temps effectif de mise en oeuvre des activités, soit moins de la moitié du temps prévu à cet effet. Conclusion : Cette managérialisation aussi bien du Pepfar que du Fonds mondial produit ainsi des effets contre-productifs contre lesquels elle était censée lutter. %$ 056 ; 052 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Bekelynck, A. %A Larmarange, Joseph %A Assoumou, N. %A Danel, C. %A Doumbia, M. %A Kone, M. %A Kouadio, A. %A Kra, A. %A Niangoran, S. %A Ouantchi, H. %A Sika, L. %A Carillon, Séverine %A Ingheis, M. %A ANRS Dod-Ci Study Group %T Pepfar 3.0's HIV testing policy in Cote d'Ivoire (2014 to 2018) : fragmentation, acceleration and disconnection %D 2019 %L fdi:010077777 %G ENG %J Journal of the International Aids Society %K Pepfar ; HIV testing ; Health policy ; COP (Country operational Plan) ; Cote d'Ivoire ; Africa %K COTE D'IVOIRE %M ISI:000505786500011 %N 12 %P e25424 [7 p.] %R 10.1002/jia2.25424 %U http://www.documentation.ird.fr/hor/fdi:010077777 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers20-01/010077777.pdf %V 22 %W Horizon (IRD) %X Introduction HIV Testing and Counselling (HTC) remains a key challenge in achieving control of the HIV epidemic by 2030. In the early 2010s, the President's Emergency Plan for AIDS Relief (Pepfar) adopted targeted HTC strategies for populations and geographical areas most affected by HIV. We examine how Pepfar defined targeted HTC in Cote d'Ivoire, a country with a mixed HIV epidemic, after a decade of expanding HTC services. Methods We explored the evolution of HTC strategies through the Country Operational Plans (COP) of Pepfar during its phase 3.0, from COP 14 to COP 17 (October 2014 to September 2018) in Cote d'Ivoire. We conducted an analysis of the grey literature over the period 2014 to 2018 (Budget & Target Report, Strategic Direction Summary, Sustainability Index and Dashboard Summary, ). We also conducted a qualitative study in Cote d'Ivoire (2015 to 2018) using in-depth interviews with stakeholders in the AIDS public response: CDC/Pepfar (3), Ministry of Health (3), intermediary NGOs (7); and public meeting observations (14). Results Since the COP 14, Pepfar's HIV testing strategies have been characterized by significant variations in terms of numerical, geographical and population targets. While the aim of COP 14 and COP 15 seemed to be the improvement of testing efficacy in general and testing yield in particular, COP 16 and COP 17 prioritized accelerating progress towards the "first 90" (i.e. reducing the proportion of people living with HIV who are unaware of their HIV). A shift was observed in the definition of testing targets, with less focus on the inclusion of programmatic data and feedback from field actors, and greater emphasis on the use of models to estimate and disaggregate the targets by geographical units and sub-populations (even if the availability of data by this disaggregation was limited or uncertain); increasingly leading to gaps between targets and results. Conclusions These trials and tribulations question the real and long-term effectiveness of annually-revised, fragmented strategies, which widen an increasing disparity between the realities of the actors on the ground and the objectives set in Washington. %$ 056 ; 052 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Gosset, A. %A Protopopescu, C. %A Larmarange, Joseph %A Orne-Gliemann, J. %A McGrath, N. %A Pillay, D. %A Dabis, F. %A Iwuji, C. %A Boyer, S. %T Retention in care trajectories of HIV-positive individuals participating in a universal test-and-treat program in rural South Africa (ANRS 12249 TasP Trial) %D 2019 %L fdi:010076589 %G ENG %J JAIDS.Journal of Acquired Immune Deficiency Syndromes %@ 1525-4135 %K universal test and treat ; HIV ; South Africa ; retention in care trajectories %K AFRIQUE DU SUD %M ISI:000480763600005 %N 4 %P 375-385 %R 10.1097/qai.0000000000001938 %U http://www.documentation.ird.fr/hor/fdi:010076589 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers19-08/010076589.pdf %V 80 %W Horizon (IRD) %X Objective: To study retention in care (RIC) trajectories and associated factors in patients eligible for antiretroviral therapy (ART) in a universal test-and-treat setting (TasP trial, South Africa, 2012-2016). Design: A cluster-randomized trial whereby individuals identified HIV positive after home-based testing were invited to initiate ART immediately (intervention) or following national guidelines (control). Methods: Exiting care was defined as >= 3 months late for a clinic appointment, transferring elsewhere, or death. Group-based trajectory modeling was performed to estimate RIC trajectories over 18 months and associated factors in 777 ART-eligible patients. Results: Four RIC trajectory groups were identified: (1) group 1 "remained" in care (reference, n = 554, 71.3%), (2) group 2 exited care then "returned" after [median (interquartile range)] 4 (3-9) months (n = 40, 5.2%), (3) group 3 "exited care rapidly" [after 4 (4-6) months, n = 98, 12.6%], and (4) group 4 "exited care later" [after 11 (9-13) months, n = 85, 10.9%]. Group 2 patients were less likely to have initiated ART within 1 month and more likely to be male, young (<29 years), without a regular partner, and to have a CD4 count >350 cells/mm(3). Group 3 patients were more likely to be women without social support, newly diagnosed, young, and less likely to have initiated ART within 1 month. Group 4 patients were more likely to be newly diagnosed and aged 39 years or younger. Conclusions: High CD4 counts at care initiation were not associated with a higher risk of exiting care. Prompt ART initiation and special support for young and newly diagnosed patients with HIV are needed to maximize RIC. %$ 056 ; 052 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Inghels, M. %A Carillon, Severine %A Desgrées du Loû, Annabel %A Larmarange, Joseph %T Effect of organizational models of provider-initiated testing and counseling (PITC) in health facilities on adult HIV testing coverage in sub-Saharan Africa %D 2019 %L fdi:010076093 %G ENG %J AIDS Care %@ 0954-0121 %K Provider initiated testing and counseling ; HIV testing ; testing cover ; organizational models ; Sub-Saharan Africa %K AFRIQUE SUBSAHARIENNE %M ISI:000472360900001 %N [Early access] %P [12 p.] %R 10.1080/09540121.2019.1626339 %U http://www.documentation.ird.fr/hor/fdi:010076093 %> http://www.documentation.ird.fr/intranet/publi/2019/07/010076093.pdf %W Horizon (IRD) %X The purpose of this paper is to identify which Provider-Initiated HIV Testing and Counseling (PITC) organizational models are the most efficient to maximize testing coverage. We conducted a systematic literature review to identify published articles that evaluated routine PITC programs implemented in adult health facilities in Sub-Saharan Africa. We considered only articles measuring PITC offer, PITC acceptability and PITC coverage. Adjusted meta-regression models were performed to measure the association between PITC offer, acceptability and coverage with PITC organizational model. A total of 30 articles were included in the meta-analysis. Overall, 85.4% [95%CI: 77.2-93.5] of patients were offered a test, and 87.1% [82.4-91.7] accepted the test resulting in a PITC coverage of 74.3% [66-82.6]. Four types of PITC organizational models were identified: PITC initiated and performed during the consultation (model A), PITC initiated before consultation (model B), PITC referred on-site (model C) and PITC referred off-site (model D). Compared to model A, model B had a similar coverage (aOR: 1.02 [0.82-1.26]). However, coverage was lower for model C (aOR: 0.81 [0.68-0.97]) and model D (aOR: 0.58 [0.44-0.77]). Initiating the testing process before or during medical consultation is recommended for maximizing testing coverage among patients. %$ 052 ; 056 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Larmarange, Joseph %A Diallo, M. H. %A McGrath, N. %A Iwuji, C. %A Plazy, M. %A Thiebaut, R. %A Tanser, F. %A Barnighausen, T. %A Orne-Gliemann, J. %A Pillay, D. %A Dabis, F. %A March, Laura %A ANRS 12249 TasP Study Group %T Temporal trends of population viral suppression in the context of Universal Test and Treat : the ANRS 12249 TasP trial in rural South Africa %D 2019 %L fdi:010077311 %G ENG %J Journal of the International AIDS Society %K HIV ; antiretroviral therapy ; sustained viral suppression ; retention in care ; population health ; South Africa %K AFRIQUE DU SUD %M ISI:000494678600005 %N 10 %P art. e25402 [11 p.] %R 10.1002/jia2.25402 %U http://www.documentation.ird.fr/hor/fdi:010077311 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers19-11/010077311.pdf %V 22 %W Horizon (IRD) %X Introduction The universal test-and-treat (UTT) strategy aims to maximize population viral suppression (PVS), that is, the proportion of all people living with HIV (PLHIV) on antiretroviral treatment (ART) and virally suppressed, with the goal of reducing HIV transmission at the population level. This article explores the extent to which temporal changes in PVS explain the observed lack of association between universal treatment and cumulative HIV incidence seen in the ANRS 12249 TasP trial conducted in rural South Africa. Methods The TasP cluster-randomized trial (2012 to 2016) implemented six-monthly repeat home-based HIV counselling and testing (RHBCT) and referral of PLHIV to local HIV clinics in 2 x 11 clusters opened sequentially. ART was initiated according to national guidelines in control clusters and regardless of CD4 count in intervention clusters. We measured residency status, HIV status, and HIV care status for each participant on a daily basis. PVS was computed per cluster among all resident PLHIV (>= 16, including those not in care) at cluster opening and daily thereafter. We used a mixed linear model to explore time patterns in PVS, adjusting for sociodemographic changes at the cluster level. Results 8563 PLHIV were followed. During the course of the trial, PVS increased significantly in both arms (23.5% to 46.2% in intervention, +22.8, p < 0.001; 26.0% to 44.6% in control, +18.6, p < 0.001). That increase was similar in both arms (p = 0.514). In the final adjusted model, PVS increase was most associated with increased RHBCT and the implementation of local trial clinics (measured by time since cluster opening). Contextual changes (measured by calendar time) also contributed slightly. The effect of universal ART (trial arm) was positive but limited. Conclusions PVS was improved significantly but similarly in both trial arms, explaining partly the null effect observed in terms of cumulative HIV incidence between arms. The PVS gains due to changes in ART-initiation guidelines alone are relatively small compared to gains obtained by strategies to maximize testing and linkage to care. The achievement of the 90-90-90 targets will not be met if the operational and implementational challenges limiting access to care and treatment, often context-specific, are not properly addressed. Clinical trial number: NCT01509508 (clinicalTrials.gov)/DOH-27-0512-3974 (South African National Clinical Trials Register). %$ 052 ; 056 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Rolland, M. %A McGrath, N. %A Tiendrebeogo, T. %A Larmarange, Joseph %A Pillay, D. %A Dabis, F. %A Orne-Gliemann, J. %A ANRS TasP Study Group %T No effect of test and treat on sexual behaviours at population level in rural South Africa %D 2019 %L PAR00019640 %G ENG %J AIDS %@ 0269-9370 %K Africa ; antiretroviral therapy ; HIV ; prevention ; sexual behaviour %K AFRIQUE DU SUD %M ISI:000480690900014 %N 4 %P 709-722 %R 10.1097/qad.0000000000002104 %U http://www.documentation.ird.fr/hor/PAR00019640 %V 33 %W Horizon (IRD) %X Context: Within the community-randomized ANRS 12249 Treatment-as-Prevention trial conducted in rural South Africa, we analysed sexual behaviours stratified by sex over time, comparing immediate antiretroviral therapy irrespective of CD4(+) cell count vs. CD4(+)-guided antiretroviral therapy (start at CD4(+) cell count >350 cells/mu l then >500 cells/mu l) arms. Methods: As part of the 6-monthly home-based trial rounds, a sexual behaviour individual questionnaire was administered to all residents at least 16 years. We considered seven indicators: sexual intercourse in the past month; at least one regular sexual partner in the past 6 months; at least one casual sexual partner in the past 6 months and more than one sexual partner in the past 6 months; condom use at last sex (CLS) with regular partner, CLS with casual partner, and point prevalence estimate of concurrency. We conducted repeated cross-sectional analyses, stratified by sex. Generalized Estimating Equations models were used, including trial arm, trial time, calendar time and interaction between trial arm and trial time. Results: CLS with regular partner varied between 29-51% and 23-46% for men and women, respectively, with significantly lower odds among women in the control vs. intervention arm by trial end (P<0.001). CLS with casual partner among men showed a significant interaction between arm and trial round, with no consistent pattern. Women declared more than one partner in the past 6 months in less than 1% of individual questionnaires; among men, rates varied between 5-12%, and odds significantly and continuously declined between calendar rounds 1 and 7 [odds ratio = 4.2 (3.24-5.45)]. Conclusion: Universal Test and Treat was not associated with increased sexual risk behaviours. %$ 052 ; 056 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Iwuji, C. C. %A Orne-Gliemann, J. %A Larmarange, Joseph %A Balestre, E. %A Thiebaut, R. %A Tanser, F. %A Okesola, N. %A Makowa, T. %A Dreyer, J. %A Herbst, K. %A McGrath, N. %A Barnighausen, T. %A Boyer, S. %A De Oliveira, T. %A Rekacewicz, C. %A Bazin, B. %A Newell, M. L. %A Pillay, D. %A Dabis, F. %A ANRS 12249 TasP Study Group %T Universal test and treat and the HIV epidemic in rural South Africa : a phase 4, open-label, community cluster randomised trial %D 2018 %L fdi:010072498 %G ENG %J Lancet HIV %@ 2352-3018 %K AFRIQUE DU SUD %M ISI:000427422000007 %N 3 %P E116-E125 %R 10.1016/s2352-3018(17)30205-9 %U http://www.documentation.ird.fr/hor/fdi:010072498 %> http://www.documentation.ird.fr/intranet/publi/2018/04/010072498.pdf %V 5 %W Horizon (IRD) %X Background Universal antiretroviral therapy (ART), as per the 2015 WHO recommendations, might reduce population HIV incidence. We investigated the effect of universal test and treat on HIV acquisition at population level in a high prevalence rural region of South Africa. Methods We did a phase 4, open-label, cluster randomised trial of 22 communities in rural KwaZulu-Natal, South Africa. We included individuals residing in the communities who were aged 16 years or older. The clusters were composed of aggregated local areas (neighbourhoods) that had been identified in a previous study in the Hlabisa subdistrict. The study statisticians randomly assigned clusters (1:1) with MapInfo Pro (version 11.0) to either the control or intervention communities, stratified on the basis of antenatal HIV prevalence. We offered residents repeated rapid HIV testing during home-based visits every 6 months for about 4 years in four clusters, 3 years in six clusters, and 2 years in 12 clusters (58 cluster-years) and referred HIV-positive participants to trial clinics for ART (fixed-dose combination of tenofovir, emtricitabine, and efavirenz) regardless of CD4 cell count (intervention) or according to national guidelines (initially <= 350 cells per mu L and <500 cells per mu L from January, 2015; control). Participants and investigators were not masked to treatment allocation. We used dried blood spots once every 6 months provided by participants who were HIV negative at baseline to estimate the primary outcome of HIV incidence with cluster-adjusted Poisson generalised estimated equations in the intention-to-treat population after 58 cluster-years of follow-up. This study is registered with ClinicalTrials. gov, number NCT01509508, and the South African National Clinical Trials Register, number DOH-27-0512-3974. Findings Between March 9, 2012, and June 30, 2016, we contacted 26 518 (93%) of 28 419 eligible individuals. Of 17 808 (67%) individuals with a first negative dried blood spot test, 14 223 (80%) had subsequent dried blood spot tests, of whom 503 seroconverted after follow-up of 22 891 person-years. Estimated HIV incidence was 2.11 per 100 person-years (95% CI 1.84-2.39) in the intervention group and 2.27 per 100 person-years (2.00-2.54) in the control group (adjusted hazard ratio 1.01, 95% CI 0.87-1.17; p=0.89). We documented one case of suicidal attempt in a woman following HIV seroconversion. 128 patients on ART had 189 life-threatening or grade 4 clinical events: 69 (4%) of 1652 in the control group and 59 (4%) of 1367 in the intervention group (p=0.83). Interpretation The absence of a lowering of HIV incidence in universal test and treat clusters most likely resulted from poor linkage to care. Policy change to HIV universal test and treat without innovation to improve health access is unlikely to reduce HIV incidence. %$ 052 ; 050 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Larmarange, Joseph %A Becquet, Valentine %A Masumbuko, J. M. %A Nouaman, M. %A Plazy, M. %A Danel, C. %A Eholie, S. %T Implementing preexposure prophylaxis among key populations : an opportunity for patient-centered services and management of hepatitis B %D 2018 %L fdi:010072500 %G ENG %J Aids %@ 0269-9370 %K COTE D'IVOIRE %M ISI:000427976500017 %N 6 %P 829-830 %R 10.1097/qad.0000000000001749 %U http://www.documentation.ird.fr/hor/fdi:010072500 %> http://www.documentation.ird.fr/intranet/publi/2018/04/010072500.pdf %V 32 %W Horizon (IRD) %$ 052 ; 050 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Larmarange, Joseph %A Diallo, Mamadou Hassimiou %A McGrath, N. %A Iwuji, C. %A Plazy, M. %A Thiebaut, R. %A Tanser, F. %A Barnighausen, T. %A Orne-Gliemann, J. %A Pillay, D. %A Dabis, F. %A TasP Anrs Study Group, %T Temporal trends of population viral suppression in the context of Universal Test and Treat : results from the ANRS 12,249 TasP trial in rural South Africa %D 2018 %L fdi:010073712 %G ENG %J Journal of the International Aids Society %@ 1758-2652 %K AFRIQUE DU SUD %M ISI:000440002700022 %N 6 %P 12-12 %U http://www.documentation.ird.fr/hor/fdi:010073712 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers18-09/010073712.pdf %V 21 %W Horizon (IRD) %$ 052 ; 050 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Larmarange, Joseph %A Diallo, Mamadou Hassimiou %A McGrath, N. %A Iwuji, C. %A Plazy, M. %A Thiebaut, R. %A Tanser, F. %A Barnighausen, T. %A Pillay, D. %A Dabis, F. %A Orne-Gliemann, J. %A ANRS TasP Study Group %T The impact of population dynamics on the population HIV care cascade : results from the ANRS 12249 treatment as prevention trial in rural KwaZulu-Natal (South Africa) %D 2018 %L fdi:010073698 %G ENG %J Journal of the International Aids Society %@ 1758-2652 %K HIV care continuum ; Public health ; Structural drivers ; Migration ; Cross-sectional cascade ; Rural South Africa ; Population dynamics %K AFRIQUE DU SUD %M ISI:000439820500007 %N 4 %P e25128 [10 p.] %R 10.1002/jia2.25128 %U http://www.documentation.ird.fr/hor/fdi:010073698 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers18-09/010073698.pdf %V 21 %W Horizon (IRD) %X Introduction: The universal test and treat strategy (UTT) was developed to maximize the proportion of all HIV-positive individuals on antiretroviral treatment (ART) and virally suppressed, assuming that it will lead to a reduction in HIV incidence at the population level. The evolution over time of the cross-sectional HIV care cascade is determined by individual longitudinal trajectories through the HIV care continuum and underlying population dynamics. The purpose of this paper is to quantify the contribution of each component of population change (in- and out-migration, HIV seroconversion, ageing into the cohort and definitive exit such as death) on the HIV care cascade in the context of the ANRS 12249 Treatment as Prevention (TasP) cluster-randomized trial, investigating UTT in rural KwaZulu-Natal, South Africa, between 2012 and 2016. Methods: HIV test results and information on clinic visits, ART prescriptions, viral load and CD4 count, migration and deaths were used to calculate residency status, HIV status and HIV care status for each individual on a daily basis. Position within the HIV care continuum was considered as a score ranging from 0 (undiagnosed) to 4 (virally suppressed). We compared the cascade score of each individual joining or leaving the population of resident adults living with HIV with the average score of their cluster at the time of entry or exit. Then, we computed the contribution of each entry or exit on the average cascade score and their annualized total contribution, by component of change. Results: While the average cascade score increased over time in all clusters, that increase was constrained by population dynamics. Permanent exits and ageing into the people living with HIV cohort had a marginal effect. Both in-migrants and out-migrants were less likely to be retained at each step of the HIV care continuum. However, their overall impact on the cross-sectional cascade was limited as the effect of in- and out-migration balanced each other. The contribution of HIV seroconversions was negative in all clusters. Conclusions: In a context of high HIV incidence, the continuous flow of newly infected individuals slows down the efforts to increase ART coverage and population viral suppression, ultimately attenuating any population-level impact on HIV incidence. %$ 050 ; 052 ; 108 %0 Book %9 OS : Ouvrages scientifiques %A Kermarec, F. %A Larmarange, Joseph %T Rapport d'analyse de l'étude Fos-Epseal - Saisine no17-DSPE-0217-1513-D du 3 mars 2017 %C Saint-Maurice %D 2018 %L fdi:010076319 %G FRE %I Santé Publique France %@ 979-10-289042-5-8 %K SANTE PUBLIQUE ; EPIDEMIOLOGIE ; ENVIRONNEMENT ; POLLUTION ; EXPERTISE ; PARTICIPATION POPULAIRE ; ETUDE REGIONALE %K GESTION PARTICIPATIVE %K FRANCE ; PROVENCE ALPES COTE D'AZUR %P 108 %U http://www.documentation.ird.fr/hor/fdi:010076319 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers19-07/010076319.pdf %W Horizon (IRD) %X Santé publique France a été saisie par l'ARS Provence-Alpes-Côte d'Azur en mars 2017 afin d'analyser la méthode mise en oeuvre dans l'étude "Fos-Epséal" menée à Fos-sur-Mer et Port-Saint-Louis-du-Rhône et les résultats qui en sont issus sur les conséquences des expositions industrielles sur la santé des populations. Pour répondre à cette saisine, Santé publique France a constitué un comité d'appui composé de scientifiques internes et d'experts externes à l'Agence. Les points traités par ce comité ont été : l'analyse critique de la méthode et des résultats de l'étude ; l'apport de la dynamique participative proposée par l'étude. L'étude Fos-Epséal est une étude participative en santé environnement (approche dite "d'épidémiologie ancrée localement"). Elle a été réalisée par une équipe du Centre Norbert Elias de Marseille (EHESS, CNRS, Université d'Avignon, Université d'Aix-Marseille) en lien avec une équipe américaine (College of Liberal Arts and Human Sciences – Virginia Tech University, School of Public Health -University of California, Berkeley) et financée par un appel à projets de recherche de l'Anses. Le comité conclut que le rapport aurait gagné à avoir une présentation claire des méthodes utilisées et une structuration rigoureuse séparant les résultats statistiques de leur interprétation. La comparaison des résultats statistiques basés sur les déclarations des personnes interrogées à des données de référence régionales ou nationales fait apparaître des excès de risque pour plusieurs pathologies au sein de l'échantillon de populations des communes enquêtées. Toutefois, le comité a estimé que l'existence de ces excès et leur ampleur est limitée par des biais de sélection de l'échantillon enquêté, les références retenues et les méthodes d'ajustement utilisées. Malgré des faiblesses méthodologiques, les résultats présentés confirment que ce territoire nécessite une grande attention de la part des autorités publiques. Les argumentaires utilisés pour faire le lien entre un résultat sanitaire (une pathologie localement observée en excès) et une cause environnementale, présentés dans l'étude comme des "éléments d'analyse participative", doivent être considérés comme des hypothèses émises par les chercheurs et les populations, que des études ad hoc plus précises seraient en mesure de confirmer. L'intérêt porté sur les maladies qui préoccupent la population, la prise en compte de la santé telle qu'elle est exprimée par la population et les concertations mises en place lors de l'étude Fos-Epséal représentent les intérêts majeurs de cette étude. La démarche d'épidémiologie ancrée localement, fondée sur les perceptions et l'expérience des populations, apparaît complémentaire à l'approche de l'épidémiologie traditionnelle. La coexistence de ces deux approches est utile pour maintenir la crédibilité et optimiser l'efficacité du système français d'alerte en santé environnementale. %B Etudes et Enquêtes %$ 056POLSAN ; 021ENVECO %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Inghels, M. %A Coffie, P.A. %A Larmarange, Joseph %T Recours aux soins de santé globale et de santé sexuelle et reproductive, chez les étudiants de l'université Houphouët-Boigny, Abidjan, Côte d'Ivoire %D 2017 %L fdi:010070598 %G FRE %J Revue d'Epidémiologie et de Santé Publique %@ 0398-7620 %K SANTE PUBLIQUE ; JEUNESSE ; ETUDIANT ; COMPORTEMENT SEXUEL ; CONTRACEPTION ; SOCIETE URBAINE ; CENTRE DE SANTE ; ENQUETE STATISTIQUE %K SANTE DE LA REPRODUCTION ; ACCES AUX SOINS %K COTE D'IVOIRE ; ABIDJAN %M ISI:00041291150000005 %N 5 %P 369-379 %R 10.1016/j.respe.2017.04.059 %U http://www.documentation.ird.fr/hor/fdi:010070598 %> http://www.documentation.ird.fr/intranet/publi/depot/2017-10-24/010070598.pdf %V 65 %W Horizon (IRD) %X Position du problème : En Côte d'Ivoire, peu de documents renseignent sur les besoins en santé et les barrières d'accès aux soins chez les jeunes. Cette étude cherchait à mesurer et à décrire l'offre de soins, les besoins et les freins au recours aux soins, en particulier en santé sexuelle et reproductive, et l'acceptabilité d'une visite médicale à la rentrée universitaire, chez les étudiants de l'université Houphouët-Boigny, à Abidjan. Méthodes : L'étude était une enquête transversale représentative des étudiants de 2e année sélectionnés par un sondage aléatoire équiprobable à deux degrés. Résultats : Au total, 543 étudiants (322 hommes et 221 femmes) ont été interrogés (98,4 % de participation). Parmi les étudiantes ayant déjà eu des relations sexuelles, 38,4 % (IC95 % [30,5 %–47,0 %]) avaient des besoins non satisfaits en matière de contraception et 31,2 % (IC95 % [23,7 %–40,0 %] avaient déjà vécu une grossesse non désirée. La peur d'effets indésirables sur la fertilité était le principal motif de non utilisation des méthodes contraceptives hormonales qui étaient les méthodes contraceptives les plus désirées chez les étudiants. Les principaux problèmes de santé déclarés par les étudiants étaient le paludisme (54,3 %), les infections respiratoires (44,6 %), les problèmes de constipation (28,0 %) et les troubles psychologiques (25,9 %). La principale barrière d'accès au centre de santé de l'université était la perception du coût élevé de ses services malgré leur gratuité, ce qui traduit des problèmes de visibilité sur cette offre et ses prestations. La majorité des étudiants étaient favorables à l'instauration d'une visite médicale lors de l'entrée à l'université. Conclusion : L'instauration d'une visite médicale permettrait d'améliorer la visibilité de l'offre du centre de santé universitaire et pourrait proposer les services suivants pour compléter au mieux l'offre de santé universitaire actuelle : i) dépistage du VIH, des chlamydiae et de la gonorrhée ; ii) dépistage et vaccination du virus hépatique B ; iii) mise à disposition d'information concernant les méthodes contraceptives ; iv) présentation de l'offre de santé sur l'université. L'aménagement d'espaces où les étudiants puissent avoir accès à une information sur certaines thématiques de santé (sexualité, nutrition, dépression) pourrait aussi compléter l'offre de santé universitaire. %$ 056POLSAN ; 108DEMOG2 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Larmarange, Joseph %A Sow, K. %A Broqua, C. %A Akindes, F. %A Bekelynck, A. %A Kone, M. %T Social and implementation research for ending AIDS in Africa %D 2017 %L fdi:010072385 %G ENG %J Lancet Public Health %@ 2468-2667 %M ISI:000425590500008 %N 12 %P E540-E540 %U http://www.documentation.ird.fr/hor/fdi:010072385 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers18-03/010072385.pdf %V 2 %W Horizon (IRD) %$ 056 ; 052 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Ruzagira, E. %A Baisley, K. %A Kamali, A. %A Biraro, S. %A Grosskurth, H. %A Larmarange, Joseph %A Working Group on Linkage to HIV Care %A et al. %T Linkage to HIV care after home-based HIV counselling and testing in sub-Saharan Africa : a systematic review %D 2017 %L fdi:010076320 %G ENG %J Tropical Medicine and International Health %@ 1360-2276 %K OUGANDA %M ISI:000404866600003 %N 7 %P 807-821 %R 10.1111/tmi.12888 %U http://www.documentation.ird.fr/hor/fdi:010076320 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers19-07/010076320.pdf %V 22 %W Horizon (IRD) %X Background: Home-based HIV counselling and testing (HBHCT) has the potential to increase HIV testing uptake in sub-Saharan Africa (SSA), but data on linkage to HIV care after HBHCT are scarce. We conducted a systematic review of linkage to care after HBHCT in SSA. Methods: Five databases were searched for studies published between 1st January 2000 and 19th August 2016 that reported on linkage to care among adults newly identified with HIV infection through HBHCT. Eligible studies were reviewed, assessed for risk of bias and findings summarised using the PRISMA guidelines. Results: A total of 14 studies from six countries met the eligibility criteria; nine used specific strategies (point-of-care CD4 count testing, follow-up counselling, provision of transport funds to clinic and counsellor facilitation of HIV clinic visit) in addition to routine referral to facilitate linkage to care. Time intervals for ascertaining linkage ranged from 1week to 12months post-HBHCT. Linkage ranged from 8.2% [95% confidence interval (CI), 6.8-9.8%] to 99.1% (95% CI, 96.9-99.9%). Linkage was generally lower (<33%) if HBHCT was followed by referral only, and higher (>80%) if additional strategies were used. Only one study assessed linkage by means of a randomised trial. Five studies had data on cotrimoxazole (CTX) prophylaxis and 12 on ART eligibility and initiation. CTX uptake among those eligible ranged from 0% to 100%. The proportion of persons eligible for ART ranged from 16.5% (95% CI, 12.1-21.8) to 77.8% (95% CI, 40.0-97.2). ART initiation among those eligible ranged from 14.3% (95% CI, 0.36-57.9%) to 94.9% (95% CI, 91.3-97.4%). Additional linkage strategies, whilst seeming to increase linkage, were not associated with higher uptake of CTX and/or ART. Most of the studies were susceptible to risk of outcome ascertainment bias. A pooled analysis was not performed because of heterogeneity across studies with regard to design, setting and the key variable definitions. Conclusion: Only few studies from SSA investigated linkage to care among adults newly diagnosed with HIV through HBHCT. Linkage was often low after routine referral but higher if additional interventions were used to facilitate it. The effectiveness of linkage strategies should be confirmed through randomised controlled trials. %$ 052 %0 Journal Article %9 ACLN : Articles dans des revues avec comité de lecture non répertoriées par l'AERES %A Larmarange, Joseph %A Dabis, F. %T La fin du sida est-elle en vue ? %B En Afrique, accoucher après la fin de l'exceptionnalité du Sida %D 2017 %E Tantchou, J. %E Tijou Traoré, A. %E Kouokam, E. %E Gruénais, Marc-Eric %E Saadia, R. %L fdi:010070396 %G FRE %J Face à Face %@ 1298-0390 %K AFRIQUE SUBSAHARIENNE %N No spécial %P art. no 1160 [15 p. en ligne] %U http://www.documentation.ird.fr/hor/fdi:010070396 %> http://www.documentation.ird.fr/intranet/publi/depot/2017-07-24/010070396.pdf %W Horizon (IRD) %X Les progrès observés ces dix dernières années dans le champ de la prévention du VIH, en particulier la place croissante prise par le traitement antirétroviral, ont amené certains leaders politiques et scientifiques à évoquer la "fin du sida", à savoir un contrôle des nouvelles infections et de la mortalité liée au VIH. Dans cet article, nous revenons en particulier sur l'objectif de contrôle de la transmission sexuelle. Le traitement antirétroviral précoce des personnes infectées permet de réduire fortement la charge virale plasmatique et, par conséquent, la probabilité de transmettre le virus (treatment as prevention ou TasP). De même, la prise d'antirétroviraux par des personnes non infectées permet également de les prémunir contre l'infection (prophylaxie préexposition ou PrEP). La question aujourd'hui n'est plus de savoir quand utiliser ces médicaments mais comment. Une stratégie de prévention combinée pourrait réduire significativement les nouvelles infections, mais à condition d'atteindre des niveaux de mise à l'échelle non encore atteints à ce jour. L'objectif de la fin du sida est atteignable, à condition de ne pas succomber aux sirènes d'un ‘tout biomédical' et de mesurer pleinement les enjeux programmatiques, opérationnels, sociaux, comportementaux et politiques qui nous font face. %$ 052 ; 056 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Boyer, S. %A Iwuji, C. %A Gosset, A. %A Protopopescu, C. %A Okesola, N. %A Plazy, M. %A Spire, B. %A Orne-Gliemann, J. %A McGrath, N. %A Pillay, D. %A Dabis, F. %A Larmarange, Joseph %T Factors associated with antiretroviral treatment initiation amongst HIV-positive individuals linked to care within a universal test and treat programme : early findings of the ANRS 12249 TasP trial in rural South Africa %D 2016 %L fdi:010067744 %G ENG %J Aids Care : Psychological and Socio-Medical Aspects of Aids/Hiv %@ 0954-0121 %K HIV infection ; universal test and treat strategy ; early antiretroviral treatment ; TasP trial ; South Africa %K AFRIQUE DU SUD %M ISI:000381048400006 %N 3 %P 39-51 %R 10.1080/09540121.2016.1164808 %U http://www.documentation.ird.fr/hor/fdi:010067744 %> http://www.documentation.ird.fr/intranet/publi/2016/09/010067744.pdf %V 28 %W Horizon (IRD) %X Prompt uptake of antiretroviral treatment (ART) is essential to ensure the success of universal test and treat (UTT) strategies to prevent HIV transmission in high-prevalence settings. We describe ART initiation rates and associated factors within an ongoing UTT cluster-randomized trial in rural South Africa. HIV-positive individuals were offered immediate ART in the intervention arm vs. national guidelines recommended initiation (CD4350cells/mm(3)) in the control arm. We used data collected up to July 2015 among the ART-eligible individuals linked to TasP clinics before January 2015. ART initiation rates at one (M1), three (M3) and six months (M6) from baseline visit were described by cluster and CD4 count strata (cells/mm(3)) and other eligibility criteria: 100; 100-200; 200-350; CD4>350 with WHO stage 3/4 or pregnancy; CD4>350 without WHO stage 3/4 or pregnancy. A Cox model accounting for covariate effect changes over time was used to assess factors associated with ART initiation. The 514 participants had a median [interquartile range] follow-up duration of 1.08 [0.69; 2.07] months until ART initiation or last visit. ART initiation rates at M1 varied substantially (36.9% in the group CD4>350 without WHO stage 3/4 or pregnancy, and 55.2-71.8% in the three groups with CD4350) but less at M6 (from 85.3% in the first group to 96.1-98.3% in the three other groups). Factors associated with lower ART initiation at M1 were a higher CD4 count and attending clinics with both high patient load and higher cluster HIV prevalence. After M1, having a regular partner was the only factor associated with higher likelihood of ART initiation. These findings suggest good ART uptake within a UTT setting, even among individuals with high CD4 count. However, inadequate staffing and healthcare professional practices could result in prioritizing ART initiation in patients with the lowest CD4 counts. %$ 108 ; 056 ; 052 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Camlin, C.S. %A Seeley, J. %A Viljoen, L. %A Vernooij, E. %A Simwinga, M. %A Reynolds, L. %A Reis, R. %A Plank, R. %A Orne-Gliemann, J. %A McGrath, N. %A Larmarange, Joseph %A Hoddinott, G. %A Getahun, M. %A Charlebois, E.D. %A Bond, V. %T Strengthening universal HIV 'test-and-treat' approaches with social science research %D 2016 %L fdi:010066573 %G ENG %J AIDS %@ 0269-9370 %K AFRIQUE %M ISI:000371905500019 %N 6 %P 969-970 %R 10.1097/QAD.0000000000001008 %U http://www.documentation.ird.fr/hor/fdi:010066573 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-03/010066573.pdf %V 30 %W Horizon (IRD) %$ 056 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Chikovore, J. %A Gillepsie, N. %A McGrath, N. %A Orne-Gliemann, J. %A Zuma, T. %A Larmarange, Joseph %A Sagaon Teyssier, Luis %A ANRS 12249 TasP Study Group %A et al. %T Men, masculinity, and engagement with treatment as prevention in KwaZulu-Natal, South Africa %D 2016 %L fdi:010076321 %G ENG %J AIDS Care.Psychological and Sociomedical Aspects of AIDS/HIV %@ 0954-0121 %K AFRIQUE DU SUD %M ISI:000381048400010 %N Suppl. 3 %P 74-82 %U http://www.documentation.ird.fr/hor/fdi:010076321 %> http://www.documentation.ird.fr/intranet/publi/depot/2019-07-18/010076321.pdf %V 28 %W Horizon (IRD) %X Men's poorer engagement with healthcare generally and HIV care specifically, compared to women, is well-described. Within the HIV public health domain, interest is growing in universal test and treat (UTT) strategies. UTT strategies refer to the expansion of antiretroviral therapy (ART) in order to reduce onward transmission and incidence of HIV in a population, through a treatment as prevention (TasP). This paper focuses on how masculinity influences engagement with HIV care in the context of an on-going TasP trial. Data were collected in January-November 2013 using 20 in-depth interviews, 10 of them repeated thrice, and 4 focus group discussions, each repeated four times. Analysis combined inductive and deductive approaches for coding and the review and consolidation of emerging themes. The accounts detailed men's unwillingness to engage with HIV testing and care, seemingly tied to their pursuit of valued masculinity constructs such as having strength and control, being sexually competent, and earning income. Articulated through fears regarding getting an HIV-positive diagnosis, observations that men preferred traditional medicine and that primary health centres were not welcoming to men, descriptions that men used lay measures to ascertain HIV status, and insinuations by men that they were removed from HIV risk, the indisposition to HIV care contrasted markedly with an apparent readiness to test among women. Gendered tensions thus emerged which were amplified in the context where valued masculinity representations were constantly threatened. Amid the tensions, men struggled with disclosing their HIV status, and used various strategies to avoid or postpone disclosing, or disclose indirectly, while women's ability to access care readily, use condoms, or communicate about HIV appeared similarly curtailed. UTT and TasP promotion should heed and incorporate into policy and health service delivery models the intrapersonal tensions, and the conflict, and poor and indirect communication at the micro-relational levels of couples and families. %$ 052 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Dah, T.T.E %A Orne-Gliemann, J. %A Guiard-Schmid, J.B. %A Becquet, R. %A Larmarange, Joseph %T Les hommes qui ont des rapports sexuels avec d'autres hommes (HSH) et l'infection à VIH à Ouagadougou, Burkina Faso : connaissances, attitudes, pratiques et enquête de séroprévalence [+ Erratum, 1 p.] %D 2016 %L fdi:010067346 %G ENG %J Revue d'Epidémiologie et de Santé Publique %@ 0398-7620 %K COMPORTEMENT SEXUEL ; HOMME ; PREVALENCE ; SIDA ; DEPISTAGE ; POPULATION URBAINE ; EXCLUSION SOCIALE ; ENQUETE %K BURKINA FASO ; OUAGADOUGOU %N 4 %P 295-300 [+ Erratum, 1 p.] %R 10.1016/j.respe.2016.02.008 %U http://www.documentation.ird.fr/hor/fdi:010067346 %> http://www.documentation.ird.fr/intranet/publi/depot/2019-10-21/010067346.pdf %V 64 %W Horizon (IRD) %X Position du problème : A l'instar de plusieurs pays africains, la question des rapports sexuels entre hommes au Burkina Faso reste taboue et est parfois cause d'exclusion sociale. Cette population qui est vulnérable face au VIH sida est méconnue, car n'ayant pas souvent fait l'objet d'exploration scientifique. Objectif : L'objectif de notre étude était de caractériser les connaissances, attitudes, pratiques sexuelles et d'estimer la séroprévalence du VIH parmi les HSH à Ouagadougou. Méthodes : Une étude transversale à visée descriptive et analytique a été conduite auprès de HSH résidant à Ouagadougou recrutés par la technique de « boule de neige », âgés d'au moins 18 ans et acceptant de participer à l'étude. Les données ont été recueillies par un questionnaire administré en face-à-face par deux enquêteurs formés. Le test de dépistage du VIH a été systématiquement proposé aux enquêtés. Résultats : Au total, 142 HSH ont été recrutés durant la période d'étude. L'échantillon était constitué à majorité d'élèves ou d'étudiants (60,8 %), de célibataires (91 %) avec un âge compris entre 18 et 30 ans (96,5 %). Le score médian de connaissance vis-à-vis du VIH était de 8/10. La séroprévalence du VIH était estimée à 8,9 % (4,5–15,4). Conclusion : Notre étude confirme la vulnérabilité des HSH de Ouagadougou vis-à-vis du VIH vu la séroprévalence élevée de l'infection par le VIH. Des interventions ciblées de prévention, de prise en charge et de recherche scientifique s'imposent aux autorités afin de pérenniser les acquis nationaux de la lutte contre le VIH sida. %$ 056SOCSAN ; 102URBHA1 ; 108DEMOG1 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Iwuji, C. %A Ome-Gliemann, J. %A Balestre, E. %A Larmarange, Joseph %A Thiebaut, R. %A Tanser, F. %A Okesola, N. %A Makowa, T. %A Dreyer, J. %A Herbst, K. %A Grath, N. %A Barnighausen, T. %A Boyer, S. %A Oliveira, T. %A Rekacewicz, C. %A Bazin, B. %A Newell, M. L. %A Pillay, D. %A Dabis, F. %A Anrs 12249 Tasp Study Group %T The impact of universal test and treat on HIV incidence in a rural South African population : ANRS 12249 TasP trial, 2012-2016 %D 2016 %L fdi:010069478 %G ENG %J Journal of the International Aids Society %@ 1758-2652 %K AFRIQUE DU SUD %M ISI:000395394300202 %N 5 %P FRAC0105LB %U http://www.documentation.ird.fr/hor/fdi:010069478 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers17-05/010069478.pdf %V 19 %W Horizon (IRD) %$ 050 ; 052 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Iwuji, C. C. %A Orne-Gliemann, J. %A Larmarange, Joseph %A Okesola, N. %A Tanser, F. %A Thiebaut, R. %A Rekacewicz, C. %A Newell, M. L. %A Dabis, F. %T Uptake of home-based hiv testing, linkage to care, and community attitudes about art in rural KwaZulu-Natal, South Africa : descriptive results from the first phase of the anrs 12249 tasp cluster-randomised trial %D 2016 %L fdi:010068181 %G ENG %J Plos Medicine %@ 1549-1676 %K AFRIQUE DU SUD %M ISI:000383357400024 %N 8 %P art. e1002107 [18 p.] %R 10.1371/journal.pmed.1002107 %U http://www.documentation.ird.fr/hor/fdi:010068181 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-10/010068181.pdf %V 13 %W Horizon (IRD) %X Background The 2015 WHO recommendation of antiretroviral therapy (ART) for all immediately following HIV diagnosis is partially based on the anticipated impact on HIV incidence in the surrounding population. We investigated this approach in a cluster-randomised trial in a high HIV prevalence setting in rural KwaZulu-Natal. We present findings from the first phase of the trial and report on uptake of home-based HIV testing, linkage to care, uptake of ART, and community attitudes about ART. Methods and Findings Between 9 March 2012 and 22 May 2014, five clusters in the intervention arm (immediate ART offered to all HIV-positive adults) and five clusters in the control arm (ART offered according to national guidelines, i.e., CD4 count <= 350 cells/mu l) contributed to the first phase of the trial. Households were visited every 6 mo. Following informed consent and administration of a study questionnaire, each resident adult (>= 16 y) was asked for a finger-prick blood sample, which was used to estimate HIV prevalence, and offered a rapid HIV test using a serial HIV testing algorithm. All HIV-positive adults were referred to the trial clinic in their cluster. Those not linked to care 3 mo after identification were contacted by a linkage-to-care team. Study procedures were not blinded. In all, 12,894 adults were registered as eligible for participation (5,790 in intervention arm; 7,104 in control arm), of whom 9,927 (77.0%) were contacted at least once during household visits. HIV status was ever ascertained for a total of 8,233/9,927 (82.9%), including 2,569 ascertained as HIV-positive (942 tested HIV-positive and 1,627 reported a known HIV-positive status). Of the 1,177 HIV-positive individuals not previously in care and followed for at least 6 mo in the trial, 559 (47.5%) visited their cluster trial clinic within 6 mo. In the intervention arm, 89% (194/218) initiated ART within 3 mo of their first clinic visit. In the control arm, 42.3%(83/196) had a CD4 count <= 350 cells/mu l at first visit, of whom 92.8% initiated ART within 3 mo. Regarding attitudes about ART, 93% (8,802/9,460) of participants agreed with the statement that they would want to start ART as soon as possible if HIV-positive. Estimated baseline HIV prevalence was 30.5%(2,028/6,656) (95% CI 25.0%, 37.0%). HIV prevalence, uptake of home-based HIV testing, linkage to care within 6 mo, and initiation of ART within 3 mo in those with CD4 count <= 350 cells/mu l did not differ significantly between the intervention and control clusters. Selection bias related to noncontact could not be entirely excluded. Conclusions Home-based HIV testing was well received in this rural population, although men were less easily contactable at home; immediate ART was acceptable, with good viral suppression and retention. However, only about half of HIV-positive people accessed care within 6 mo of being identified, with nearly two-thirds accessing care by 12 mo. The observed delay in linkage to care would limit the individual and public health ART benefits of universal testing and treatment in this population. %$ 052 ; 056 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Larmarange, Joseph %A Kassoum, O. %A Kakou, E. %A Fradier, Y. %A Sika, L. %A Danel, C. %A Groupe DOD-CI ANRS 12 287 %A Dutreuilh, C. %T Feasibility and representativeness of a random sample mobile phone survey in Côte d'Ivoire %D 2016 %L fdi:010067565 %G ENG %J Population English Edition %@ 0032-4663 %K COTE D'IVOIRE %M ISI:000378368400007 %N 1 %P 119-129 %U http://www.documentation.ird.fr/hor/fdi:010067565 %> http://www.documentation.ird.fr/intranet/publi/depot/2016-07-27/010067565.pdf %V 71 %W Horizon (IRD) %X This short paper presents the results of an exploratory pilot survey on HIV-AIDS screening (DOD-CI) conducted in Côte d'Ivoire to test the feasibility and representativeness of a national general population survey based on a random sample of mobile phone numbers. The refusal rate was low, and below the levels habitually observed for similar surveys conducted in France. In terms of representativeness, the sample obtained was younger, more urban and more masculine than the population in general. Four HIV-AIDS screening indicators were compared with those obtained in the Demographic and Health survey (DHS) conducted in 2011-2012. Owing to differences in selection biases affecting the two surveys, the indicators were higher than those observed in the DHS 2011-2012. However, the differences observed by sex, age group, level of education and place of residence were similar. This confirms the feasibility of applying such an approach for a national survey in Côte d'Ivoire, providing that several adjustments are made, such as including non-subscribers living in the same household as a mobile phone subscriber. %$ 056 ; 052 ; 108 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Larmarange, Joseph %A Kassoum, O. %A Kakou, E. %A Fradier, Y. %A Sika, L. %A Danel, C. %A Groupe DOD-CI ANRS 12 287 %T Faisabilité et représentativité d'une enquête téléphonique avec échantillonnage aléatoire de lignes mobiles en Côte d'Ivoire %D 2016 %L fdi:010067564 %G FRE %J Population %@ 0032-4663 %K COTE D'IVOIRE %N 1 %P 123-134 %R 10.3917/popu.1601.0121 %U http://www.documentation.ird.fr/hor/fdi:010067564 %> http://www.documentation.ird.fr/intranet/publi/depot/2016-07-12/010067564.pdf %V 71 %W Horizon (IRD) %X Cet article présente les résultats d'une enquête exploratoire pilote sur le dépistage du VIH/sida (DOD-CI) visant à tester la faisabilité et la représentativité d'une enquête nationale en population générale en Côte d'Ivoire à partir d'un échantillon aléatoire de numéros de téléphones portables. Les refus ont été peu nombreux et inférieurs à ce qui est habituellement observé dans des enquêtes similaires en France. En termes de représentativité, l'échantillon obtenu s'avère être plus jeune, plus urbain et plus masculin. Nous avons comparé quatre indicateurs de dépistage du VIH/sida avec l'Enquête démographique et de santé (EDS) réalisée en 2011-2012. Du fait de biais de sélection différents dans les deux enquêtes, les indicateurs étaient plus élevés que ceux observés dans l'EDS 2011-2012. Cependant, les différentiels observés par sexe, groupe d'âges, niveau d'instruction et milieu de résidence étaient similaires. Il paraît dès lors envisageable de réaliser une enquête nationale en Côte d'Ivoire selon cette approche, en opérant plusieurs ajustements, dont la prise en compte des non-abonnés à des téléphones mobiles résidant dans le même ménage qu'un abonné. %$ 056 ; 052 ; 108 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Larmarange, Joseph %T Evaluation of geospatial methods to generate subnational HIV prevalence estimates for local level planning [consise communication] %D 2016 %L fdi:010067180 %G ENG %J Aids %@ 0269-9370 %K AFRIQUE SUBSAHARIENNE %M ISI:000376457300017 %N 9 %P 1467-1474 %R 10.1097/QAD.0000000000001075 %U http://www.documentation.ird.fr/hor/fdi:010067180 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-05/010067180.pdf %V 30 %W Horizon (IRD) %X Objective: There is evidence of substantial subnational variation in the HIV epidemic. However, robust spatial HIV data are often only available at high levels of geographic aggregation and not at the finer resolution needed for decision making. Therefore, spatial analysis methods that leverage available data to provide local estimates of HIV prevalence may be useful. Such methods exist but have not been formally compared when applied to HIV. Design/methods: Six candidate methods – including those used by the Joint United Nations Programme on HIV/AIDS to generate maps and a Bayesian geostatistical approach applied to other diseases – were used to generate maps and subnational estimates of HIV prevalence across three countries using cluster level data from household surveys. Two approaches were used to assess the accuracy of predictions: internal validation, whereby a proportion of input data is held back (test dataset) to challenge predictions; and comparison with location-specific data from household surveys in earlier years. Results: Each of the methods can generate usefully accurate predictions of prevalence at unsampled locations, with the magnitude of the error in predictions similar across approaches. However, the Bayesian geostatistical approach consistently gave marginally the strongest statistical performance across countries and validation procedures. Conclusions: Available methods may be able to furnish estimates of HIV prevalence at finer spatial scales than the data currently allow. The subnational variation revealed can be integrated into planning to ensure responsiveness to the spatial features of the epidemic. The Bayesian geostatistical approach is a promising strategy for integrating HIV data to generate robust local estimates. %$ 056 ; 052 ; 020 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Moshabela, M. %A Zuma, T. %A Orne-Gliemann, J. %A Iwuji, C. %A Larmarange, Joseph %A McGrath, N. %T "It is better to die": experiences of traditional health practitioners within the HIV treatment as prevention trial communities in rural South Africa (ANRS 12249 TasP trial) %D 2016 %L fdi:010067745 %G ENG %J Aids Care : Psychological and Socio-Medical Aspects of Aids/Hiv %@ 0954-0121 %K HIV testing ; antiretroviral treatment ; treatment-as-prevention ; traditional healers ; HIV stigma ; South Africa %K AFRIQUE DU SUD %M ISI:000381048400004 %N 3 %P 24-32 %R 10.1080/09540121.2016.1181296 %U http://www.documentation.ird.fr/hor/fdi:010067745 %> http://www.documentation.ird.fr/intranet/publi/2016/09/010067745.pdf %V 28 %W Horizon (IRD) %X The ANRS 12249 Treatment-as-Prevention (TasP) cluster-randomized trial in rural South Africa uses a test and treat approach. Home-based testing services and antiretroviral treatment initiation satellite clinics were implemented in every cluster as part of the trial. A social science research agenda was nested within TasP with the aim of understanding the social, economic and contextual factors that affect individuals, households, communities and health systems with respect to TasP. Considering the rural nature of the trial setting, we sought to understand community perceptions and experiences of the TasP Trial interventions as seen through the eyes of traditional health practitioners (THPs). A qualitative study design was adopted using four repeat focus group discussions conducted with nine THPs, combined with community walks and photo-voice techniques, over a period of 18 months. A descriptive, interpretive and explanatory approach to analysis was adopted. Findings indicate that THPs engaged with the home-based testing services and HIV clinics established for TasP. Specifically, home-based testing services were perceived as relatively successful in increasing access to HIV testing. A major gap observed by THPs was linkage to HIV clinics. Most of their clients, and some of the THPs themselves, found it difficult to use HIV clinics due to fear of labelling, stigma and discrimination, and the ensuing personal implications of unsolicited disclosure. On the one hand, a growing number of patients diagnosed with HIV have found sanctuary with THPs as alternatives to clinics. On the other hand, THPs in turn have been struggling to channel patients suspected of HIV into clinics through referrals. Therefore, acceptability of the TasP test and treat approach by THPs is a major boost to the intervention, but further success can be achieved through strengthened ties with communities to combat stigma and effectively link patients into HIV care, including partnerships with THPs themselves. %$ 056 ; 108 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Orne-Gliemann, J. %A Zuma, T. %A Chikovore, J. %A Gillespie, N. %A Grant, M. %A Iwuji, C. %A Larmarange, Joseph %A McGrath, N. %A Lert, F. %A Imrie, J. %T Community perceptions of repeat HIV-testing : experiences of the ANRS 12249 Treatment as Prevention trial in rural South Africa %D 2016 %L fdi:010067746 %G ENG %J Aids Care : Psychological and Socio-Medical Aspects of Aids/Hiv %@ 0954-0121 %K South Africa ; HIV ; testing ; community ; UTT ; treatment as prevention %K AFRIQUE DU SUD %M ISI:000381048400003 %N 3 %P 14-23 %R 10.1080/09540121.2016.1164805 %U http://www.documentation.ird.fr/hor/fdi:010067746 %> http://www.documentation.ird.fr/intranet/publi/2016/09/010067746.pdf %V 28 %W Horizon (IRD) %X In the context of the ANRS 12249 Treatment as Prevention (TasP) trial, we investigated perceptions of regular and repeat HIV-testing in rural KwaZulu-Natal (South Africa), an area of very high HIV prevalence and incidence. We conducted two qualitative studies, before (2010) and during the early implementation stages of the trial (2013-2014), to appreciate the evolution in community perceptions of repeat HIV-testing over this period of rapid changes in HIV-testing and treatment approaches. Repeated focus group discussions were organized with young adults, older adults and mixed groups. Repeat and regular HIV-testing was overall well perceived before, and well received during, trial implementation. Yet community members were not able to articulate reasons why people might want to test regularly or repeatedly, apart from individual sexual risk-taking. Repeat home-based HIV-testing was considered as feasible and convenient, and described as more acceptable than clinic-based HIV-testing, mostly because of privacy and confidentiality. However, socially regulated discourses around appropriate sexual behaviour and perceptions of stigma and prejudice regarding HIV and sexual risk-taking were consistently reported. This study suggests several avenues to improve HIV-testing acceptability, including implementing diverse and personalised approaches to HIV-testing and care, and providing opportunities for antiretroviral therapy initiation and care at home. %$ 056 ; 108 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Plazy, M. %A El Farouki, K. %A Iwuji, C. %A Okesola, N. %A Orne-Gliemann, J. %A Larmarange, Joseph %A Lert, F. %A Newell, M.L. %A Dabis, F. %A Dray-Spira, R. %T Access to HIV care in the context of universal test and treat : challenges within the ANRS 12249 TasP cluster-randomized trial in rural South Africa [+ supplementary files] %D 2016 %L fdi:010067455 %G ENG %J Journal of the International AIDS Society %@ 1758-2652 %K AFRIQUE DU SUD %M ISI:000377027700001 %N 1 %P art. 20913 [12 p. + annexes, 9 p.] %R 10.7448/IAS.19.1.20913 %U http://www.documentation.ird.fr/hor/fdi:010067455 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-06/010067455.pdf %V 19 %W Horizon (IRD) %$ 056 ; 052 %0 Journal Article %9 ACLN : Articles dans des revues avec comité de lecture non répertoriées par l'AERES %A Bekelynck, A. %A Larmarange, Joseph %A Masumbuko, J.M. %A Msellati, Philippe %T Le Fonds mondial : un bailleur comme les autres ? L'exemple de la Côte d'Ivoire %D 2016 %L fdi:010070398 %G FRE %J Transversal %@ 2391-7385 %K SIDA ; AIDE AU DEVELOPPEMENT ; COOPERATION INTERNATIONALE ; FINANCEMENT %K COTE D'IVOIRE %P [en ligne] %U http://www.documentation.ird.fr/hor/fdi:010070398 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers17-08/010070398.pdf %V 19 sept. %W Horizon (IRD) %$ 095DEVEL ; 056POLSAN %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Iwuji, C. %A Dray-Spira, R. %A Calmy, A. %A Larmarange, Joseph %A Orne-Gliemann, J. %A Dabis, F. %A Pillay, D. %A Porter, K. %T Does a universal test and treat strategy impact ART adherence in rural South Africa ? ANRS 12249 TasP cluster-randomized trial %D 2015 %L fdi:010064888 %G ENG %J Journal of the International Aids Society %@ 1758-2652 %K AFRIQUE DU SUD %M ISI:000358675700028 %N Suppl. 4 %P 16-17 %R 10.7448/ias.18.5.20340 %U http://www.documentation.ird.fr/hor/fdi:010064888 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-03/010064888.pdf %V 18 %W Horizon (IRD) %B IAS Conference on HIV Pathogenesis, Treatment and Prevention %8 2015/07/19-22 %$ 052 ; 050 ; 108 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Larmarange, Joseph %A Mossong, J. %A Barnighausen, T. %A Newell, M. L. %T Participation dynamics in population-based longitudinal HIV surveillance in rural South Africa %D 2015 %L fdi:010064170 %G ENG %J Plos One %@ 1932-6203 %K AFRIQUE DU SUD %M ISI:000352845100165 %N 4 %P e0123345 [16 p.] %R 10.1371/journal.pone.0123345 %U http://www.documentation.ird.fr/hor/fdi:010064170 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-03/010064170.pdf %V 10 %W Horizon (IRD) %X Population-based HIV surveillance is crucial to inform understanding of the HIV pandemic and evaluate HIV interventions, but little is known about longitudinal participation patterns in such settings. We investigated the dynamics of longitudinal participation patterns in a high HIV prevalence surveillance setting in rural South Africa between 2003 and 2012, taking into account demographic dynamics. At any given survey round, 22,708 to 30,495 persons were eligible. Although the yearly participation rates were relatively modest (26% to 46%), cumulative rates increased substantially with multiple recruitment opportunities: 68% of eligible persons participated at least once, 48% at least twice and 31% at least three times after five survey rounds. We identified two types of study fatigue: at the individual level, contact and consent rates decreased with multiple recruitment opportunities and, at the population level, these rates also decreased over calendar time, independently of multiple recruitment opportunities. Using sequence analysis and hierarchical clustering, we identified three broad individual participation profiles: consenters (20%), switchers (43%) and refusers (37%). Men were over represented among refusers, women among consenters, and temporary non-residents among switchers. The specific subgroup of persons who were systemically not contacted or refusers constitutes a challenge for population-based surveillance and interventions. %$ 108 ; 052 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Orne-Gliemann, J. %A Larmarange, Joseph %A Boyer, S. %A Iwuji, C. %A McGrath, N. %A Barnighausen, T. %A Zuma, T. %A Dray-Spira, R. %A Spire, B. %A Rochat, T. %A Lert, F. %A Imrie, J. %T Addressing social issues in a universal HIV test and treat intervention trial (ANRS 12249 TasP) in South Africa : methods for appraisal %D 2015 %L fdi:010063987 %G ENG %J Bmc Public Health %@ 1471-2458 %K HIV infections ; HIV testing ; Community ; HIV care ; Antiretroviral treatment ; Social ; Behaviour ; Cost ; South Africa %K AFRIQUE DU SUD %M ISI:000350796200003 %P art. 209 [14 p.] %R 10.1186/s12889-015-1344-y %U http://www.documentation.ird.fr/hor/fdi:010063987 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-03/010063987.pdf %V 15 %W Horizon (IRD) %X Background: The Universal HIV Test and Treat (UTT) strategy represents a challenge for science, but is also a challenge for individuals and societies. Are repeated offers of provider-initiated HIV testing and immediate antiretroviral therapy (ART) socially-acceptable and can these become normalized over time? Can UTT be implemented without potentially adding to individual and community stigma, or threatening individual rights? What are the social, cultural and economic implications of UTT for households and communities? And can UTT be implemented within capacity constraints and other threats to the overall provision of HIV services? The answers to these research questions will be critical for routine implementation of UTT strategies. Methods/design: A social science research programme is nested within the ANRS 12249 Treatment-as-Prevention (TasP) cluster-randomised trial in rural South Africa. The programme aims to inform understanding of the (i) social, economic and environmental factors affecting uptake of services at each step of the continuum of HIV prevention, treatment and care and (ii) the causal impacts of the TasP intervention package on social and economic factors at the individual, household, community and health system level. We describe a multidisciplinary, multi-level, mixed-method research protocol that includes individual, household, community and clinic surveys, and combines quantitative and qualitative methods. Discussion: The UTT strategy is changing the overall approach to HIV prevention, treatment and care, and substantial social consequences may be anticipated, such as changes in social representations of HIV transmission, prevention, HIV testing and ART use, as well as changes in individual perceptions and behaviours in terms of uptake and frequency of HIV testing and ART initiation at high CD4. Triangulation of social science studies within the ANRS 12249 TasP trial will provide comprehensive insights into the acceptability and feasibility of the TasP intervention package at individual, community, patient and health system level, to complement the trial's clinical and epidemiological outcomes. It will also increase understanding of the causal impacts of UTT on social and economic outcomes, which will be critical for the long-term sustainability and routine UTT implementation. %$ 052 ; 056 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Plazy, M. %A ElFarouki, K. %A Iwuji, C. %A Okesola, N. %A Orne-Gliemann, J. %A Larmarange, Joseph %A Newell, M. L. %A Pillay, D. %A Dabis, F. %A Dray-Spira, R. %T Entry into care following universal home-based HIV testing in rural KwaZulu-Natal, South Africa : the ANRS TasP 12249 cluster-randomized trial %D 2015 %L fdi:010064887 %G ENG %J Journal of the International Aids Society %@ 1758-2652 %K AFRIQUE DU SUD %M ISI:000358675700123 %N Suppl. 4 %P 78-79 %R 10.7448/ias.18.5.20409 %U http://www.documentation.ird.fr/hor/fdi:010064887 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-03/010064887.pdf %V 18 %W Horizon (IRD) %B IAS Conference on HIV Pathogenesis, Treatment and Prevention %8 2015/07/19-22 %$ 052 ; 050 ; 108 %0 Journal Article %9 ACLN : Articles dans des revues avec comité de lecture non répertoriées par l'AERES %A Enel, C. %A Desgrées du Loû, Annabel %A N'Dri Yoman, T. %A Danel, C. %A Larmarange, Joseph %T Les hépatites virales B et C en Côte d'Ivoire : l'urgence d'une dynamisation de la lutte %D 2015 %L fdi:010066646 %G FRE %J Journal Africain d'Hépato-Gastroentérologie %@ 1954-3204 %K COTE D'IVOIRE %N 3 %P 94-98 %R 10.1007/s12157-015-0596-6 %U http://www.documentation.ird.fr/hor/fdi:010066646 %> http://www.documentation.ird.fr/intranet/publi/depot/2016-04-28/010066646.pdf %V 9 %W Horizon (IRD) %X En Côte d'Ivoire, malgré une prévalence d'environ 12% du VHB et 5% du VHC, le dépistage et la prise en charge des hépatites virales B et C demeurent très limités. Une étude qualitative a été menée en 2013 à Abidjan pour évaluer les modalités de dépistage et de prise en charge de ces infections. Les résultats révèlent la méconnaissance des hépatites tant dans la population générale que parmi les soignants non spécialistes. L'offre et la demande de dépistage sont restreintes et la formation insuffisante du personnel de santé engendre des occasions manquées. Seuls les donneurs de sang sont systématiquement dépistés, mais la prévention par la vaccination et la prise en charge sont peu effectives, faute de moyens financiers. Officiellement, les traitements sont disponibles, mais inaccessibles du fait de leur coût élevé, en l'absence de couverture maladie universelle. Le Programme National de Lutte contre les Hépatites Virales, créé en 2008, ne dispose pas du budget nécessaire pour pratiquer dépistage, prise en charge, prévention et campagnes de sensibilisation. L'absence de mobilisation financière internationale, comme celle qu'a connue l'épidémie de VIH, est vécue comme une injustice, tant par les médecins spécialisés qui ont les compétences pour traiter la maladie mais pas les moyens de les mettre au service des patients, que par les personnes porteuses d'une hépatite chronique B et/ou C. Il apparaît donc urgent de dynamiser et renforcer la lutte contre les hépatites B et C en Côte d'Ivoire. %$ 056 ; 050 %0 Journal Article %9 ACLN : Articles dans des revues avec comité de lecture non répertoriées par l'AERES %A Larmarange, Joseph %T Dépistage du VIH en Afrique : enjeux actuels %D 2015 %L fdi:010070399 %G FRE %J VIH.org [blog] %K SIDA ; DEPISTAGE ; SANTE PUBLIQUE %K AFRIQUE SUBSAHARIENNE %P [en ligne] %U http://www.documentation.ird.fr/hor/fdi:010070399 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers17-08/010070399.pdf %V 24 sept. %W Horizon (IRD) %$ 095DEVEL ; 056POLSAN %0 Conference Proceedings %9 ACTI : Communications avec actes dans un congrès international %A Larmarange, Joseph %T Dépistage et traitement universel : enjeux et état de la recherche %S Les nouveaux enjeux de la prévention combinée du VIH/sida : des apports scientifiques aux pratiques de terrain %C Bruxelles %D 2015 %E Pezeril, C. (dir). %E Metten, D. %L fdi:010070397 %G FRE %I Observatoire du Sida et des Sexualités %K SANTE PUBLIQUE ; SIDA ; DEPISTAGE ; TRAITEMENT MEDICAL ; ESSAI CLINIQUE ; PROGRAMME DE RECHERCHE %K AFRIQUE SUBSAHARIENNE ; AFRIQUE AUSTRALE %P 55-62 %U http://www.documentation.ird.fr/hor/fdi:010070397 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers17-07/010070397.pdf %W Horizon (IRD) %B Observatoire du Sida et des Sexualités : Cycle de Conférences %8 2014-2015 %$ 052MALTRA03 ; 056POLSAN %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Larmarange, Joseph %A Balestre, E. %A Orne-Gliemann, J. %A Iwuji, C. %A Okesola, N. %A Newell, M.L. %A Dabis, F. %A Lert, F. %T HIV ascertainment through repeat home-based testing in the context of a treatment as prevention trial (ANRS 12249 TasP) in rural South Africa %D 2014 %L fdi:010063442 %G ENG %J AIDS Research and Human Retroviruses %@ 1931-8405 %K SIDA ; METHODE DE LUTTE ; PREVENTION SANITAIRE ; DEPISTAGE ; TEST ; MILIEU RURAL ; COMMUNAUTE VILLAGEOISE %K AFRIQUE DU SUD %N Suppl. 1 %P A287 %R 10.1089/aid.2014.5650.abstract %U http://www.documentation.ird.fr/hor/fdi:010063442 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-03/010063442.pdf %V 30 %W Horizon (IRD) %$ 052MALTRA03 ; 108DEMOG1 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Larmarange, Joseph %A Bendaud, V. %T HIV estimates at second subnational level from national population-bases surveys %B The 2013/14 UNAIDS estimates methods : extending the scope and granularity of HIV estimates %D 2014 %E Case, K.K. %E Ghys P. %E Hallett T.B %E Porter K. %L fdi:010063252 %G ENG %J AIDS %@ 0269-9370 %K SIDA ; EPIDEMIOLOGIE ; METHODE D'ANALYSE ; ESTIMATION ; PREVALENCE ; VARIATION SPATIALE %K AFRIQUE SUBSAHARIENNE %M ISI:00034590080008 %N Suppl. 4 %P S469-476 %R 10.1097/QAD.0000000000000480 %U http://www.documentation.ird.fr/hor/fdi:010063252 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers15-01/010063252.pdf %V 28 %W Horizon (IRD) %X Objectives:A better understanding of the subnational variations could be paramount to the efficiency and effectiveness of the response to the HIV epidemic. The purpose of this study is to describe the methodology used to produce the first estimates at second subnational level released by UNAIDS. Methods:We selected national population-based surveys with HIV testing and survey clusters geolocation, conducted in 2008 or later. A kernel density estimation approach (prevR) with adaptive bandwidths was used to generate a surface of HIV prevalence. This surface was combined with LandScan global population distribution grid to estimate the spatial distribution of people living with HIV (PLWHIV). Finally, results were adjusted to national UNAIDS's published estimates and merged per second subnational administrative unit. An indicator of the quality of the estimates was computed for each administrative unit. Results:These estimates combine two complementary approaches: the prevR method, focusing on spatial variations of HIV prevalence, as well as national estimates published by UNAIDS, taking into account trends of HIV prevalence over time. Seventeen country reports have been produced. However, quality of the estimates at second subnational level is highly heterogonous between countries, depending on the number of units and the survey sampling size. In some countries, estimates at second subnational level are very uncertain and should be interpreted with caution. Conclusion:These estimates at second subnational level constitute a first step to help countries to better understand their HIV epidemic and to inform programming at lower geographical levels. Further developments are needed to better match local needs. %$ 052MALTRA03 ; 108DEMOG1 %0 Journal Article %9 ACLN : Articles dans des revues avec comité de lecture non répertoriées par l'AERES %A Larmarange, Joseph %A Coulibaly, S. %A Koriko, O. %A Fall, M. %T Appréhender la structure éco-démographique des ménages à partir d'enquêtes économiques : l'exemple des Enquêtes sur les Dépenses des Ménages 2008 %D 2014 %L fdi:010063533 %G FRE %J Statéco %@ 0224-098X %K ABIDJAN ; COTE D'IVOIRE ; BAMAKO ; MALI ; BISSAU ; GUINEE BISSAU ; COTONOU ; BENIN ; DAKAR ; SENEGAL ; LOME ; TOGO ; NIAMEY ; NIGER ; OUAGADOUGOU ; BURKINA FASO %P 75-97 %U http://www.documentation.ird.fr/hor/fdi:010063533 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers15-02/010063533.pdf %V 108 %W Horizon (IRD) %X Lieu premier de socialisation des individus, le ménage constitue une dimension essentielle à la compréhension des changements à l'oeuvre dans les sociétés africaines. Une description fine de la structure démographique des ménages nécessite des dispositifs de collecte complexes et coûteux. Cependant, même avec des enquêtes dont la finalité première n’est pas l'analyse démographique des ménages, il est déjà possible de dresser un panorama de leur diversité. Dans cet article, en partant des Enquêtes sur les Dépenses des Ménages menées en 2008 dans les capitales de l'UEMOA, nous montrons comment il est possible de tirer parti de la variable “dispose d’un revenu monétaire” pour construire une typologie « éco-démographique » des ménages, rendant compte de leur taille et de leur structure de dépendance et permettant de traduire la diversité des situations rencontrées par les familles usuellement classées comme « élargies ». %$ 094 ; 108 %0 Book %9 OS : Ouvrages scientifiques %A Larmarange, Joseph %T Burkina Faso. Developing subnational estimates of HIV prevalence and the number of people living with HIV survey data : methodology note %C Genève %D 2014 %L fdi:010063385 %G ENG %I UNAIDS %K SIDA ; PREVALENCE ; ESTIMATION ; DISTRIBUTION SPATIALE ; METHODOLOGIE %K BURKINA FASO %P 17 %U http://www.documentation.ird.fr/hor/fdi:010063385 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers15-03/010063385.pdf %W Horizon (IRD) %$ 108DEMOG1 ; 052MALTRA03 %0 Book %9 OS : Ouvrages scientifiques %A Larmarange, Joseph %T Burundi. Developing subnational estimates of HIV prevalence and the number of people living with HIV survey data : methodology note %C Genève %D 2014 %L fdi:010063384 %G ENG %I UNAIDS %K SIDA ; PREVALENCE ; ESTIMATION ; DISTRIBUTION SPATIALE ; METHODOLOGIE %K BURUNDI %P 17 %U http://www.documentation.ird.fr/hor/fdi:010063384 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers15-03/010063384.pdf %W Horizon (IRD) %$ 108DEMOG1 ; 052MALTRA03 %0 Book %9 OS : Ouvrages scientifiques %A Larmarange, Joseph %T Cameroon. Developing subnational estimates of HIV prevalence and the number of people living with HIV survey data : methodology note %C Genève %D 2014 %L fdi:010063393 %G ENG %I UNAIDS %K SIDA ; PREVALENCE ; ESTIMATION ; DISTRIBUTION SPATIALE ; METHODOLOGIE %K CAMEROUN %P 21 %U http://www.documentation.ird.fr/hor/fdi:010063393 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers15-03/010063393.pdf %W Horizon (IRD) %$ 108DEMOG1 ; 052MALTRA03 %0 Book %9 OS : Ouvrages scientifiques %A Larmarange, Joseph %T Côte d'Ivoire. Developing subnational estimates of HIV prevalence and the number of people living with HIV survey data : methodology note %C Genève %D 2014 %L fdi:010063395 %G ENG %I UNAIDS %K SIDA ; PREVALENCE ; ESTIMATION ; DISTRIBUTION SPATIALE ; METHODOLOGIE %K COTE D'IVOIRE %P 21 %U http://www.documentation.ird.fr/hor/fdi:010063395 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers15-03/010063395.pdf %W Horizon (IRD) %$ 108DEMOG1 ; 052MALTRA03 %0 Book %9 OS : Ouvrages scientifiques %A Larmarange, Joseph %T Guinea. Developing subnational estimates of HIV prevalence and the number of people living with HIV survey data : methodology note %C Genève %D 2014 %L fdi:010063766 %G ENG %I UNAIDS %K GUINEE %P 17 %U http://www.documentation.ird.fr/hor/fdi:010063766 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers15-04/010063766.pdf %W Horizon (IRD) %$ 108 ; 052 %0 Book %9 OS : Ouvrages scientifiques %A Larmarange, Joseph %T Haïti. Developing subnational estimates of HIV prevalence and the number of people living with HIV survey data : methodology note %C Genève %D 2014 %L fdi:010063383 %G ENG %I UNAIDS %K SIDA ; PREVALENCE ; ESTIMATION ; DISTRIBUTION SPATIALE ; METHODOLOGIE %K HAITI %P 17 %U http://www.documentation.ird.fr/hor/fdi:010063383 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers15-03/010063383.pdf %W Horizon (IRD) %$ 108DEMOG1 ; 052MALTRA03 %0 Book %9 OS : Ouvrages scientifiques %A Larmarange, Joseph %T Lesotho. Developing subnational estimates of HIV prevalence and the number of people living with HIV survey data : methodology note %C Genève %D 2014 %L fdi:010063745 %G ENG %I UNAIDS %K SIDA ; PREVALENCE ; ESTIMATION ; DISTRIBUTION SPATIALE ; METHODOLOGIE %K LESOTHO %P 16 %U http://www.documentation.ird.fr/hor/fdi:010063745 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers15-04/010063745.pdf %W Horizon (IRD) %$ 108DEMOG1 ; 052MALTRA03 %0 Book %9 OS : Ouvrages scientifiques %A Larmarange, Joseph %T Malawi. Developing subnational estimates of HIV prevalence and the number of people living with HIV survey data : methodology note %C Genève %D 2014 %L fdi:010063381 %G ENG %I UNAIDS %K SIDA ; PREVALENCE ; ESTIMATION ; DISTRIBUTION SPATIALE ; METHODOLOGIE %K SEROPOSITIVITE %K MALAWI %P 11 %U http://www.documentation.ird.fr/hor/fdi:010063381 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers15-03/010063381.pdf %W Horizon (IRD) %$ 108DEMOG1 ; 052MALTRA03 %0 Book %9 OS : Ouvrages scientifiques %A Larmarange, Joseph %T Rwanda. Developing subnational estimates of HIV prevalence and the number of people living with HIV survey data : methodology note %C Genève %D 2014 %L fdi:010063490 %G ENG %I UNAIDS %K SIDA ; PREVALENCE ; ESTIMATION ; DISTRIBUTION SPATIALE ; METHODOLOGIE %K RWANDA %P 13 %U http://www.documentation.ird.fr/hor/fdi:010063490 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers15-01/010063490.pdf %W Horizon (IRD) %$ 108DEMOG1 ; 052MALTRA03 %0 Book %9 OS : Ouvrages scientifiques %A Larmarange, Joseph %T Tanzania. Developing subnational estimates of HIV prevalence and the number of people living with HIV survey data : methodology note %C Genève %D 2014 %L fdi:010063819 %G ENG %I UNAIDS %K SIDA ; PREVALENCE ; ESTIMATION ; DISTRIBUTION SPATIALE ; METHODOLOGIE %K TANZANIE %P 24 %U http://www.documentation.ird.fr/hor/fdi:010063819 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers15-06/010063819.pdf %W Horizon (IRD) %$ 108DEMOG1 ; 052MALTRA03 %0 Book %9 OS : Ouvrages scientifiques %A Larmarange, Joseph %T Uganda. Developing subnational estimates of HIV prevalence and the number of people living with HIV survey data : methodology note %C Genève %D 2014 %L fdi:010063820 %G ENG %I UNAIDS %K SIDA ; PREVALENCE ; ESTIMATION ; DISTRIBUTION SPATIALE ; METHODOLOGIE %K OUGANDA %P 22 %U http://www.documentation.ird.fr/hor/fdi:010063820 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers15-06/010063820.pdf %W Horizon (IRD) %$ 108DEMOG1 ; 052MALTRA03 %0 Book %9 OS : Ouvrages scientifiques %A Larmarange, Joseph %T Zimbabwe. Developing subnational estimates of HIV prevalence and the number of people living with HIV survey data : methodology note %C Genève %D 2014 %L fdi:010063765 %G ENG %I UNAIDS %K SIDA ; PREVALENCE ; ESTIMATION ; DISTRIBUTION SPATIALE ; METHODOLOGIE %K ZIMBABWE %P 18 %U http://www.documentation.ird.fr/hor/fdi:010063765 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers15-04/010063765.pdf %W Horizon (IRD) %$ 108DEMOG1 ; 052MALTRA03 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Iwuji, C.C. %A Orne-Gliemann, J. %A Tanser, F. %A Boyer, S. %A Lessells, R.J. %A Lert, F. %A Imrie, J. %A Bärnighausen, T. %A Rekacewicz, C. %A Bazin, B. %A Newell, M.L. %A Dabis, F. %A Okesola, N. %A Bland, R. %A de Oliveira, T. %A Viljoen, J. %A Newell, C. %A Naidu, K. %A Lert, F. %A Dray-Spira, R. %A Larmarange, Joseph %A Spire, B. %A Chaix, M.L. %A Karcher, S. %A Thiébaut, R. %A Freeberg, K. %T Evaluation of the impact of immediate versus WHO recommendations-guided antiretroviral therapy initiation on HIV incidence : the ANRS 12249 TasP (treatment as prevention) trial in Hlabisa sub-district, KwaZulu-Natal, South Africa : study protocol for a cluster randomised controlled trial %D 2013 %L fdi:010059973 %G ENG %J Trials %K SIDA ; VIRUS ; INFECTION ; TRANSMISSION ; CONTAMINATION ; DIAGNOSTIC ; MEDICAMENT ; PREVENTION SANITAIRE ; EFFICACITE ; MILIEU RURAL ; ESSAI CLINIQUE ; TOXICITE ; COMPORTEMENT SEXUEL ; COMPORTEMENT SOCIAL ; ETUDE COMPARATIVE %K ANTIRETROVIRAUX ; RANDOMISATION ; EFFET SECONDAIRE %K AFRIQUE DU SUD ; KWAZULU ; NATAL %K HLABISA %N 230 %P 1-15 %R 10.1186/1745-6215-14-230 %U http://www.documentation.ird.fr/hor/fdi:010059973 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-03/010059973.pdf %V 14 %W Horizon (IRD) %$ 052MALTRA03 %0 Journal Article %9 PV : Publications de vulgarisation %A Larmarange, Joseph %T Epidémies généralisées et concentrées : une épidémie peut en cacher une autre %B Compte rendu de la 19ème conférence internationale sur le sida %D 2012 %L fdi:010057891 %G FRE %J Transcriptases %P 29 %U http://www.documentation.ird.fr/hor/fdi:010057891 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-03/010057891.pdf %V 149 %W Horizon (IRD) %B Conférence Internationale sur le Sida : Inverser le Cours de l'Epidémie Tous Ensemble %8 2012/07/22-27 %0 Journal Article %9 PV : Publications de vulgarisation %A Larmarange, Joseph %T Le TasP toujours plus présent %B Compte rendu de la 19ème conférence internationale sur le sida %D 2012 %L fdi:010057892 %G FRE %J Transcriptases %P 51-54 %U http://www.documentation.ird.fr/hor/fdi:010057892 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-03/010057892.pdf %V 149 %W Horizon (IRD) %B Conférence Internationale sur le Sida : Inverser le Cours de l'Epidémie Tous Ensemble %8 2012/07/22-27 %0 Book %9 OS : Ouvrages scientifiques %A Désesquelle, A. %A Meslé, F. %A Duthé, G. %A Larmarange, Joseph %T Demopaedia : dictionnaire démographique multilingue %C Paris %D 2012 %L fdi:010059399 %G FRE %I Demopaedia %K DEMOGRAPHIE ; POPULATION ; REPARTITION GEOGRAPHIQUE ; NUPTIALITE ; FECONDITE ; NATALITE ; MORTALITE ; MOBILITE ; DONNEES STATISTIQUES ; DICTIONNAIRE %K TRANSITION DEMOGRAPHIQUE %P 195 %U http://www.documentation.ird.fr/hor/fdi:010059399 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers19-12/010059399.pdf %W Horizon (IRD) %$ 108DEMOG1 %0 Book Section %9 OS CH : Chapitres d'ouvrages scientifiques %A Larmarange, Joseph %A Yaro, S. %A Vallo, R. %A Msellati, Philippe %A Médas, N. %A Ferry, Benoît %T Cartographier les données des enquêtes démographiques et de santé à partir des coordonnées des zones d'enquête %B Les systèmes d'information en démographie et en sciences sociales : nouvelles questions, nouveaux outils ? : actes de la Chaire Quételet 2006 %C Louvain-la-Neuve %D 2012 %E Schoumaker, B. %E Tabutin, D. %E Deboosere, P. %E Marquet, J. %E Masuy-Stroobant, G. %E Vandeschrick, C. %L fdi:010058446 %G FRE %I Presses Universitaires de Louvain %@ 978-2-87558-075-7 %K SIDA ; PREVALENCE ; EPIDEMIOLOGIE ; MILIEU URBAIN ; MILIEU RURAL ; CARTOGRAPHIE ; MODELE ; SIMULATION ; METHODOLOGIE ; ETUDE COMPARATIVE %K ENQUETE DEMOGRAPHIQUE ET DE SANTE ; SONDAGE EN GRAPPE %K AFRIQUE ; AFRIQUE SUBSAHARIENNE ; BURKINA FASO ; CAMEROUN %P 421-447 %U http://www.documentation.ird.fr/hor/fdi:010058446 %W Horizon (IRD) %B Chaire Quételet 2006 : Les Systèmes d'Information en Démographie et en Sciences Sociales : Nouvelles Questions, Nouveaux Outils ? %8 2006/11/29-2006/12/01 %$ 108DEMOG1 ; 056SOCSAN %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Larmarange, Joseph %A Vallo, R. %A Yaro, S. %A Msellati, Philippe %A Méda, N. %T Methods for mapping regional trends of HIV prevalence from demographic and health surveys (DHS) %D 2011 %L fdi:010053205 %G ENG %J Cybergeo : European Journal of Geography %K SIDA ; PREVALENCE ; EPIDEMIOLOGIE ; ENQUETE STATISTIQUE ; DEMOGRAPHIE ; CARTOGRAPHIE ; VARIATION SPATIALE ; ANALYSE SPATIALE ; ANALYSE STATISTIQUE ; METHODE D'ANALYSE ; ESTIMATION ; MODELISATION %K ENQUETE DEMOGRAPHIQUE ET DE SANTE %K BURKINA FASO %N 558 %P 27 %U http://www.documentation.ird.fr/hor/fdi:010053205 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-03/010053205.pdf %W Horizon (IRD) %$ 020STAT02 ; 050EPID %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Larmarange, Joseph %A Vallo, R. %A Yaro, S. %A Msellati, Philippe %A Méda, N. %T Méthodes pour cartographier les tendances régionales de la prévalence du VIH à partir des enquêtes démographiques et de santé (EDS) %D 2011 %L fdi:010052060 %G FRE %J Cybergeo : European Journal of Geography %@ 1278-3366 %K SIDA ; PREVALENCE ; EPIDEMIOLOGIE ; ENQUETE STATISTIQUE ; DEMOGRAPHIE ; CARTOGRAPHIE ; VARIATION SPATIALE ; ANALYSE SPATIALE ; ANALYSE STATISTIQUE ; METHODE D'ANALYSE ; ESTIMATION ; MODELISATION %K ENQUETE DEMOGRAPHIQUE ET DE SANTE %K AFRIQUE ; BURKINA FASO %N 539 %P 27 %U http://www.documentation.ird.fr/hor/fdi:010052060 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-03/010052060.pdf %W Horizon (IRD) %$ 020STAT02 ; 050EPID ; 128CARTO %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Henry, E. %A Marcellin, F. %A Yomb, Y. %A Fugon, L. %A Nemande, S. %A Gueboguo, C. %A Larmarange, Joseph %A Trenado, E. %A Eboko, Fred %A Spire, B. %T Factors associated with unprotected anal intercourse among men who have sex with men in Douala, Cameroon %D 2010 %L fdi:010049404 %G ENG %J Sexually Transmitted Infections %@ 1368-4973 %K CAMEROUN ; DOUALA %M ISI:000275896700015 %N 2 %P 136-140 %R 10.1136/sti.2009.036939 %U http://www.documentation.ird.fr/hor/fdi:010049404 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-03/010049404.pdf %V 86 %W Horizon (IRD) %X Objectives Research on men who have sex with men (MSM) in sub-Saharan Africa was neglected for a long time. The objective of this study was to understand factors associated with unprotected anal intercourse (UAI) with male partners among a group of MSM living in the city of Douala, Cameroon. Methods In 2008, a survey on the sexual activity and practices of MSM was set up in Douala in collaboration with a local community-based organisation. Data were collected among a convenience sample of 168 MSM during face-to-face interviews with trained interviewers. Results A total of 142 individuals reported sexual activity during the previous 6 months, among whom 80 (57%) reported UAI with male partners. In a multivariate logistic regression model adjusted for the frequency of sexual intercourse, not having had access to prevention interventions and not knowing any HIV-infected person were both independently associated with a higher risk of UAI. Other factors associated with this higher risk included having had a stable male partnership at some point in one's life and not having been out of Douala for more than 4 weeks during the previous year. Conclusions This community-based research is the first study of MSM in Cameroon and the HIV transmission risks they face. Results show the importance of HIV prevention interventions from peers, and underline the need to maintain efforts to develop specific interventions targeting MSM more efficiently in the African context. %$ 052 ; 056 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Larmarange, Joseph %A Wade, A.S. %A Diop, A.K. %A Diop, O. %A Gueye, K. %A Marra, Adama %A Desgrées du Loû, Annabel %T Men who have sex with men (MSM) and factors associated with not using a condom at last sexual intercourse with a man and with a woman in Senegal %D 2010 %L fdi:010050914 %G ENG %J PLoS One %K COMPORTEMENT SEXUEL ; HOMME ; SIDA ; EDUCATION SANITAIRE ; PREVENTION SANITAIRE ; AGE PHYSIOLOGIQUE ; NIVEAU D'INSTRUCTION ; ANTHROPOLOGIE DE LA SANTE ; ENQUETE %K PRESERVATIF ; HOMOSEXUALITE ; BISEXUALITE %K SENEGAL %M ISI:000282506100014 %N 10 %P e13189 %R 10.1371/journal.pone.0013189 %U http://www.documentation.ird.fr/hor/fdi:010050914 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-03/010050914.pdf %V 5 %W Horizon (IRD) %$ 052MALTRA03 ; 056EDUSAN %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Wade, A.S. %A Larmarange, Joseph %A Diop, A.K. %A Diop, O. %A Gueye, K. %A Marra, Adama %A Sene, A. %A Enel, C. %A Niang Diallo, P. %A Toure Kane, N.C. %A Mboup, S. %A Desgrées du Loû, Annabel %T Reduction in risk-taking behaviors among MSM in Senegal between 2004 and 2007 and prevalence of HIV and others STIs %D 2010 %L fdi:010048898 %G ENG %J AIDS Care %@ 1360-0451 %K SIDA ; HOMME ; COMPORTEMENT SEXUEL ; EPIDEMIOLOGIE ; PREVALENCE ; PREVENTION SANITAIRE ; COMPORTEMENT SEXUEL ; PROSTITUTION ; ENQUETE %K MALADIE SEXUELLEMENT TRANSMISSIBLE ; HOMOSEXUALITE ; PRESERVATIF %K SENEGAL ; DAKAR ; SAINT LOUIS %K MBOUR ; THIES ; KAOLACK %M ISI:000277313800002 %N 4 %P 409-414 %R 10.1080/09540120903253973 %U http://www.documentation.ird.fr/hor/fdi:010048898 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-03/010048898.pdf %V 22 %W Horizon (IRD) %$ 052MALTRA03 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Enel, C. %A Larmarange, Joseph %A Desgrées du Loû, Annabel %A Wade, A. S. %T A propos des partenaires féminines des hommes ayant des pratiques homosexuelles au Sénégal %B La fabrique des identités sexuelles %D 2009 %E Broqua, C. %E Eboko, Fred %L fdi:010048894 %G FRE %J Autrepart %@ 1278-3986 %K SEXUALITE ; HOMME ; FEMME ; RELATION DE GENRE ; SIDA ; EPIDEMIE ; COMPORTEMENT SEXUEL ; PROSTITUTION ; RAPPORTS SOCIAUX ; MARIAGE ; ENQUETE %K IDENTITE SEXUELLE ; PARTENAIRE SEXUEL ; HOMOSEXUALITE ; BISEXUALITE ; CONFIDENTIALITE ; RELATIONS CONJUGALES ; RELATIONS INTERPERSONNELLES ; MALADIE SEXUELLEMENT TRANSMISSIBLE %K AFRIQUE ; SENEGAL ; DAKAR %N 49 %P 103-116 %U http://www.documentation.ird.fr/hor/fdi:010048894 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-03/010048894.pdf %W Horizon (IRD) %$ 056SOCSAN ; 106GESOC2 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Larmarange, Joseph %A Desgrées du Loû, Annabel %A Enel, C. %A Wade, A. %T Homosexualité et bisexualité au Sénégal : une réalité multiforme %D 2009 %L fdi:010049807 %G FRE %J Population %@ 0032-4663 %K SEXUALITE ; COMPORTEMENT SEXUEL ; HOMME ; AGE PHYSIOLOGIQUE ; SEXE ; SIDA ; EPIDEMIOLOGIE ; ANTHROPOLOGIE SOCIALE ; ANTHROPOLOGIE DE LA SANTE ; VIOLENCE ; TYPOLOGIE ; ENQUETE %K HOMOSEXUALITE ; BISEXUALITE ; VIOLENCE SEXUELLE ; MALADIE SEXUELLEMENT TRANSMISSIBLE ; PRESERVATIF %K SENEGAL %M ISI:000276231100002 %N 4 %P 723-756 %U http://www.documentation.ird.fr/hor/fdi:010049807 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-03/010049807.pdf %V 64 %W Horizon (IRD) %$ 106GESOC2 ; 056SOCSAN %0 Journal Article %9 PV : Publications de vulgarisation %A Larmarange, Joseph %T Prévalence du VIH en Afrique sb-saharienne : historique d'une estimation %D 2009 %L fdi:010045404 %G FRE %J Médecine/Sciences %K SIDA ; EPIDEMIE ; PREVALENCE ; TAUX DE MORTALITE ; TRAITEMENT MEDICAL ; POLITIQUE DE SANTE ; ENQUETE STATISTIQUE %K ANTIRETROVIRAUX %K AFRIQUE SUBSAHARIENNE %M ISI:000263258900020 %N 1 %P 87-92 %U http://www.documentation.ird.fr/hor/fdi:010045404 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-03/010045404.pdf %V 25 %W Horizon (IRD) %$ 056POLSAN ; 052MALTRA03 %0 Journal Article %9 ACLN : Articles dans des revues avec comité de lecture non répertoriées par l'AERES %A Larmarange, Joseph %T Afrique subsaharienne : quel outil de mesure du VIH ? %D 2009 %L fdi:010047224 %G FRE %J Transversal %@ 1627-0428 %N 48 %P 29-30 %U http://www.documentation.ird.fr/hor/fdi:010047224 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers19-11/010047224.pdf %W Horizon (IRD) %0 Book Section %9 OS CH : Chapitres d'ouvrages scientifiques %A Larmarange, Joseph %A Ferry, Benoît %T Estimation des niveaux de prévalence du VIH dans les pays d'Afrique sub-saharienne et ajustement possible à partir des femmes enceintes %B Santé de la reproduction au Nord et au Sud : de la connaissance à l'action %C Louvain-la-Neuve %D 2009 %E Gourbin, C. %L PAR00007143 %G FRE %I Presses Universitaires de Louvain %@ 978-2-87463-182-5 %K AFRIQUE SUBSAHARIENNE %M EN:2rf0fesfn5s5tze9wdbv5v955tx20xt2r5de %P 305-318 %U http://www.documentation.ird.fr/hor/PAR00007143 %W Horizon (IRD) %$ 108 ; 052 %0 Unpublished Work %9 AP : Autres productions %A Larmarange, Joseph %A Vallo, R. %A Yaro, S. %A Msellati, Philippe %A Méda, N. %A Ferry, Benoît %T Estimating effect of non response on HIV prevalence estimates from demographic and health surveys %C Paris %D 2009 %L fdi:010047153 %G ENG %I CEPED %K SIDA ; PREVALENCE ; ANALYSE MULTIVARIABLE ; ENQUETE ; SEX RATIO ; GROUPE A RISQUE ; SANTE PUBLIQUE ; PREVENTION SANITAIRE %K SURVEILLANCE SANITAIRE %K AFRIQUE SUBSAHARIENNE %N 3 %P 9 %U http://www.documentation.ird.fr/hor/fdi:010047153 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers12-11/010047153.pdf %W Horizon (IRD) %$ 052MALTRA03 %0 Journal Article %9 PV : Publications de vulgarisation %A Larmarange, Joseph %T Accès aux antiviraux en Afrique et baisse de la mortalité %D 2008 %L fdi:010045403 %G FRE %J Transcriptases %K SIDA ; EPIDEMIE ; PREVALENCE ; TAUX DE MORTALITE ; TRAITEMENT MEDICAL ; POLITIQUE DE SANTE ; ENQUETE STATISTIQUE %K ANTIRETROVIRAUX %K AFRIQUE %N 137 %P 2-4 %U http://www.documentation.ird.fr/hor/fdi:010045403 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-03/010045403.pdf %W Horizon (IRD) %$ 056SOCSAN ; 052MALTRA03 %0 Journal Article %9 PV : Publications de vulgarisation %A Larmarange, Joseph %T Homosexuels masculins : une épidémie sous-estimée %D 2008 %L fdi:010045402 %G FRE %J Transcriptases %K SIDA ; EPIDEMIE ; PREVALENCE ; COMPORTEMENT SEXUEL ; PREVENTION SANITAIRE %K HOMOSEXUALITE ; DROIT A LA SANTE ; DISCRIMINATION SEXUELLE %K MONDE %N 138 %P 61-62 %U http://www.documentation.ird.fr/hor/fdi:010045402 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-03/010045402.pdf %W Horizon (IRD) %$ 056SOCSAN ; 052MALTRA03 %0 Book Section %9 OS CH : Chapitres d'ouvrages scientifiques %A Larmarange, Joseph %T HIV prevalence estimates : the new deal in Sub-Saharan African since 2000 %B The political economy of HIV/AIDS in developing countries : TRIPS, public health systems and free access %C Cheltenham %D 2008 %E Coriat, B. %L fdi:010045400 %G ENG %I E. Elgar %K SIDA ; PREVALENCE ; SURVEILLANCE ; OBSERVATOIRE ; GROUPE A RISQUE ; VARIATION SPATIALE ; POLITIQUE DE SANTE ; PROSPECTIVE %K AFRIQUE SUBSAHARIENNE %P 169-189 %U http://www.documentation.ird.fr/hor/fdi:010045400 %> http://www.documentation.ird.fr/intranet/publi/depot/2009-07-16/010045400.pdf %W Horizon (IRD) %$ 052MALTRA03 ; 065POLSAN %0 Conference Proceedings %9 ACTI : Communications avec actes dans un congrès international %A Larmarange, Joseph %A Yaro, S. %A Vallo, R. %A Msellati, Philippe %A Media, N. %A Ferry, Benoît %T Cartographier les données des Enquêtes Démographiques et de Santé à partir des coordonnées des zones d'enquête %C Louvain-la-Neuve %D 2007 %L fdi:010056256 %G FRE %I Université Catholique de Louvain %K SIDA ; PREVALENCE ; SYSTEME D'INFORMATION GEOGRAPHIQUE ; CARTOGRAPHIE ; VARIATION SPATIALE ; ENQUETE ; DEMOGRAPHIE ; METHODOLOGIE %K ENQUETE DEMOGRAPHIQUE ET DE SANTE %K AFRIQUE ; BURKINA FASO ; CAMEROUN %P 20 %U http://www.documentation.ird.fr/hor/fdi:010056256 %> http://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-03/010056256.pdf %W Horizon (IRD) %B Chaire Quételet 2006 : Les Systèmes d'Information en Démographie et en Sciences Sociales : Nouvelles Questions, Nouveaux Outils ? : Séance Les Techniques Récentes d'Enquête, d'Echantillonnage et de Traitement %8 2006/11/29 %$ 128CARTO ; 050EPID ; 108DEMOG1 %0 Thesis %9 THE : Thèses %A Larmarange, Joseph %T Prévalences du VIH en Afrique : validité d'une mesure %C Paris %D 2007 %L PAR00007352 %G FRE %I Université de Paris 5 %K VIH/SIDA ; Afrique subsaharienne ; prévalence ; validité épistémologique ; EDS (Enquêtes Démographiques et de Santé) ; surveillance sentinelle ; interpolation spatiale ; épidémiologie %K AFRIQUE SUBSAHARIENNE %M HAL:tel-00320283 %P 582 p. multigr. %U http://www.documentation.ird.fr/hor/PAR00007352 %W Horizon (IRD) %X Les prévalences nationales du VIH sont estimées, en Afrique subsaharienne, à partir de deux sources : la surveillance sentinelle des femmes enceintes et les enquêtes nationales en population générale (EDS). En plusieurs endroits, les résultats divergent, questionnant la validité de chaque approche. Quelles portée, limites et signification objective peuvent être accordées aux diverses observations, chacune appréhendant le réel sous un angle différent ?Les EDS constituent un bon indicateur du niveau des épidémies à l'échelle national et régional, voir infrarégional grâce au recours à des techniques d'analyse spatiale en composantes d'échelles. Mais leur fréquence est inadaptée pour mesurer les évolutions à court terme. La surveillance sentinelle, estimateur local des ordres de grandeur, peut être un indicateur de tendances sous certaines conditions. Cependant, si la situation actuelle commence à être mieux connue, une mesure réelle des dynamiques est encore hors de notre portée. %B Université René Descartes - Paris 5 %$ 108 ; 050