%0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A d'Elbee, M. %A Terris-Prestholt, F. %A Briggs, A. %A Griffiths, U. K. %A Larmarange, Joseph %A Medley, G. F. %A Gomez, G. B. %T Estimating health care costs at scale in low- and middle-income countries : mathematical notations and frameworks for the application of cost functions %D 2023 %L fdi:010088201 %G ENG %J Health Economics %@ 1057-9230 %K cost functions ; econometrics ; health economics ; low- and middle-income countries ; microeconomics ; production costs %K PAYS EN DEVELOPPEMENT %M ISI:001013441300001 %P [18 ] %R 10.1002/hec.4722 %U https://www.documentation.ird.fr/hor/fdi:010088201 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-08/010088201.pdf %V [Early access] %W Horizon (IRD) %X Appropriate costing and economic modeling are major factors for the successful scale-up of health interventions. Various cost functions are currently being used to estimate costs of health interventions at scale in low- and middle-income countries (LMICs) potentially resulting in disparate cost projections. The aim of this study is to gain understanding of current methods used and provide guidance to inform the use of cost functions that is fit for purpose. We reviewed seven databases covering the economic and global health literature to identify studies reporting a quantitative analysis of costs informing the projected scale-up of a health intervention in LMICs between 2003 and 2019. Of the 8725 articles identified, 40 met the inclusion criteria. We classified studies according to the type of cost functions applied-accounting or econometric-and described the intended use of cost projections. Based on these findings, we developed new mathematical notations and cost function frameworks for the analysis of healthcare costs at scale in LMICs setting. These notations estimate variable returns to scale in cost projection methods, which is currently ignored in most studies. The frameworks help to balance simplicity versus accuracy and increase the overall transparency in reporting of methods. %$ 056 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Schneider, J. %A Coutinho, R. %A Hatcher, A. M. %A Larmarange, Joseph %A Letendre, S. %A Paraskevis, D. %A Strathdee, S. %A Vance, D. E. %A Martinez, E. %T Stimulating dissemination of research that addresses the social and contextual drivers of HIV prevention and treatment in the journal AIDS %D 2023 %L fdi:010087777 %G ENG %J AIDS %@ 0269-9370 %M ISI:000981919800001 %N 7 %P 1021-1021 %R 10.1097/qad.0000000000003582 %U https://www.documentation.ird.fr/hor/fdi:010087777 %> https://www.documentation.ird.fr/intranet/publi/2023-07/010087777.pdf %V 37 %W Horizon (IRD) %$ 056 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Ky-Zerbo, O. %A Desclaux, Alice %A Boye, Sokhna %A Maheu-Giroux, M. %A Rouveau, Nicolas %A Vautier, A. %A Camara, C. S. %A Kouadio, B. A. %A Sow, S. %A Doumenc-Aidara, C. %A Gueye, P. A. %A Geoffroy, O. %A Kamemba, O. K. %A Ehui, E. %A Ndour, C. T. %A Keita, A. %A Larmarange, Joseph %T "I take it and give it to my partners who will give it to their partners" : Secondary distribution of HIV self-tests by key populations in Cote d'Ivoire, Mali, and Senegal %D 2023 %L fdi:010087766 %G ENG %J BMC Infectious Diseases %K HIVST ; Secondary distribution ; Key population ; ATLAS ; West and Central Africa %K COTE D'IVOIRE ; MALI ; SENEGAL ; AFRIQUE DE L'OUEST ; AFRIQUE CENTRALE %M ISI:000994255200001 %N Suppl. 1 %P 970 [17 ] %R 10.1186/s12879-023-08319-4 %U https://www.documentation.ird.fr/hor/fdi:010087766 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-07/010087766.pdf %V 22 %W Horizon (IRD) %X Introduction HIV epidemics in Western and Central Africa (WCA) remain concentrated among key populations, who are often unaware of their status. HIV self-testing (HIVST) and its secondary distribution among key populations, and their partners and relatives, could reduce gaps in diagnosis coverage.We aimed to document and understand secondary HIVST distribution practices by men who have sex with men (MSM), female sex workers (FSW), people who use drugs (PWUD); and the use of HIVST by their networks in Cote d'Ivoire, Mali, and Senegal.Methods A qualitative study was conducted in 2021 involving (a) face-to-face interviews with MSM, FSW, and PWUD who received HIVST kits from peer educators (primary users) and (b) telephone interviews with people who received kits from primary contacts (secondary users). These individual interviews were audio-recorded, transcribed, and coded using Dedoose software. Thematic analysis was performed.ResultsA total of 89 participants, including 65 primary users and 24 secondary users were interviewed. Results showed that HIVST were effectively redistributed through peers and key populations networks. The main reported motivations for HIVST distribution included allowing others to access testing and protecting oneself by verifying the status of partners/clients. The main barrier to distribution was the fear of sexual partners' reactions. Findings suggest that members of key populations raised awareness of HIVST and referred those in need of HIVST to peer educators. One FSW reported physical abuse. Secondary users generally completed HIVST within two days of receiving the kit. The test was used half the times in the physical presence of another person, partly for psychological support need. Users who reported a reactive test sought confirmatory testing and were linked to care. Some participants mentioned difficulties in collecting the biological sample (2 participants) and interpreting the result (4 participants).Conclusion The redistribution of HIVST was common among key populations, with minor negative attitudes. Users encountered few difficulties using the kits. Reactive test cases were generally confirmed. These secondary distribution practices support the deployment of HIVST to key populations, their partners, and other relatives. In similar WCA countries, members of key populations can assist in the distribution of HIVST, contributing to closing HIV diagnosis gaps. %$ 056 ; 056 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Plazy, M. %A Diallo, A. %A Hlabisa, T. %A Okesola, N. %A Iwuji, C. %A Herbst, K. %A Boyer, S. %A Lert, F. %A McGrath, N. %A Pillay, D. %A Dabis, F. %A Larmarange, Joseph %A Orne-Gliemann, J. %A ANRS TasP Study Group %T Implementation and effectiveness of a linkage to HIV care intervention in rural South Africa (ANRS 12249 TasP trial) %D 2023 %L fdi:010087820 %G ENG %J PLoS One %@ 1932-6203 %K AFRIQUE DU SUD %M ISI:000967499900001 %P e0280479 [17 ] %R 10.1371/journal.pone.0280479 %U https://www.documentation.ird.fr/hor/fdi:010087820 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-08/010087820.pdf %W Horizon (IRD) %X Background : Timely linkage to care and ART initiation is critical to decrease the risks of HIV-related morbidity, mortality and HIV transmission, but is often challenging. We report on the implementation and effectiveness of a linkage-to-care intervention in rural KwaZulu-Natal, South Africa.Methods : In the ANRS 12249 TasP trial on Universal Testing and Treatment (UTT) implemented between 2012-2016, resident individuals ?16 years were offered home-based HIV testing every six months.Those ascertained to be HIV-positive were referred to trial clinics. Starting May 2013, a linkage-to-care intervention was implemented in both trial arms, consisting of tracking through phone calls and/or home visits to ?re-refer? people who had not linked to care to trial clinics within three months of the first home-based referral. Fidelity in implementing the planned intervention was described using Kaplan-Meier estimation to compute conditional probabilities of being tracked and of being re-referred by the linkage-to-care team. Effect of the intervention on time to linkage-to-care was analysed using a Cox regression model censored for death, migration, and end of data follow-up.Results : Among the 2,837 individuals (73.7% female) included in the analysis, 904 (32%) were tracked at least once, and 573 of them (63.4%) were re-referred. Probabilities of being re-referred was 17% within six months of first referral and 31% within twelve months. Compared to individuals not re-referred by the intervention, linkage-to-care was significantly higher among those with at least one re-referral through phone call (adjusted hazard ratio [aHR] = 1.82; 95% confidence interval [95% CI] = 1.47-2.25), and among those with re-referral through both phone call and home visit (aHR = 3.94; 95% CI = 2.07-7.48).Conclusions : Phone calls and home visits following HIV testing were challenging to implement, but appeared effective in improving linkage-to-care amongst those receiving the intervention. Such patient-centred strategies should be part of UTT programs to achieve the UNAIDS 95-95-95 targets %$ 052MALTRA03 ; 056SOCSAN %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture non répertoriées par l'AERES %A Larmarange, Joseph %A Desclaux, Alice %A Ky-Zerbo, O. %A Simo Fotso, A. %A Kra Kouassi, Arsène %T Projet ATLAS : les autotests VIH, un outil pour pallier le manque d'accès au dépistage en Afrique de l'Ouest %D 2022 %L fdi:010087056 %G FRE %J The Conversation France %@ 2431-2134 %K SENEGAL ; MALI ; COTE D'IVOIRE %P en ligne [4 ] %U https://www.documentation.ird.fr/hor/fdi:010087056 %V 28 juillet 2022 %W Horizon (IRD) %$ 052MALTRA03 ; 056SOCSAN %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture non répertoriées par l'AERES %A Baisley, K. %A Orne-Gliemann, J. %A Larmarange, Joseph %A Plazy, M. %A Collier, D. %A Dreyer, J. %A Mngomezulu, T. %A Herbst, K. %A Hanekom, W. %A Dabis, F. %A Siedner, M.J. %A Iwuji, C. %T Early HIV treatment and survival over six years of observation in the ANRS 12249 treatment as prevention trial %D 2022 %L fdi:010087012 %G ENG %J HIV Medicine %@ 1464-2662 %K AFRIQUE DU SUD %N 8 %P 922-928 %R 10.1111/hiv.13263 %U https://www.documentation.ird.fr/hor/fdi:010087012 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-07/010087012.pdf %V 23 %W Horizon (IRD) %X Objectives : Population- based universal test and treat (UTT) trials have shown an impact on population- level virological suppression. We followed the ANRS 12249 TasP trial population for 6 years to determine whether the intervention had longer- term survival benefits. Methods: The TasP trial was a cluster-randomized trial in South Africa from 2012 to 2016. All households were offered 6- monthly home- based HIV testing. Immediate antiretroviral therapy (ART) was offered through trial clinics to all people living with HIV (PLHIV) in intervention clusters and according to na-tional guidelines in control clusters. After the trial, individuals attending the trial clinics were transferred to the public ART programme. Deaths were ascertained through annual demographic surveillance. Random- effects Poisson regression was used to estimate the effect of trial arm on mortality among (i) all PLHIV; (ii) PLHIV aware of their status and not on ART at trial entry; and (iii) PHLIV who started ART during the trial. Results: Mortality rates among PLHIV were 9.3/1000 and 10.4/1000 person- years in the control and intervention arms, respectively. There was no evidence hat the intervention decreased mortality among all PLHIV [adjusted rate ratio (aRR) = 1.10, 95% confidence interval (CI) = 0.85- 1.43, p = 0.46] or among PLHIV who were aware of their status but not on ART. Among individuals who initiated ART, the intervention decreased mortality during the trial (aRR = 0.49, 95% CI = 0.28- 0.85, p = 0.01), but not after the trial ended. Conclusions: The 'treat all' strategy reduced mortality among individuals who started ART but not among all PLHIV. To achieve maximum benefit of immedi-ate ART, barriers to ART uptake and retention in care need to be addressed. %$ 052MALTRA03 ; 050MEDECI ; 108DEMOG1 ; 106PROSO %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture non répertoriées par l'AERES %A Traoré, M.M. %A Badiane, K. %A Vautier, A. %A Simo Fotso, A. %A Kanku Kabemba, O. %A Rouveau, Nicolas %A Maheu-Giroux, M. %A Boily, M.C. %A Larmarange, Joseph %A Terris-Prestholt, F. %A D'Elbée, M. %A Atlas Team %T Economic analysis of low volume interventions using real-world data : costs of HIV self-testing distribution and HIV testing services in West Africa from the ATLAS project %D 2022 %L fdi:010087014 %G ENG %J Frontiers in Health Services %@ 2813-0146 %K COTE D'IVOIRE ; MALI ; SENEGAL ; AFRIQUE DE L'OUEST %P 886513 [11 ] %R 10.3389/frhs.2022.886513 %U https://www.documentation.ird.fr/hor/fdi:010087014 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2022-12/010087014.pdf %V 2 %W Horizon (IRD) %X Achieving the first 95 of the UNAIDS targets requires the implementation of innovative approaches to knowing one's HIV status. Among these innovations is the provision of HIV self-testing (HIVST) kits in west Africa by the international partner organization Solthis (IPO). In order to provide guidance for the optimal use of financial resources, this study aims to estimate the program and site level costs of dispensing HIVST as well as HIV testing services (HTS)-excluding HIVST-in health facilities in Côte d'Ivoire, Mali and Senegal as part of the ATLAS project. We estimated from the provider's perspective, HIVST and HTS incremental costs using top-down and bottom-up costing approaches and conducted a time and motion study. We identified costs at the program level for HIVST (including IPO central costs) and at the site level for HIVST and HTS. The economic costs of distributing HIVST kits were assessed in 37 health facilities between July 2019 and March 2021 (21 months). Sensitivity analyses were also performed on unit costs to examine the robustness of our estimates related to key assumptions. In total, 16,001 HIVST kits were dispensed for 32,194 HTS sessions carried out. Program level HIVST average costs ranged $12-286, whereas site level costs ranged $4-26 across distribution channels and countries. Site level HTS costs ranged $7-8 per testing session, and ranged $72-705 per HIV diagnosis. Across countries and channels, HIVST costs were driven by personnel (27-68%) and HIVST kits (32-73%) costs. The drivers of HTS costs were personnel costs ranging between 65 and 71% of total costs across distribution channels and countries, followed by supplies costs between 21 and 30%. While program level HIVST average costs were high, site level HIVST average costs remained comparable to HTS costs in all countries. Health facility-based distribution channels operating at low volume exhibit high proportion of central costs which should be considered carefully for financial planning when run alongside high volumes mobile outreach distribution channels. HIVST can diversify the HIV testing offer at health facilities, thus improving access to screening for target populations not reached by HTS services. %$ 094 ; 052 ; 020 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Sabapathy, K. %A Balzer, L. %A Larmarange, Joseph %A Block, L. %A Floyd, S. %A Iwuji, C. %A Wirth, K. %A Ayles, H. %A Fidler, S. %A Kamya, M. %A Petersen, M. %A Havlir, D. %A Dabis, F. %A Moore, J. %A Hayes, R. %T Achieving the UNAIDS 90-90-90 targets : a comparative analysis of four large community randomised trials delivering universal testing and treatment to reduce HIV transmission in sub-Saharan Africa %D 2022 %L fdi:010086780 %G ENG %J BMC Public Health %K HIV ; Antiretroviral treatment ; Universal Testing and Treatment ; Treatment as Prevention ; UNAIDS 90-90-90 %K AFRIQUE SUBSAHARIENNE ; BOTSWANA ; KENYA ; UGANDA ; ZAMBIE ; AFRIQUE DU SUD %M ISI:000898773600006 %N 1 %P 2333 [16 ] %R 10.1186/s12889-022-14713-5 %U https://www.documentation.ird.fr/hor/fdi:010086780 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-02/010086780.pdf %V 22 %W Horizon (IRD) %X Background: Four large community-randomized trials examining universal testing and treatment (UTT) to reduce HIV transmission were conducted between 2012-2018 in Botswana, Kenya, Uganda, Zambia and South Africa. In 2014, the UNAIDS 90-90-90 targets were adopted as a useful metric to monitor coverage. We systematically review I the approaches used by the trials to measure intervention delivery, and estimate coverage against the 90-90-90 targets. We aim to provide in-depth understanding of the background contexts and complexities that affect estimation of population-level coverage related to the 90-90-90 targets. Methods: Estimates were based predominantly on "process" data obtained during delivery of the interventions which included a combination of home-based and community-based services. Cascade coverage data included routine electronic health records, self-reported data, survey data, and active ascertainment of HIV viral load measurements in the field. Results: The estimated total adult populations of trial intervention communities included in this study ranged from 4,290 (TasP) to 142,250 (Zambian PopART Arm-B). The estimated total numbers of PLHIV ranged from 1,283 (TasP) to 20,541 (Zambian PopART Arm-B). By the end of intervention delivery, the first-90 target (knowledge of HIV status among all PLHIV) was met by all the trials (89.2%-94.0%). Three of the four trials also achieved the second- and third-90 targets, and viral suppression in BCPP and SEARCH exceeded the UNAIDS target of 73%, while viral suppression in the Zambian PopART Arm-A and B communities was within a small margin (similar to 3%) of the target. Conclusions: All four UTT trials aimed to implement wide-scale testing and treatment for HIV prevention at population level and showed substantial increases in testing and treatment for HIV in the intervention communities. This study has not uncovered any one estimation approach which is superior, rather that several approaches are available and researchers or policy makers seeking to measure coverage should reflect on background contexts and complexities that affect estimation of population-level coverage in their specific settings. %$ 056 ; 050 ; 052 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Nouaman, M.N. %A Becquet, V. %A Plazy, M. %A Coffie, P.A. %A Zébago, C. %A Montoyo, A. %A Anoma, C. %A Eholié, S. %A Dabis, F. %A Larmarange, Joseph %T Incidence of HIV infection and associated factors among female sex workers in Côte d'Ivoire, results of the ANRS 12361 PrEP-CI study using recent infection assays %D 2022 %L fdi:010087013 %G ENG %J PLoS One %@ 1932-6203 %K COTE D'IVOIRE ; ABIDJAN ; SAN PEDRO COTE D'IVOIRE %M ISI:000959278200001 %N 11 %P e0271988 [13 ] %R 10.1371/journal.pone.0271988 %U https://www.documentation.ird.fr/hor/fdi:010087013 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-07/010087013.pdf %V 17 %W Horizon (IRD) %X Background : This study aimed to estimate, using an HIV Recent Infection Testing Algorithm (RITA), the HIV incidence and its associated factors among female sex workers (FSW) in Côte d'Ivoire. Methods : A cross-sectional study was conducted in 2016-2017 in Abidjan and San Pedro's region among FSW aged sup. or eq. 18 years. In addition, a sociodemographic questionnaire, HIV screening was carried out by two rapid tests. In the event of a positive result, a dried blood spot sample was taken to determine, using a RITA adapted to the Ivorian context, if it was a recent HIV infection. Results: A total of 1000 FSW were surveyed with a median age of 25 years (interquartile range: 21-29 years). 39 (3.9%) tested positive for HIV. The incidence of HIV was estimated to be 2.3 per 100 person-years, with higher incidence rates among those 24 years old or less (3.0% vs. 1.9%), non-Ivorian FSW (3.2% vs. 1.9%) and those with the lowest education level (4.6% in FSW who never went to school vs. 2.6%). The incidence seemed to be associated with the sex work practice conditions: higher incidence among FSW whose usual price was less than 3.50$ (4.3% vs.1.0%), FSW who had a larger number of clients on the last day of work (6.1% in those with 7 clients or more vs. 1.8%), FSW who reported not always using condoms with their clients (8.5% vs. 1.5%) and FSW who reported agreeing to sex without a condom in exchange for a large sum of money (10.1% vs. 1.2%). Conclusion: This study confirms that FSW remain highly exposed to HIV infection. Exposure to HIV is also clearly associated with certain sex-work factors and the material conditions of sex work. Efforts in the fight against HIV infection must be intensified to reduce new infections among FSW. %$ 052MALTRA03 ; 050MEDECI ; 108DEMOG1 ; 056SOCSAN %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Mohareb, A. M. %A Larmarange, Joseph %A Kim, A. Y. %A Coffie, P. A. %A Kouame, M. G. %A Boyd, A. %A Freedberg, K. A. %A Hyle, E. P. %T Risks and benefits of oral HIV pre-exposure prophylaxis for people with chronic hepatitis B %D 2022 %L fdi:010086363 %G ENG %J Lancet HIV %@ 2352-3018 %K MONDE %M ISI:000863913400014 %N 8 %P E585-E594 %R 10.1016/s2352-3018(22)00123-0 %U https://www.documentation.ird.fr/hor/fdi:010086363 %> https://www.documentation.ird.fr/intranet/publi/2022-11/010086363.pdf %V 9 %W Horizon (IRD) %X Individuals with chronic hepatitis B virus (HBV) infection who are at substantial risk of HIV acquisition benefit from pre-exposure prophylaxis (PrEP) with tenofovir-based antiviral therapy. Considering that tenofovir potently inhibits HBV, providing PrEP to individuals with HBV effectively results in treatment of their HBV infection. However, some clinicians might be hesitant to initiate PrEP in people with chronic HBV due to unknown risks of HBV reactivation, hepatitis, and acute liver failure during periods of antiviral cessation. Unfortunately, these knowledge gaps affect scale up of PrEP among people with chronic HBV. Emerging data regarding the risks and benefits of antiviral cessation in people with chronic HBV suggest that PrEP can be safely initiated despite the risks of non-adherence or discontinuation. People with chronic HBV who stop PrEP should be closely monitored for HBV reactivation and hepatitis flares after antiviral cessation. %$ 050 ; 052 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Fotso, A. S. %A Johnson, C. %A Vautier, A. %A Kouame, K. B. %A Diop, P. M. %A Silhol, R. %A Maheu-Giroux, M. %A Boily, M. C. %A Rouveau, Nicolas %A Doumenc-Aidara, C. %A Baggaley, R. %A Ehui, E. %A Larmarange, Joseph %T Routine programmatic data show a positive population-level impact of HIV self-testing : the case of Cote d'Ivoire and implications for implementation %D 2022 %L fdi:010086296 %G ENG %J Aids %@ 0269-9370 %K antiretroviral treatment ; diagnosis ; female sex workers ; HIV ; self-testing ; implementation ; key populations ; men who have sex with men ; testing ; triangulation of programmatic data %K COTE D'IVOIRE %M ISI:000861441200015 %N 13 %P 1871-1879 %R 10.1097/qad.0000000000003328 %U https://www.documentation.ird.fr/hor/fdi:010086296 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2022-11/010086296.pdf %V 36 %W Horizon (IRD) %X Objectives: We estimate the effects of ATLAS's HIV self-testing (HIVST) kit distribution on conventional HIV testing, diagnoses, and antiretroviral treatment (ART) initiations in Cote d'Ivoire. Design: Ecological study using routinely collected HIV testing services program data. Methods: We used the ATLAS's programmatic data recorded between the third quarter of 2019 and the first quarter of 2021, in addition to data from the President's Emergency Plan for AIDS Relief dashboard. We performed ecological time series regression using linear mixed models. Results are presented per 1000 HIVST kits distributed through ATLAS. Results: We found a negative but nonsignificant effect of the number of ATLAS' distributed HIVST kits on conventional testing uptake (-190 conventional tests; 95% confidence interval [CI]: -427 to 37). The relationship between the number of HIVST kits and HIV diagnoses was significant and positive (+8 diagnosis; 95% CI: 0 to 15). No effect was observed on ART initiation (-2 ART initiations; 95% CI: -8 to 5). Conclusions: ATLAS' HIVST kit distribution had a positive impact on HIV diagnoses. Despite the negative signal on conventional testing, even if only 20% of distributed kits are used, HIVST would increase access to testing. The methodology used in this paper offers a promising way to leverage routinely collected programmatic data to estimate the effects of HIVST kit distribution in real-world programs. %$ 108 ; 050 ; 052 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Ante-Testard, P. A. %A Hamidouche, M. %A Apouey, B. %A Baggaley, R. %A Larmarange, Joseph %A Benmarhnia, T. %A Temime, L. %A Jean, K. %T Understanding the pathways leading to socioeconomic inequalities in HIV testing uptake in 18 sub-Saharan African countries %D 2022 %L fdi:010086046 %G ENG %J AIDS %@ 0269-9370 %K health inequalities ; HIV ; HIV testing ; mediation analysis ; socioeconomic ; inequalities ; sub-Saharan Africa %K AFRIQUE SUBSAHARIENNE %M ISI:000848890300011 %N 12 %P 1707-1716 %R 10.1097/qad.0000000000003316 %U https://www.documentation.ird.fr/hor/fdi:010086046 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2022-10/010086046.pdf %V 36 %W Horizon (IRD) %X Objective: To better understand the different pathways linking socioeconomic position and HIV testing uptake in 18 sub-Saharan African countries. Design: We used cross-sectional population-based surveys between 2010 and 2018. Methods: Using a potential outcomes framework and the product method, we decomposed the total effect linking wealth and recent (<12 months) HIV testing into direct effects, and indirect effects, via internal (related to individual's ability to perceive need for and to seek care) or external (ability to reach, pay for and engage in healthcare) mediators to calculate the proportion mediated (PM) by each mediator. Results: High levels of inequalities were observed in nine and 15 countries among women and men, respectively. The mediator indirect effect varied greatly across countries. The PM tended to be higher for internal than for external mediators. For instance, among women, HIV-related knowledge was estimated to mediate up to 12.1% of inequalities in Cote d'Ivoire; and up to 31.5% for positive attitudes towards people with HIV (PWH) in Senegal. For the four external mediators, the PM was systematically below 7%. Similar findings were found when repeating analyses on men for the internal mediators, with higher PM by attitudes towards PWH (up to 39.9% in Senegal). Conclusions: Our findings suggest that wealth-related inequalities in HIV testing may be mediated by internal more than external characteristics, with important variability across countries. Overall, the important heterogeneities in the pathways of wealth-related inequalities in HIV testing illustrate that addressing inequalities requires tailored efforts and upstream interventions. %$ 056 ; 052 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Stannah, J. %A Anato, J. L. F. %A Mitchell, K. M. %A Larmarange, Joseph %A Maheu-Giroux, M. %A Boily, M. C. %T Improving our understanding of how structural determinants impact HIV epidemics : a scoping review of dynamic models to guide future research %D 2022 %L fdi:010085920 %G ENG %J Journal of the International AIDS Society %M ISI:000834867400268 %N suppl. 3 %P 142-143 %U https://www.documentation.ird.fr/hor/fdi:010085920 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2022-09/010085920.pdf %V 25 %W Horizon (IRD) %$ 052 ; 056 ; 020 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Bousmah, Marwan-al-Qays %A Iwuji, C. %A Okesola, N. %A Orne-Gliemann, J. %A Pillay, D. %A Dabis, F. %A Larmarange, Joseph %A Boyer, S. %T Costs and economies of scale in repeated home-based HIV counselling and testing : evidence from the ANRS 12249 treatment as prevention trial in South Africa %D 2022 %L fdi:010085273 %G ENG %J Social Science and Medicine %@ 0277-9536 %K AIDS/HIV ; HIV ; Prevention ; Cost of care ; Economies of scale ; Interventions ; Clinical trials ; South Africa %K AFRIQUE DU SUD %M ISI:000809823700009 %P 115068 [10 ] %R 10.1016/j.socscimed.2022.115068 %U https://www.documentation.ird.fr/hor/fdi:010085273 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2022-09/010085273.pdf %V 305 %W Horizon (IRD) %X Universal HIV testing is now recommended in generalised HIV epidemic settings. Although home-based HIV counselling and testing (HB-HCT) has been shown to be effective in achieving high levels of HIV status awareness, little is still known about the cost implications of universal and repeated HB-HCT. We estimated the costs of repeated HB-HCT and the scale economies that can be obtained when increasing the population coverage of the intervention. We used primary data from the ANRS 12249 Treatment as Prevention (TasP) trial in rural South Africa (2012-2016), whose testing component included six-monthly repeated HB-HCT. We relied on the dynamic system generalised method of moments (GMM) approach to produce unbiased short-and long-run estimates of economies of scale, using the number of contacts made by HIV counsellors for HB-HCT as the scale variable. We also estimated the mediating effect of the contact quality - measured as the proportion of HIV tests performed among all contacts eligible for an HIV test - on scale economies. The mean cost (standard deviation) of universal and repeated HB-HCT was $24.2 (13.7) per contact, $1694.3 (1527.8) per new HIV diagnosis, and $269.2 (279.0) per appropriate referral to HIV care. The GMM estimations revealed the presence of economies of scale, with a 1% increase in the number of contacts for HB-HCT leading to a 0.27% decrease in the mean cost. Our results also suggested a significant long-run relationship between mean cost and scale, with a 1% increase in the scale leading to a 0.36% decrease in mean cost in the long run. Overall, we showed that significant cost savings can be made from increasing population coverage. Nevertheless, there is a risk that this gain is made at the expense of quality: the higher the quality of HB-HCT activities, the lower the economies of scale. %$ 056 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Inghels, M. %A Kouassi, Arsène Kra %A Niangoran, S. %A Bekelynck, A. %A Carilon, S. %A Sika, L. %A Kone, M. %A Danel, C. %A Desgrées du Loû, Annabel %A Larmarange, Joseph %A Anrs, Dod-Ci %T Preferences and access to community-based HIV testing sites among men who have sex with men (MSM) in Cote d'Ivoire %D 2022 %L fdi:010085347 %G ENG %J BMJ Open %@ 2044-6055 %K HIV & AIDS ; International health services ; SEXUAL MEDICINE %K COTE D'IVOIRE %M ISI:000818834200008 %N 6 %P e052536 [11 ] %R 10.1136/bmjopen-2021-052536 %U https://www.documentation.ird.fr/hor/fdi:010085347 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2022-09/010085347.pdf %V 12 %W Horizon (IRD) %X Objective Measuring access and preferences to Men who have Sex with Men focused community-based HIV testing sites (MSM-CBTS) in Cote d'Ivoire. Design A respondent-driven sampling telephone survey. Setting National survey conducted in 2018 in Cote d'Ivoire. Participants 518 MSM aged over 18 years old. Primary and secondary outcome measures Knowledge, practices, satisfaction and preferences regarding MSM-CBTS. Factors associated with MSM-CTBS access or knowledge and with HIV testing venue preferences were examined. Results Only half of the respondents (47%) reported knowing of an MSM-CBTS. Of these, 79% had already attended one. Both knowing of and ever visiting an MSM-CBTS were significantly associated with a higher number of HIV tests performed in the past 12 months and having disclosed sexual orientation to one family member. In terms of preferences, 37% of respondents said they preferred undifferentiated HIV testing sites (ie, 'all patients' HIV testing sites), 34% preferred MSM-CBTS and 29% had no preference. Those who reported being sexually attracted to women, being bisexual and those who did not know an MSM non-governmental organisation were less likely to prefer MSM-CBTS. MSM who preferred undifferentiated HIV testing sites mentioned the lack of discretion and anonymity of community-based sites and the desire to avoid the gaze of others. Conclusion Community-based HIV testing is well suited for MSM who identify as homosexual and those close to the MSM community, while maintaining undifferentiated HIV testing is essential for others. Both types of activities need to be maintained and developed. Healthcare professionals in undifferentiated HIV testing sites need to be properly trained in the non-judgemental reception of MSM. %$ 056 ; 052 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Ky-Zerbo, O. %A Desclaux, Alice %A Boye, Sokhna %A Vautier, A. %A Rouveau, Nicolas %A Kouadio, B. A. %A Fotso, A. S. %A Pourette, Dolores %A Maheu-Giroux, M. %A Sow, S. %A Camara, C. S. %A Doumenc-Aidara, C. %A Keita, A. %A Boily, M. C. %A Silhol, R. %A D'Elbee, M. %A Bekelynck, A. %A Gueye, P. A. %A Diop, P. M. %A Geoffroy, O. %A Kamemba, O. K. %A Diallo, S. %A Ehui, E. %A Ndour, C. T. %A Larmarange, Joseph %A ATLAS Team %T Willingness to use and distribute HIV self-test kits to clients and partners : a qualitative analysis of female sex workers' collective opinion and attitude in Cote d'Ivoire, Mali, and Senegal %D 2022 %L fdi:010084704 %G ENG %J Womens Health %@ 1745-5057 %K ATLAS ; female sex workers ; HIV self-testing ; partners ; perception ; secondary distribution ; West Africa %K COTE D'IVOIRE ; MALI ; SENEGAL %M ISI:000784035800001 %P [11 ] %R 10.1177/17455057221092268 %U https://www.documentation.ird.fr/hor/fdi:010084704 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2022-06/010084704.pdf %V 18 %W Horizon (IRD) %X Background: In West Africa, female sex workers are at increased risk of HIV acquisition and transmission. HIV self-testing could be an effective tool to improve access to and frequency of HIV testing to female sex workers, their clients and partners. This article explores their perceptions regarding HIV self-testing use and the redistribution of HIV self-testing kits to their partners and clients. Methods: Embedded within ATLAS, a qualitative study was conducted in Cote-d'Ivoire, Mali, and Senegal in 2020. Nine focus group discussions were conducted. A thematic analysis was performed. Results: A total of 87 participants expressed both positive attitudes toward HIV self-testing and their willingness to use or reuse HIV self-testing. HIV self-testing was perceived to be discreet, confidential, and convenient. HIV self-testing provides autonomy from testing by providers and reduces stigma. Some perceived HIV self-testing as a valuable tool for testing their clients who are willing to offer a premium for condomless sex. While highlighting some potential issues, overall, female sex workers were optimistic about linkage to confirmatory testing following a reactive HIV self-testing. Female sex workers expressed positive attitudes toward secondary distribution to their partners and clients, although it depended on relationship types. They seemed more enthusiastic about secondary distribution to their regular/emotional partners and regular clients with whom they had difficulty using condoms, and whom they knew enough to discuss HIV self-testing. However, they expressed that it could be more difficult with casual clients; the duration of the interaction being too short to discuss HIV self-testing, and they fear violence and/or losing them. Conclusion: Overall, female sex workers have positive attitudes toward HIV self-testing use and are willing to redistribute to their regular partners and clients. However, they are reluctant to promote such use with their casual clients. HIV self-testing can improve access to HIV testing for female sex workers and the members of their sexual and social network. %$ 050 ; 052 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Baisley, K. %A Orne-Gliemann, J. %A Larmarange, Joseph %A Plazy, M. %A Collier, D. %A Dreyer, J. %A Mngomezulu, T. %A Herbst, K. %A Hanekom, W. %A Dabis, F. %A Siedner, M. J. %A Iwuji, C. %T Treat-all strategy and long-term survival among people living with HIV in South Africa : results after 6 years of observation in the ANRS 12249 treatment as prevention trial %D 2022 %L fdi:010084354 %G ENG %J HIV Medicine %@ 1464-2662 %K HIV ; immediate antiretroviral therapy ; mortality ; South Africa ; test and ; treat %K AFRIQUE DU SUD %M ISI:000761366200001 %N 8 %P 922-928 %U https://www.documentation.ird.fr/hor/fdi:010084354 %> https://www.documentation.ird.fr/intranet/publi/2022-04/010084354.pdf %V 23 %W Horizon (IRD) %X Objectives: Population-based universal test and treat (UTT) trials have shown an impact on population-level virological suppression. We followed the ANRS 12249 TasP trial population for 6 years to determine whether the intervention had longer-term survival benefits. Methods: The TasP trial was a cluster-randomized trial in South Africa from 2012 to 2016. All households were offered 6-monthly home-based HIV testing. Immediate antiretroviral therapy (ART) was offered through trial clinics to all people living with HIV (PLHIV) in intervention clusters and according to national guidelines in control clusters. After the trial, individuals attending the trial clinics were transferred to the public ART programme. Deaths were ascertained through annual demographic surveillance. Random-effects Poisson regression was used to estimate the effect of trial arm on mortality among (i) all PLHIV; (ii) PLHIV aware of their status and not on ART at trial entry; and (iii) PHLIV who started ART during the trial. Results: Mortality rates among PLHIV were 9.3/1000 and 10.4/1000 person-years in the control and intervention arms, respectively. There was no evidence that the intervention decreased mortality among all PLHIV [adjusted rate ratio (aRR) = 1.10, 95% confidence interval (CI) = 0.85-1.43, p = 0.46] or among PLHIV who were aware of their status but not on ART. Among individuals who initiated ART, the intervention decreased mortality during the trial (aRR = 0.49, 95% CI = 0.28-0.85, p = 0.01), but not after the trial ended. Conclusions: The 'treat all' strategy reduced mortality among individuals who started ART but not among all PLHIV. To achieve maximum benefit of immediate ART, barriers to ART uptake and retention in care need to be addressed. %$ 050 ; 052 ; 108 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Simo Fotso, Arlette %A Kouassi, Arsène Kra %A Maheu-Giroux, M. %A Boye, Sokhna %A d'Elbee, M. %A Ky-zerbo, O. %A Rouveau, Nicolas %A N'Guessan, N. K. %A Geoffroy, O. %A Vautier, A. %A Larmarange, Joseph %A ATLAS Team %T Is it possible to recruit HIV self-test users for an anonymous phone-based survey using passive recruitment without financial incentives ? : lessons learned from a pilot study in Cote d'Ivoire %D 2022 %L fdi:010083936 %G ENG %J Pilot and Feasibility Studies %K HIV ; AIDS ; HIV self-testing ; ATLAS project ; Key populations ; Men who ; have sex with men ; Female sex workers ; Drug users ; Secondary distribution ; Monitoring ; Telephone survey %K COTE D'IVOIRE %M ISI:000739954900001 %N 1 %P 4 [7 ] %R 10.1186/s40814-021-00965-2 %U https://www.documentation.ird.fr/hor/fdi:010083936 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2022-02/010083936.pdf %V 8 %W Horizon (IRD) %X Background Due to the discreet and private nature of HIV self-testing (HIVST), it is particularly challenging to monitor and assess the impacts of this testing strategy. To overcome this challenge, we conducted a study in Cote d'Ivoire to characterize the profile of end users of HIVST kits distributed through the ATLAS project (AutoTest VIH, Libre d'Acceder a la connaissance de son Statut). Feasibility was assessed using a pilot phone-based survey. Methods The ATLAS project aims to distribute 221300 HIVST kits in Cote d'Ivoire from 2019 to 2021 through both primary (e.g., direct distribution to primary users) and secondary distribution (e.g., for partner testing). The pilot survey used a passive recruitment strategy-whereby participants voluntarily called a toll-free survey phone number-to enrol participants. The survey was promoted through a sticker on the HIVST instruction leaflet and hotline invitations and informal promotion by HIVST kit-dispensing agents. Importantly, participation was not financially incentivized, even though surveys focussed on key populations usually use incentives in this context. Results After a 7-month period in which 25,000 HIVST kits were distributed, only 42 questionnaires were completed. Nevertheless, the survey collected data from users receiving HIVST kits via both primary and secondary distribution (69% and 31%, respectively). Conclusion This paper provides guidance on how to improve the design of future surveys of this type. It discusses the need to financial incentivize participation, to reorganize the questionnaire, the importance of better informing and training stakeholders involved in the distribution of HIVST, and the use of flyers to increase the enrolment of users reached through secondary distribution. %$ 056 ; 052 ; 124 %0 Unpublished Work %9 AP : Autres productions %A Rouveau, Nicolas %A Ky-Serbo, O. %A Boye, S. %A Simo Fotso, A. %A D'Elbée, M. %A Maheu-Giroux, M. %A Silhol, R. %A Kouassi, Arsène Kra %A Vautier, A. %A Doumenc-Aïdara, C. %A Breton, G. %A Keita, A. %A Ehui, E. %A Tidiane Ndour, C. %A Boilly, M.C. %A Terris-Prestholt, F. %A Pourette, Dolorès %A Desclaux, Alice %A Larmarange, Joseph %T Décrire, analyser et comprendre les effets de l'introduction de l'autodépistage du VIH en Afrique de l'Ouest à travers l'exemple du programme ATLAS en Côte d'Ivoire, au Mali et au Sénégal %C Paris %D 2022 %L fdi:010088047 %G FRE %I CEPED %K SENEGAL ; COTE D'IVOIRE ; MALI %N 52 %P 22 multigr. %R https://zenodo.org/record/5599410 %U https://www.documentation.ird.fr/hor/fdi:010088047 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-08/010088047.pdf %W Horizon (IRD) %X Contexte : Le programme ATLAS vise à promouvoir et à déployer l'autodépistage du VIH (ADVIH) dans trois pays d'Afrique de l'Ouest : Côte d'Ivoire, Mali et Sénégal. Sur la période 2019-2021, en étroite collaboration avec les partenaires nationaux de mise en oeuvre de la lutte contre le sida et les communautés, ATLAS prévoit de distribuer 500 000 kits VIHST à travers huit canaux de distribution, combinant des stratégies fixes et des stratégies avancées, une distribution primaire et une distribution secondaire d'ADVIH. Tenant compte de l'épidémiologie ouest-africaine, les cibles du programme ATLAS sont les populations difficiles à atteindre : les populations clés (travailleuses de sexe, hommes ayant des rapports sexuels avec des hommes et usager·e·s de drogues), leurs clients ou partenaires sexuels, les partenaires des personnes vivant avec le VIH et les patients diagnostiqués avec des infections sexuellement transmissibles et leurs partenaires. Le programme ATLAS intégrer ainsi un volet recherche ayant pour objectif d'accompagner cette mise en oeuvre et de générer des connaissances sur le passage à l'échelle de l'ADVIH en Afrique de l'Ouest. L'objectif principal est de décrire, d'analyser et de comprendre les effets sociaux, sanitaires, épidémiologiques et économiques de l'introduction de l'autodépistage du VIH en Côte d'Ivoire, au Mali et au Sénégal pour améliorer l'offre de dépistage (accessibilité, efficacité, éthique). Méthodes : La recherche ATLAS est organisée en cinq work packages (WP) multidisciplinaires : WP Populations clés : enquêtes qualitatives (entretiens individuels approfondis, discussions de groupe) menées auprès des acteurs clés, des populations clés et des utilisateurs des services de dépistage du VIH. WP Dépistage des cas index : observation ethnographique de trois services de soins VIH introduisant l'ADVIH pour le dépistage du partenaire. WP Enquête coupons : une enquête téléphonique anonyme auprès des utilisateurs de l'ADVIH. WP Volet économique : analyse des coûts économiques différentiels de chaque modèle de dispensation à l'aide d'une approche descendante avec collecte des coûts programmatiques, complété par une approche ascen-dante auprès d'un échantillon de sites de dispensations de l'ADVIH, et une étude temps-mouvement auprès d'un échantillon d'agent·e·s dispensateurs. WP Modélisation : adaptation, paramétrisation et calibration d'un modèle compartimental dynamique qui prend en compte les diverses populations ciblées par le programme ATLAS et les différentes modalités et stratégies de dépistage. Discussion : Le programme ATLAS est la première étude complète sur l'autodépistage du VIH en Afrique de l'Ouest. Le programme ATLAS se concentre particulièrement sur la distribution secondaire de l'ADVIH. Ce protocole a été approuvé par trois comités d'éthique nationaux et par le comité d'éthique de la recherche de l'OMS. %$ 056 ; 052 %0 Conference Proceedings %9 ACTI : Communications avec actes dans un congrès international %A Nouaman, N.M. %A Coffie, P.A. %A Plazy, M. %A Becquet, V. %A Agoua, A. %A Zébago, C. %A Dao, H. %A Larmarange, Joseph %A Eholie, S. %T Prevalence and incidence of sexually transmitted infections in a cohort of female sex workers in San Pedro, Côte d'Ivoire (ANRS 12381 PRINCESSE project) [poster] %C Paris (FRA) ; Stockolm %D 2022 %L fdi:010087003 %G ENG %I ANRS ; International AIDS Society %K COTE D'IVOIRE %P 1 multigr. %U https://www.documentation.ird.fr/hor/fdi:010087003 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-07/010087003.pdf %W Horizon (IRD) %X Background : The ANRS 12381 PRINCESSE study is an interventional single-arm cohort. Participants recruitment started in November 2019. The study aimed to evaluate a comprehensive and community-based care offer among FSWs aged '¥ 18 years in the San Pedro area. Methods : Care services included quarterly syndromic screening for STIs, as well as vaginal and anal swabs for the screening of chlamydia trachomatis (CT) and neisseria gonorrhoea (NG) by polymerase chain reaction (PCR) at M0, M12 and M24. At the same visits, identification of dysplasias and precancerous lesions of the cervix was performed by visual inspection after applying acetic acid and Lugol's iodine. STIs were managed according to the national algorithm. We describe (i) the characteristics of cervical lesions as well as the prevalence of STIs (syndromic and PCR) and associated symptoms and (ii) the incidence of syndromic STIs during follow-up. Results : In November 2021, 372 FSWs were included. The median age was 29 years, 34% had never been to school, 56% were Ivorian, and the median duration of sex work was 2 years. At inclusion, 4.7% [95% confidence interval: 2.8-7.5] had cervical lesions with 3.5% leukoplakia and 2.2% haemorrhagic cervical junction zone. The prevalence of syndromic STIs was 17.2% [13.0-22.6]; associated clinical signs were vaginal discharge (13.7%), vaginal ulceration (2.1%), lower abdominal pain (4.3%) and cervical inflammation (2.6%). The prevalence of anovaginal CT and NG were 8.7% [6.2- 12.1] and 10.4% [7.6- 13.9], respectively; clinical signs were found in 2.4% of CT-positive and 12.2% of NG-positive FSWs. Most FSWs with syndromic STIs did not have CT or NG infection. During the follow-up, 82 cases of syndromic STIs were observed per 209 person-years, i.e. an incidence of 39.1% [31.1- 49.0]. PCR data at M12 and M24 are being consolidated and will allow estimating the incidence of CT and NG. Conclusions : A high prevalence and incidence of syndromic STIs were observed among FSWs, highlighting the importance and the interest of a regular follow-up. The results also showed the predominantly asymptomatic nature of STIs discovered by PCR in this at-risk population and, therefore, the importance of coupling syndromic screening and PCR analyses. %B International AIDS Conference %8 2022/07/29-2022/08/02 %$ 052MALTRA03 ; 050MEDECI %0 Conference Proceedings %9 ACTI : Communications avec actes dans un congrès international %A Simo Fotso, A. %A Johnson, C. %A Vautier, A. %A Kouamé, K.B. %A Diop, P.M. %A Silhol, R. %A Maheu-Giroux, M. %A Boily, M.C. %A Rouveau, Nicolas %A Doumenc-Aïdara, C. %A Baggaley, R. %A Ehui, E. %A Larmarange, Joseph %A Atlas Team %T Mesure de l'impact populationnel de l'autodépistage du VIH par la triangulation de données programmatiques de routine : exemple du projet ATLAS en Côte d'Ivoire [poster] %C Paris (FRA) ; Marseille %D 2022 %L fdi:010087004 %G FRE %I AFD ; IRD %K COTE D'IVOIRE %P 1 multigr. %U https://www.documentation.ird.fr/hor/fdi:010087004 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-07/010087004.pdf %W Horizon (IRD) %X Objectifs : L'auto-dépistage du VIH (ADVIH) est recommandé comme stratégie de dépistage par l'OMS. Il a pour avantage de permettre aux personnes de réaliser elles-mêmes leur test et de garantir la discrétion et confidentialité, permettant de toucher des populations non testées et difficiles à atteindre. Cependant, son caractère confidentiel et l'approche de distribution via les réseaux (ciblant les population clés et leurs proches et partenaires) rendent difficile l'estimation de l'impact de l'ADVIH au niveau populationnel. Cette étude propose un moyen de surmonter ce défi et utilise des données programmatiques de routine pour estimer indirectement les impacts du projet ATLAS sur l'accès au dépistage du VIH, le dépistage du VIH conventionnel (c'est-à-dire autre que l'ADVIH), les nouveaux diagnostics du VIH et l'initiation de traitement antirétroviral (TAR) en Côte d'Ivoire. Matériels et Méthodes Les données sur le nombre de kits d'ADVIH distribués par ATLAS proviennent des rapports des partenaires de mise en oeuvre entre le troisième trimestre (T3) de 2019 et le T1 2021. Nous utilisons également les indicateurs de routine du PEPFAR agrégées par districts sanitaires et par trimestre. Les analyses se font par une régression de séries chronologiques écologiques à l'aide de modèles mixtes linéaires. Résultats Entre T3 2019 et T1 2021, 99353 kits d'ADVIH ont été distribués par ATLAS dans les 78 districts sanitaires inclus dans l'analyse. Les résultats (tableau 1) montrent un effet négatif mais non significatif sur le volume de tests conventionnels (-195) ce qui traduirait une légère substitution entre ADVIH et test conventionnel. Malgré cela l'effet net est positif sur l'accès au dépistage : pour 1000 ADVIH distribués via ATLAS, 589 personnes supplémentaires ont eu accès au dépistage du VIH avec l'hypothèse d'un taux d'utilisation d'ADVIH (TU) de 80 % et 393 avec une hypothèse de 60%. L'effet de l'ADVIH sur le diagnostic du VIH était significatif et positif (8). Pas d'effet significatif observé sur l'initiation TAR (-2). Conclusion Nos résultats mettent en évidence qu'une stratégie de distribution de l'ADVIH basée sur les réseaux ciblant les population clés et leurs proches et partenaires augmentent l'accès au dépistage du VIH et améliore le diagnostic. La méthodologie utilisée dans cet article pourrait être reproduite dans différents contextes pour l'évaluation des programmes d'ADVIH, sans nécessité de systèmes de collecte additionnels. %B AFRAVIH.Alliance Francophone des Acteurs de Santé contre le VIH et les Infections Virales Chroniques ou Emergentes %8 2022/04/06-09 %$ 108DEMOG1 ; 052MALTRA03 %0 Conference Proceedings %9 ACTI : Communications avec actes dans un congrès international %A Plazy, M. %A Nouaman, M. %A Becquet, V. %A Agoua, A. %A Zebago, C. %A Dao, H. %A Coffie, P.A. %A Eholie, S. %A Larmarange, Joseph %T Retards à l'initiation de la PrEP orale chez les travailleuses du sexe en Côte d'Ivoire (projet ANRS 12381 PRINCESSE) [poster] %C Paris (FRA) ; Marseille %D 2022 %L fdi:010086646 %G FRE %I ANRS ; CEPED ; IRD %K COTE D'IVOIRE %P 1 multigr. %U https://www.documentation.ird.fr/hor/fdi:010086646 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-07/010086646.pdf %W Horizon (IRD) %X Objectifs : Décrire les retards et obstacles à l'initiation de la prophylaxie pre-exposition (PrEP) orale des travailleuses du sexe (TS) en Côte d'Ivoire. Matériels et Méthodes : Le projet ANRS 12381 PRINCESSE est une cohorte interventionnelle mono-bras, dont les inclusions ont débuté le 26/11/2019, qui vise à évaluer la mise en oeuvre d'une offre de soins globale et communautaire auprès des TS de sup. ou ég. 18 ans dans la région de San Pedro. Il s'organise autour d'une clinique mobile se déplaçant sur 10 sites prostitutionnels (chaque site étant visité toutes les deux semaines) et d'une clinique fixe. La PrEP est proposée à toutes les TS VIH- ; l'initiation est possible après vérification du taux de créatinine (déterminé via un bilan biologique ; résultats valables un mois). L'analyse présentée se limite aux TS VIH- et séronégatives au virus de l'hépatite B (AgHBs-) incluses jusqu'au 30/09/21, et décrit ce qu'il s'est passé entre l'intérêt exprimé pour la PrEP et la prescription de la PrEP (ou la fin de suivi). La probabilité d'initiation de la PrEP après avoir exprimé son intérêt est décrite via une courbe de Kaplan-Meier censurée au 23/11/21 (une analyse censurée à la date de dernière visite a aussi été conduite). Résultats : Parmi les 362 TS étaient incluses dans la cohorte PRINCESSE, 302 étaient VIH-/AgHBs-. Sur les 296 TS à qui la PrEP a été présentée (95,2% à l'inclusion), 292 se sont déclarées intéressées (99,7% le jour même). Parmi elles, 192 (65,8% des TS intéressées) ont reçu une prescription de PrEP : 18 le jour même de l'intérêt exprimé (le bilan biologique ayant été réalisé lors d'une précédente visite), 148 lors de la visite suivante (délai médian depuis l'intérêt : 3 semaines [Intervalle Inter-Quartile : 2-6]) et 26 lors d'une visite ultérieure (délai médian : 20 semaines [9-36], soit parce qu'elles n'étaient temporairement plus intéressées (n=3), soit parce qu'elles sont revenues tardivement). Au final, la probabilité de prescription de la PrEP après avoir exprimé son intérêt est de 39,0% à 1 mois et de 56,6% à 3 mois (en censurant sur la date de dernière visite, ces proportions sont respectivement de 50,7% et 74,6%). Parmi les 100 TS qui n'ont pas initié la PrEP malgré un intérêt exprimé, 68 n'ont jamais été revues dans le projet ; parmi les 32 TS qui sont revenues à au moins une deuxième visite suivant leur intérêt pour la PrEP, 4 ont déclaré ne plus être intéressées par la PrEP (délai médian depuis l'intérêt : 12 semaines [10-19]), 1 a été dépistée VIH+ (délai de 2 semaines) et 27 sont revenues plus d'un mois après (leur bilan biologique n'était plus valable). Conclusion : Malgré un fort intérêt exprimé pour la PrEP, son initiation reste sous-optimale parmi les TS de PRINCESSE. Les premières analyses exploratoires et discussions avec les équipes terrain suggèrent plusieurs obstacles (mobilité des TS, intérêt mal perçu pour la PrEP, lourdeur du suivi, fidélité des sorties de la clinique mobile), et confirment la nécessité de trouver des solutions adaptées pour rendre la PrEP effective chez les TS. %B AFRAVIH.Alliance Francophone des Acteurs de Santé contre le VIH et les Infections Virales Chroniques ou Emergentes %8 2022/04/06-09 %$ 052MALTRA03 %0 Conference Proceedings %9 ACTI : Communications avec actes dans un congrès international %A Plazy, M. %A Nouaman, M. %A Becquet, V. %A Agoua, A. %A Zebago, C. %A Dao, H. %A Coffie, P.A. %A Eholie, S. %A Larmarange, Joseph %T Delays to PrEP initiation among female sex workers in Côte d'Ivoire (ANRS 12381 PRINCESSE project) [poster] %C Paris (FRA) ; Stockolm %D 2022 %L fdi:010086647 %G ENG %I ANRS ; International AIDS Society %K COTE D'IVOIRE %P 1 multigr. %U https://www.documentation.ird.fr/hor/fdi:010086647 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-07/010086647.pdf %W Horizon (IRD) %X Background : To describe the delays to initiation of oral pre-exposure prophylaxis (PrEP) among female sex workers (FSW) in Côte d'Ivoire. Methods : The ANRS 12381 PRINCESSE project is a single-arm interventional cohort aiming to evaluate the implementation of a comprehensive and community-based care offer among FSW aged sup. or eg.18 years in the San Pedro region since end-2019, through a mobile clinic operating on 10 prostitution sites (visited every two weeks). PrEP is offered to all HIV-positive FSW after verifying the creatinine level (results valid for one month). We described the time between FSW's interest for PrEP and PrEP initiation (or end of follow-up) among HIV- and hepatitis B virus-negative (HBsAg-) FSW included until end-October 2021. The probability of PrEP initiation since PrEP interest is described through a Kaplan-Meier curve censored on end-November 2021 (an analysis censored at the date of the last visit was also conducted). Results : Of the 362 FSW included in the PRINCESSE cohort, 302 were HIV-/AgHBs-, and for 296 of them, PrEP was presented by medical staff (95.2% at inclusion). In total, 292 FSW expressed PrEP interest, and 192 (65.8%) initiated PrEP: 18 on the same day (the biological test having been performed during a previous visit), 148 during the next visit (median time since interest: 3 weeks [Inter-Quartile Range: 2-6]) and 26 during a subsequent visit (median time: 20 weeks [9-36]). The probability of PrEP initiation after PrEP interest was 39.0% at 1 month and 56.6% at 3 months (censoring on the date of the last visit, these proportions were 50.7% and 74.6%, respectively). Among the 100 FSW who did not initiate PrEP despite expressing interest, 68 were never seen again in the project; 4 declared that they were no longer interested in PrEP (median time since interest: 12 weeks [10-19]), 1 was tested HIV+ (delay of 2 weeks), and 27 were seen >1 month later (their biological tests were no longer valid). Conclusions : Despite strong PrEP interest among FSW, PrEP initiation remained suboptimal. Barriers to PrEP initiation should be more explored and considered to find appropriate solutions to make PrEP effective among this specific key population. %B International AIDS Conference %8 2022/07/29-2022/08/02 %$ 052MALTRA03 %0 Conference Proceedings %9 ACTI : Communications avec actes dans un congrès international %A Silhol, R. %A Maheu-Giroux, M. %A Soni, N. %A Simo Fotso, A. %A Rouveau, Nicolas %A Vautier, A. %A Doumenc-Aïdara, C. %A Geoffroy, O. %A N'Guessan, K.N. %A Mukandavire, C. %A Vickerman, P. %A Keita, A. %A Ndour, C.T. %A Larmarange, Joseph %A Boily, M.C. %A Atlas Team %T Identifying population-specific HIV diagnosis gaps in Western Africa and assessing their impact on new infections : a modelling analysis for Côte d'Ivoire, Mali and Senegal [poster] %C Stocoklm %D 2022 %L fdi:010087005 %G ENG %I International AIDS Society %K COTE D'IVOIRE ; MALI ; SENEGAL %P 1 multigr. %U https://www.documentation.ird.fr/hor/fdi:010087005 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-07/010087005.pdf %W Horizon (IRD) %X Background : Progress towards HIV elimination in Western Africa may be hindered by diagnosis gaps among people living with HIV (PLHIV), especially among key populations (KP) such as female sex workers (FSW), their clients, and men who have sex with men (MSM). We aimed to identify largest gaps in diagnosis by risk group in Mali, Côte d'Ivoire, and Senegal, and project their contribution to new HIV infections. METHODS : Deterministic models of HIV transmission/diagnosis/treatment that incorporate HIV transmission among KP were parameterized following comprehensive country-specific reviews of demographic, behavioural, HIV and intervention data. The model was calibrated to country- and group-specific empirical outcomes such as HIV incidence/prevalence, the fractions of PLHIV ever tested, diagnosed, and on treatment. We estimated the distribution of undiagnosed PLHIV by risk group in 2020 and the population-attributable-fractions (tPAFs) (i.e. fraction of new primary and secondary HIV infections 2020-2029 originating from risk groups of undiagnosed PLHIV). Results : From 46% (95% UI: 38-58) to 69% (59-79) of undiagnosed PLHIV in 2020 were males, with the lowest proportion in Mali and the highest proportion in Senegal, where 41% (28-59) of undiagnosed PLHIV were MSM. Undiagnosed men are estimated to contribute most new HIV infections occurring over 2020-2029 (Table). Undiagnosed FSW and their clients contribute substantial proportions of new HIV infections in Mali, with tPAF=20% (10-36) and tPAF=43% (26-56), respectively, while undiagnosed MSM in Senegal are estimated to contribute half of new infections. A lower proportion of new HIV infections are transmitted by undiagnosed KP in Côte d'Ivoire (tPAF=21%(10-38)). Conclusions : Current HIV testing services and approaches are leaving members of KP behind. Increasing the availability of confidential HIV testing modalities in addition to traditional tests may substantially reduce gaps in HIV diagnosis and accelerate the decrease of new HIV infections in Western Africa since half of them could be transmitted by undiagnosed KP. %B International AIDS Conference %8 2022/07/29-2022/08/02 %$ 122 ; 052 %0 Conference Proceedings %9 ACTI : Communications avec actes dans un congrès international %A Simo Fotso, A. %A Johnson, C. %A Vautier, A. %A Kouamé, K.B. %A Diop, P.M. %A Silhol, R. %A Maheu-Giroux, M. %A Boily, M.C. %A Rouveau, Nicolas %A Doumenc-Aïdara, C. %A Baggaley, R. %A Ehui, E. %A Larmarange, Joseph %A Atlas Team %T Estimating the impact of HIV self-testing on HIV testing services, diagnoses, and treatment initiation at the population-level with routine data : the example of the ATLAS program in Côte d'Ivoire [poster] %C Marseille (FRA) ; Paris %D 2022 %L fdi:010087006 %G ENG %I IRD ; AFD %K COTE D'IVOIRE %P 1 multigr. %U https://www.documentation.ird.fr/hor/fdi:010087006 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-07/010087006.pdf %W Horizon (IRD) %X Background : HIV self-testing (HIVST) is a critical testing approach particularly for reaching those at HIV risk who are hesitant or unable to access existing services. While the discreet and flexible nature of HIVST is appealing to users, these features can limit the ability for programmes to monitor and estimate the population-level impacts of HIVST implementation. This study triangulates publicly available routine programme data from Côte d'Ivoire in order estimate the effects of HIVST distribution on access to testing, conventional testing (self-testing excluded), HIV diagnoses, and antiretroviral treatment (ART) initiations. Methods : We used quarterly programmatic data (Q3-2019 to Q1-2021) from ATLAS, a project that aims to promote and implement network-based HIVST distribution in West Africa, in addition to routine HIV testing services program data obtained from the PEPFAR dashboard. We performed ecological time series regression using linear mixed-models. Results : Between Q3-2019 and Q1-2021, 99,353 HIVST kits were distributed by ATLAS in 78 health districts included in the analysis. The results (Table 1) show a negative but non-significant effect of the number of ATLAS HIVST on the volume of conventional tests (-190), suggesting the possibility of a slight substitution effect. Despite this, the the beneficial effect on access to testing is significant: for each 1000 HIVST distributed via ATLAS, 390 to 590 additional HIV tests were performed if 60% to 80% of HIVST are used . The effect of HIVST on HIV diagnosis was significant and positive, with 8 additional diagnoses per 1,000 HIVST distributed. No effect of HIVST was observed on ART initiations. Conclusions : Our study provides a standard methodology for estimating the population-level impact of HIVST that can be used across countries. It shows that HIVST distribution was associated with increased access to HIV testing and diagnosis in Côte d'Ivoire. Wide-scale adoption of this method will improve HIVST data quality and inform evidence-based programming. %B International AIDS Conference %8 2022/07/29-2022/08/02 %$ 052 ; 122 ; 020 %0 Conference Proceedings %9 ACTI : Communications avec actes dans un congrès international %A Traore, M.M. %A Badiane, K. %A Vautier, A. %A Simo Fotso, A. %A Kabemba, O.K. %A Rouveau, Nicolas %A Maheu-Giroux, M. %A Boily, M.C. %A Larmarange, Joseph %A Terris-Prestholt, F. %A D'Elbée, M. %A Atlas Team %T Coûts unitaires de l'autodépistage et du dépistage classique du VIH dans les centres de santé publics et communautaires en Côte d'Ivoire, au Mali et au Sénégal [poster] %C Marseille (FRA) ; Paris %D 2022 %L fdi:010087007 %G FRE %I IRD ; AFD %K COTE D'IVOIRE ; MALI ; SENEGAL %P 1 multigr. %U https://www.documentation.ird.fr/hor/fdi:010087007 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-07/010087007.pdf %W Horizon (IRD) %X Objectifs : L'atteinte des 'trois 95' de l'ONUSIDA a induit l'adoption de stratégies de dépistage VIH innovantes en Afrique de l'Ouest. Le projet ATLAS déploie l'autodépistage du VIH (ADVIH) en Côte d'Ivoire (CI), au Mali (ML) et au Sénégal (SN) en stratégie avancée et fixe (Figure 1). Les stratégies fixes sont mises en oeuvre dans (i) des structures de santé fixes pour le dépistage des partenaires de personnes vivant avec le VIH (Index), et pour celui des patients ayant une Infection Sexuellement Transmissible (IST) et leurs partenaires, et (ii) dans des cliniques communautaires à destination des hommes ayant des rapports sexuels avec des hommes (HSH), des travailleuses du sexe (TS) et des personnes usagères de drogues (UD). Cette étude a pour objectif d'estimer les coûts unitaires des stratégies fixes ADVIH et celui des tests de diagnostic rapide (TDR). Matériels et Méthodes : L'évaluation des coûts de dispensation des ADVIH a porté sur 37 (CI=16 ; ML=11 ; SN=10) centres de santé publics et communautaires entre 2019 et 2021 suivant la perspective du fournisseur. Nous avons combiné une analyse de rapports financiers avec celle d'une collecte de coûts dans les centres complétés par des observations de sessions de dispensation ADVIH et de dépistage VIH, en excluant les coûts centraux. Résultats : Au total, 16001 kits d'ADVIH (CI=9306 ; ML=3973 ; SN=2722) ont été dispensés pour 32194 TDR réalisés (CI=8213; ML=3612; SN=20369). Les coûts unitaires moyens de l'ADVIH étaient compris entre 4 et 8 pour la Côte d'Ivoire et le Sénégal (Tableau 1). Ces coûts étaient plus élevés au Mali, entre 7 et 26, liés à des coûts de personnels élevés (management/administration et agents dispensateurs HSH), ainsi que de faibles volumes de kits ADVIH dispensés pour certains canaux. En Côte d'Ivoire et au Sénégal, les coûts moyens du dépistage avec TDR ont été estimés dans l'ensemble des canaux à environ 4$ par personne testée (coûts non estimés au Mali). Conclusion : Dans les trois pays, les coûts moyens d'introduction des ADVIH en stratégies fixes à faible volume étaient légèrement plus élevés que ceux des TDR. L'ADVIH peut diversifier l'offre de service de dépistage au niveau des structures fixes, améliorant ainsi l'accès au dépistage des populations cibles non-atteintes par les services TDR. %B AFRAVIH.Alliance Francophone des Acteurs de Santé contre le VIH et les Infections Virales Chroniques ou Emergentes %8 2022/04/06-09 %$ 094 ; 052 ; 056 %0 Conference Proceedings %9 ACTI : Communications avec actes dans un congrès international %A Boye, S. %A Kouadio, A. %A Vautier, A. %A Ky-Zerbo, O. %A Rouveau, Alexis %A Kouvahe, A.F. %A Maheu-Giroux, M. %A Larmarange, Joseph %A Pourette, Dolores %A Le Groupe Atlas %T L'introduction de l'autodépistage du VIH dans les consultations des Infections Sexuellement Transmissibles (IST) peut-elle améliorer l'accès au dépistage des patients IST et leurs partenaires ? : une étude qualitative exploratoire du projet ATLAS à Abidjan/Côte d'Ivoire [poster] %C Marseille (FRA) ; Paris %D 2022 %L fdi:010087008 %G FRE %I IRD ; AFD %K COTE D'IVOIRE ; ABIDJAN %P 1 multigr. %U https://www.documentation.ird.fr/hor/fdi:010087008 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-07/010087008.pdf %W Horizon (IRD) %X Objectifs : Dans le cadre de son projet d'introduction de l'auto dépistage du VIH (ADVIH), le programme ATLAS a initié une étude pour documenter les modalités de dispensation des kits d'ADVIH aux patient.e.s présentant une Infection Sexuellement Transmissible (IST) et leurs partenaires à Abidjan/Côte d'Ivoire. Matériels et Méthodes : Une enquête qualitative a été réalisée entre mars et août 2021 dans trois services dispensant des ADVIH auprès des patient.e.s IST: (1) consultation prénatale (CPN) ; (2) consultation générale incluant IST et (3) dispensaire IST dédié. Les données ont été collectées par (i) des observations de consultations médicales de patient·e·s IST (N=98) et (ii) des entretiens auprès de soignants impliqués dans la dispensation des kits d'ADVIH (N=18), de patient.e.s ayant reçu des kits ADVIH à proposer à leurs partenaires (N=21) et de partenaires de patientes IST ayant réalisé l'ADVIH (N=2). Résultats : Les trois services présentent des différences d'organisation du circuit du patient et des modalités de dispensation des kits d'ADVIH. En CPN, le dépistage du VIH est proposé systématiquement à toute femme enceinte lors de la première consultation. Lorsqu'une IST est diagnostiquée, un ADVIH est proposé presque systématiquement pour le partenaire (N=27/29). En consultation générale, il y a eu peu de propositions de dépistage et d'ADVIH aux patient.e.s IST et pour leurs partenaires (N=3/16). Malgré l'existence d'une délégation des tâches du dépistage et l'offre d'ADVIH, il n'y a pas de routinisation du dépistage dans ce service. Au dispensaire IST, le circuit du patient est mieux défini : diffusion de la vidéo ADVIH en salle d'attente, consultation des patient.e.s et référencement aux infirmières pour le dépistage avec proposition fréquente de kits d'ADVIH aux patient.e.s IST pour leurs partenaires (N=28/53). De manière générale, l'ADVIH est accepté lorsqu'il est proposé. Mais, la proposition de l'ADVIH aux partenaires n'est pas toujours facile, surtout pour les femmes : difficultés à aborder la question du VIH avec le conjoint, relation de couple 'fragile'. Les soignants en général ont une perception positive des ADVIH, mais, ils soulignent le caractère chronophage de la dispensation des ADVIH et souhaitent une meilleure organisation : délégation des tâches (CPN). Conclusion : L'organisation des consultations est déterminante : les contraintes structurelles (organisation du service, délégation des tâches) influent sur la proposition d'un dépistage VIH et l'ADVIH ne suffit pas à les lever. La proposition par les soignants d'un ADVIH pour les partenaires nécessite du temps et un accompagnement des patients.e.s. La proposition est plus systématique quand le dépistage est 'routinisé' et concerne tous les patient.e.s. Quand l'ADVIH est proposé, il est en général accepté. Si l'ADVIH constitue une opportunité d'améliorer l'accès au dépistage des patient.e.s et de leurs partenaires, une intégration réussie implique d'améliorer l'organisation des services et de promouvoir la délégation des tâches. %B AFRAVIH.Alliance Francophone des Acteurs de Santé contre le VIH et les Infections Virales Chroniques ou Emergentes %8 2022/04/06-09 %$ 052MALTRA03 ; 056SOCSAN %0 Conference Proceedings %9 ACTI : Communications avec actes dans un congrès international %A Stannah, J. %A Anato, J.L.F. %A Mitchell, K.M. %A Larmarange, Joseph %A Maheu-Giroux, M. %A Boily, M.C. %T Improving our understanding of how structural determinants impact HIV epidemics : a scoping review of dynamic models to guide future research [poster] %C Stockolm %D 2022 %L fdi:010087009 %G ENG %I International AIDS Society %K MONDE %P 1 multigr. %U https://www.documentation.ird.fr/hor/fdi:010087009 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-07/010087009.pdf %W Horizon (IRD) %X Background : Dynamic models of HIV transmission have proven valuable tools for informing HIV prevention strategies. Including structural determinants in models is crucial to estimate their population-level impacts on HIV transmission and inform efforts towards HIV elimination. However, this is challenging due to a lack of coherent conceptual frameworks, limited understanding of their specific causal pathways, and few empirical estimates of their impacts on downstream mediators. Methods : With the overarching aim to improve models, we conducted a scoping review of studies that used dynamic HIV transmission models to evaluate the impact of structural determinants. From included studies, we extracted information on the types of structural determinants and methods used to model their impacts on HIV transmission. We appraised studies on how they conceptualized structural exposures and represented their causal relationships over time within models. Results : We identified 9 dynamic transmission modelling studies that incorporated structural determinants of HIV, including violence (N=3), incarceration (N=2), stigma (N=2), housing instability (N=2), migration (N=1), and education (N=1). Only one study modelled multiple determinants simultaneously. In most models, structural determinants were conceptualized using current, recent, non-recent and/or lifetime exposure categories. Modelled structural determinants largely impacted HIV transmission through mediated effects on one or more proximate risk factors, including sharing injection equipment, condom use, number of partners, and access to treatment. However, causal pathways were simplistic, with few mediators and/or lack of clear empirical justification. To measure impact, most studies simply assumed the elimination of structural determinants in counterfactual comparison scenarios. Few models included long-term and/or delayed effects of past, recurrent, or acute exposure, potentially overestimating impacts of determinants. Conclusions : Despite the importance of structural determinants for HIV prevention, methods for including them in dynamic HIV transmission models remain insufficient. Few studies have attempted to incorporate structural determinants in HIV models, and methods vary considerably. To improve inferences, models should adopt precise exposure definitions, deconstruct and estimate their complex causal pathways, and translate them into their mechanistic components. The need for development of coherent frameworks to conceptualize the synergistic interplay between strengthened empirical data analysis and the inclusion of structural determinants in dynamic models is pressing. %B International AIDS Conference %8 2022/07/29-2022/08/02 %$ 122 ; 052 ; 056 %0 Conference Proceedings %9 ACTI : Communications avec actes dans un congrès international %A Zonhoulou, D. %A Agoua, A. %A Zebago, C. %A Nouaman, M. %A Coffie, P. %A Plazy, M. %A Becquet, V. %A Larmarange, Joseph %T Défis de la prise en charge des condylomes acuminés en stratégie avancée dans une cohorte de travailleuses du sexe en Côte d'Ivoire : leçons apprises dans la cohorte ANRS 12381 Princesse [poster] %C Paris (FRA) ; Marseille %D 2022 %L fdi:010087011 %G FRE %I ANRS ; IRD %K COTE D'IVOIRE %P 1 multigr. %U https://www.documentation.ird.fr/hor/fdi:010087011 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-07/010087011.pdf %W Horizon (IRD) %X Objectifs : Les condylomes acuminés résultent d'une infection du papillomavirus humain et peuvent évoluer vers des formes graves comme des cancers. Du fait de leurs pratiques, les travailleuses du sexe (TS) y sont particulièrement exposées. Nous décrivons ici les défis d'une prise en charge des condylomes en stratégie avancée. Matériels et Méthodes : Le projet Princesse est une cohorte interventionnelle avec une offre de soins élargies en santé sexuelle, incluant un dépistage et une prise en charge des infections sexuellement transmissibles (IST), pour des TS de ? 18 ans dans la région de San Pedro, Côte d'Ivoire. Un suivi trimestriel est proposé, disponible à la fois sur sites prostitutionnels via une clinique mobile et à la clinique fixe d'Aprosam à San Pedro. Résultats : Sur 381 TS suivies entre 11/2019 et 11/2020, 11 présentaient des condylomes à l'inclusion ou lors d'une visite de suivi. Dix présentaient des condylomes très développés (multiples, volumineux, kératosiques). Toutes présentaient des condylomes au niveau pubien et vaginal. Deux TS présentaient en plus des condylomes anaux. L'âge des patientes variait entre 19 et 42 ans. L'ancienneté dans le travail du sexe était variable (entre 1 et 17 ans), mais la majorité (10) travaillait dans des maisons closes, signe d'un nombre élevé de clients. Une participante a été vue en clinique fixe. Elle a bénéficié d'un traitement local à base de podophyllotoxine pour éviter de multiples cicatrices, suivi d'une cryothérapie. Les dix autres cas ont été diagnostiqués en clinique mobile qui, pour des raisons logistiques, ne dispose pas d'un appareil de cryothérapie. Les participantes vues en cliniques mobiles ont été référées vers la clinique fixe pour une prise en charge adéquate. À ce jour, aucune ne s'y est encore présentée, malgré des relances et le constat d'une extension du nombre de condylomes lors de visites de suivi. La clinique mobile disposant d'un appareil portatif de thermoablation pour la prise en charge des dysplasies du col (un dépistage annuel étant inclus), une thermoablation des condylomes a été essayée chez 6 TS pour lesquelles les condylomes étaient de bonne taille. En effet, si les condylomes sont plus petits que la sonde d'ablation, il y a un risque d'abimer des tissus sains. Aucun effet n'a été constaté immédiatement après la pose de la sonde, ni au cours des visites de suivi. Une TS s'est plainte de douleurs et de brûlures persistantes au bout de deux semaines. Conclusion : Les TS sont exposées aux condylomes ano-génitaux et le diagnostic survient à un stade avancé. C'est une population difficile à engager dans les soins et le référencement vers une clinique fixe ne fonctionne pas. Une solution de prise en charge sur site est donc essentielle. Les appareils de cryothérapie sont peu adaptés pour un camion mobile. La thermoablation ne fonctionne pas sur les condylomes. L'arrivée d'appareil portatif d'électrocoagulation pourrait être une solution. Elle sera testée en 2022 dans Princesse. %B AFRAVIH.Alliance Francophone des Acteurs de Santé contre le VIH et les Infections Virales Chroniques ou Emergentes %8 2022/04/06-09 %$ 052MALTRA03 ; 050MEDECI ; 056SOCSAN %0 Conference Proceedings %9 ACTI : Communications avec actes dans un congrès international %A Kouassi, Arsène Kra %A Simo Fosto, A. %A N'Guessan, K.N. %A Geoffroy, O. %A Younoussa, S. %A Kanku Kamemba, O. %A Dieng, B. %A Dam Ndeye, P. %A Rouveau, Nicolas %A Maheu-Giroux, M. %A Boily, M.C. %A Silhol, R. %A D'Elbée, M. %A Vauthier, A. %A Larmarange, Joseph %A Atlas Team %T Atteindre les populations clés et périphériques : une enquête téléphonique auprès des utilisateurs d'autotests de dépistage du VIH en Afrique de l'Ouest [poster] %C Marseille (FRA) ; Paris %D 2022 %L fdi:010087010 %G FRE %I IRD ; AFD %K AFRIQUE DE L'OUEST ; COTE D'IVOIRE ; MALI ; SENEGAL %P 1 multigr. %U https://www.documentation.ird.fr/hor/fdi:010087010 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-02/010087010.pdf %W Horizon (IRD) %X Objectifs : En Afrique de l'Ouest, les stratégies communautaires ciblant les populations clés (PC) telles que les travailleuses du sexe (TS) et les hommes ayant des rapports sexuels avec des hommes (HSH) ont considérablement amélioré leur accès au dépistage du VIH. Cependant, il demeure difficile d'atteindre une partie de ces populations (TS occasionnelles, HSH 'cachés') et leurs réseaux (pairs, partenaires sexuels, clients). Les kits d'autodépistage du VIH (ADVIH) peuvent être distribués aux PC pour leur usage personnel mais également pour une distribution secondaire à leurs pairs, partenaires et proches. Depuis 2019, le programme ATLAS met en oeuvre une telle stratégie en Côte d'Ivoire, au Mali et au Sénégal, notamment auprès des TS et des HSH. Matériels et Méthodes : Afin de préserver la confidentialité et l'anonymat que procure l'ADVIH tout en documentant le profil des utilisateurs, une enquête téléphonique a été réalisée. Entre mars et juin 2021, des dépliants ont été distribués avec les kits d'ADVIH, invitant les utilisateurs à appeler un numéro de téléphone de manière anonyme et gratuite (avec une incitation de 2000 CFA de crédit téléphonique). Chaque dépliant comportait un numéro de participation unique permettant d'identifier anonymement le canal de distribution. Résultats : Au total, 1305 participants ont été recrutés dans le canal de distribution TS et 1100 dans celui HSH dans les trois pays, sur un total de 44 598 kits d'ADVIH distribués (taux de participation : 5,4%). 69% ont reçu leur kit d'un pair-éducateur ou d'un agent de santé, et 31% l'ont reçu d'un ami (17%), partenaire sexuel (7%), parent (6%) ou collègue (1%). Pour les ADVIH distribués via les TS, 48% des participants étaient des hommes, et pour ceux via les HSH, 9% étaient des femmes. Ceci montre la capacité de l'ADVIH à atteindre les partenaires sexuels des PC et les clients des TS. Seuls 50% des participants masculins du canal de distribution HSH ont déclaré à l'enquêteur avoir déjà eu des rapports sexuels avec un homme. Un tiers des participantes du canal de distribution TS et 45% des participants masculins du canal HSH étaient des primo-testeurs. Les proportions de ceux dont le dernier test VIH remontait à plus d'un an étaient respectivement de 24% et 14%. Ces proportions sont plus élevées que celles observées dans des enquêtes menées auprès de TS et de HSH dans les mêmes pays. Une enquête complémentaire (rappels téléphoniques) a été menée auprès de celles et ceux ayant rapporté un test réactif afin de documenter le lien vers la confirmation et les soins. Les résultats de ces rappels seront disponibles début 2022. Conclusion : L'ADVIH est une offre complémentaire permettant d'augmenter l'accès au dépistage des PC peu atteintes via les stratégies conventionnelles. La distribution secondaire des ADVIH est faisable et acceptable. Elle a le potentiel d'atteindre, au-delà des populations-clés elles-mêmes, d'autres populations périphériques et vulnérables au VIH. %B AFRAVIH.Alliance Francophone des Acteurs de Santé contre le VIH et les Infections Virales Chroniques ou Emergentes %8 2022/04/06-09 %$ 108DEMOG1 ; 052MALTRA03 ; 124COMMUN %0 Book %9 OS : Ouvrages scientifiques %A Boye, S. %A Bouaré, S. %A Ky-Zerbo, O. %A Rouveau, Nicolas %A Simo Fotso, A. %A D'Elbée, M. %A Silhol, R. %A Maheu-Giroux, M. %A Vautier, A. %A Breton, G. %A Keita, A. %A Bekelynck, A. %A Desclaux, Alice %A Larmarange, Joseph %A Pourette, Dolores %A Equipe Atlas %T Défis de la distribution des autotests VIH pour le dépistage des cas index lorsque le partage du statut VIH est faible : résultats préliminaires d'une étude qualitative à Bamako (Mali) dans le cadre du projet ATLAS %C Paris %D 2022 %L fdi:010087047 %G FRE %I CEPED %K MALI ; BAMAKO %N 53 %P 18 multigr. %R 10.5281/zenodo.6861911 %U https://www.documentation.ird.fr/hor/fdi:010087047 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-07/010087047.pdf %W Horizon (IRD) %X Contexte : Le taux de partage du statut VIH aux partenaires est faible au Mali, un pays d'Afrique de l'Ouest avec une prévalence nationale du VIH de 1,2%. L'autodépistage du VIH (ADVIH) pourrait augmenter la couverture du dépistage chez les partenaires des personnes vivant avec le VIH (PVVIH). Le programme AutoTest-VIH, Libre d'accéder à la connaissance de son Statut (ATLAS) a été lancé en Afrique de l'Ouest avec l'objectif de distribuer près d'un demi-million d'autotests VIH de 2019 à 2021 en Côte d'Ivoire, au Mali et au Sénégal. Le programme ATLAS intègre plusieurs activités de recherche. Cet article présente les résultats préliminaires de l'étude qualitative du programme ATLAS au Mali. Cette étude vise à améliorer notre compréhension des pratiques, des limites et des enjeux liés à la distribution des autotests VIH aux PVVIH afin qu'elles puissent proposer ces tests à leurs partenaires sexuels. Méthodes : Cette étude qualitative a été menée en 2019 dans une clinique de prise en charge du VIH à Bamako. Elle a consisté en (i) des entretiens individuels avec 8 professionnels de santé impliqués dans la distribution des autotests VIH ; (ii) 591 observations de consultations médicales, y compris de consultations de services sociaux, avec des PVVIH ; (iii) 7 observations de discussions de groupe de PVVIH animées par des pairs éducateurs, entretiens avec les professionnels de santé et les notes d'observation ont fait l'objet d'une analyse de contenu. Résultats : L'ADVIH a été abordé dans seulement 9% des consultations observées (51/591). Lorsque l'ADVIH était abordée, la discussion était presque toujours initiée par le professionnel de santé plutôt que par la PVVIH. La discussion sur l'ADVIH était peu fréquente car, dans la plupart des consultations, il n'était pas approprié de proposer l'ADVIH au partenaire (par exemple, lorsque les PVVIH étaient veuves, n'avaient pas de partenaire ou avaient délégué quelqu'un pour renouveler leurs ordonnances). Certaines PVVIH n'avaient pas révélé leur statut VIH à leur partenaire. La distribution de l'ADVIH prenait beaucoup de temps, et les consultations médicales étaient très courtes. Trois principaux obstacles à la distribution d'ADVIH lorsque le statut VIH n'avait pas été divulgué aux partenaires ont été identifiés : (1) la quasi-totalité des professionnels de santé évitaient de proposer l'ADVIH aux PVVIH lorsqu'ils pensaient ou savaient que les PVVIH n'avaient pas révélé leur statut VIH à leurs partenaires ; (2) les PVVIH étaient réticentes à proposer l'ADVIH à leurs partenaires s'ils ne leur avaient pas révélé leur séropositivité ; (3) l'utilisation des stratégies de soutien à la divulgation du statut VIH était limitée. Conclusion : Il est essentiel de renforcer les stratégies de soutien à la révélation du statut VIH+. Il est nécessaire de développer une approche spécifique pour la mise à disposition des autotests VIH pour les partenaires des PVVIH en repensant l'implication des acteurs. Cette approche doit leur permettre de bénéficier d'une formation adaptée aux problématiques liées à la (non)divulgation du statut VIH et aux inégalités de genre, et d'améliorer le conseil aux PVVIH. %B Working Papers du CEPED %$ 052 ; 056 %0 Thesis %9 THE : Thèses %A Larmarange, Joseph %T Décrire les épidémies, comprendre les populations : une démographie du VIH en Afrique subsaharienne %C Paris %D 2022 %L fdi:010087002 %G FRE %I Université Paris Cité %K SENEGAL ; DAKAR ; THIES ; SAINT LOUIS ; AFRIQUE SUBSAHARIENNE %K MBOUR %P 549 multigr. %U https://www.documentation.ird.fr/hor/fdi:010087002 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2022-12/010087002.pdf %W Horizon (IRD) %B Univ. Paris Cité %8 %$ 108DEMOG1 ; 052MALTRA03 ; 056SOCSAN %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 Agoua, A. %A Zebago, C. %A Dao, H. %A Montoyo, A. %A Jary, A. %A Coffie, P. A. %A Eholie, S. %A Larmarange, Joseph %A ANRS PRINCESSE Team, %T A community-based healthcare package combining testing and prevention tools, including pre-exposure prophylaxis (PrEP), immediate HIV treatment, management of hepatitis B virus, and sexual and reproductive health (SRH), targeting female sex workers (FSWs) in Cote d'Ivoire : the ANRS 12381 PRINCESSE project %D 2021 %L fdi:010083784 %G ENG %J BMC Public Health %K HIV prevention ; Sexual and reproductive health ; Sexually transmitted ; infections (STIs) ; hepatitis B ; Pre-exposure prophylaxis (PrEP) ; Sex work ; Mixed-methods research ; Mobile clinics ; Cote d'Ivoire %K COTE D'IVOIRE %M ISI:000726280500006 %N 1 %P 2214 [14 ] %R 10.1186/s12889-021-12235-0 %U https://www.documentation.ird.fr/hor/fdi:010083784 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2022-01/010083784.pdf %V 21 %W Horizon (IRD) %X Background: Pre-exposure prophylaxis (PrEP) is recommended by the WHO for HIV prevention among female sex workers (FSWs). A study conducted in 2016-2017 in Cote d'Ivoire showed that if PrEP is acceptable, FSWs also have many uncovered sexual health needs. Based on this evidence, the ANRS 12381 PRINCESSE project was developed in collaboration with a community-based organization. The main objective is to develop, document, and analyze a comprehensive sexual and reproductive healthcare package among FSWs in Cote d'Ivoire. Methods: PRINCESSE is an open, single-arm interventional cohort of 500 FSWs in San Pedro (Cote d'Ivoire) and its surroundings. Recruitment started on November 26th, 2019 and is ongoing; the cohort is planned to last at least 30 months. The healthcare package (including HIV, hepatitis B, and sexually transmitted infection management, pregnancy screening, and contraception) is available both at mobile clinics organized for a quarterly follow-up (10 intervention sites, each site being visited every two weeks) and at a fixed clinic. Four waves of data collection were implemented: (i) clinical and safety data; (ii) socio-behavioral questionnaires; (iii) biological data; and (iv) in-depth interviews with female participants. Four additional waves of data collection are scheduled outside the cohort itself: (i) the medical and activity records of Aprosam for the PRINCESSE participants; (ii) the medical records of HIV+ FSW patients not participating in the PRINCESSE cohort, and routinely examined by Aprosam; (iii) in-depth interviews with key informants in the FSW community; and (iv) in-depth interviews with PRINCESSE follow-up actors. Discussion: The PRINCESSE project is one of the first interventions offering HIV oral PrEP as part of a more global sexual healthcare package targeting both HIV- and HIV+ women. Second, STIs and viral hepatitis B care were offered to all participants, regardless of their willingness to use PrEP. Another innovation is the implementation of mobile clinics for chronic/quarterly care. In terms of research, PRINCESSE is a comprehensive, interdisciplinary project combining clinical, biological, epidemiological, and social specific objectives and outcomes to document the operational challenges of a multidisease program in real-life conditions. %$ 056 ; 052 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Ky-Zerbo, O. %A Desclaux, Alice %A Kouadio, A. B. %A Rouveau, Nicolas %A Vautier, A. %A Sow, S. %A Camara, S. C. %A Boye, Sokhna %A Pourette, Dolores %A Sidibe, Y. %A Maheu-Giroux, M. %A Larmarange, Joseph %A ATLAS Team %T Enthusiasm for introducing and integrating HIV self-testing but doubts about users : a baseline qualitative analysis of key stakeholders' attitudes and perceptions in Cote d'Ivoire, Mali and Senegal %D 2021 %L fdi:010083335 %G ENG %J Frontiers in Public Health %K HIV self-testing ; key population ; perceptions ; stakeholders ; West Africa ; ATLAS %K COTE D'IVOIRE ; MALI ; SENEGAL %M ISI:000715599100001 %P 653481 [14 ] %R 10.3389/fpubh.2021.653481 %U https://www.documentation.ird.fr/hor/fdi:010083335 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2021-12/010083335.pdf %V 9 %W Horizon (IRD) %X Since 2019, the ATLAS project, coordinated by Solthis in collaboration with national AIDS programs, has introduced, promoted and delivered HIV self-testing (HIVST) in Cote d'Ivoire, Mali and Senegal. Several delivery channels have been defined, including key populations: men who have sex with men, female sex workers and people who use injectable drugs. At project initiation, a qualitative study analyzing the perceptions and attitudes of key stakeholders regarding the introduction of HIVST in their countries and its integration with other testing strategies for key populations was conducted. The study was conducted from September to November 2019 within 3 months of the initiation of HIVST distribution. Individual interviews were conducted with 60 key informants involved in the project or in providing support and care to key populations: members of health ministries, national AIDS councils, international organizations, national and international non-governmental organizations, and peer educators. Semi structured interviews were recorded, translated when necessary, and transcribed. Data were coded using Dedoose (c) software for thematic analyses. We found that stakeholders' perceptions and attitudes are favorable to the introduction and integration of HIVST for several reasons. Some of these reasons are held in common, and some are specific to each key population and country. Overall, HIVST is considered able to reduce stigma; preserve anonymity and confidentiality; reach key populations that do not access testing via the usual strategies; remove spatial barriers; save time for users and providers; and empower users with autonomy and responsibility. It is non-invasive and easy to use. However, participants also fear, question and doubt users' autonomy regarding their ability to use HIVST kits correctly; to ensure quality secondary distribution; to accept a reactive test result; and to use confirmation testing and care services. For stakeholders, HIVST is considered an attractive strategy to improve access to HIV testing for key populations. Their doubts about users' capacities could be a matter for reflective communication with stakeholders and local adaptation before the implementation of HIVST in new countries. Those perceptions may reflect the West African HIV situation through the emphasis they place on the roles of HIV stigma and disclosure in HIVST efficiency. %$ 056 ; 052 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Sjoberg, D. D. %A Whiting, K. %A Curry, M. %A Lavery, J. A. %A Larmarange, Joseph %T Reproducible summary tables with the gtsummary package %D 2021 %L fdi:010082695 %G ENG %J R Journal %@ 2073-4859 %M ISI:000684952200035 %N 1 %P 570-594 %U https://www.documentation.ird.fr/hor/fdi:010082695 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2021-09/010082695.pdf %V 13 %W Horizon (IRD) %X The gtsummary package provides an elegant and flexible way to create publication-ready summary tables in R. A critical part of the work of statisticians, data scientists, and analysts is summarizing data sets and regression models in R and publishing or sharing polished summary tables. The gtsummary package was created to streamline these everyday analysis tasks by allowing users to easily create reproducible summaries of data sets, regression models, survey data, and survival data with a simple interface and very little code. The package follows a tidy framework, making it easy to integrate with standard data workflows, and offers many table customization features through function arguments, helper functions, and custom themes. %$ 020 ; 050 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Kra, A. K. %A Colin, G. %A Diop, P. M. %A Fotso, A. S. %A Rouveau, Nicolas %A Herve, K. K. %A Geoffroy, O. %A Diallo, B. %A Kabemba, O. K. %A Dieng, B. %A Diallo, S. %A Vautier, A. %A Larmarange, Joseph %A ATLAS Team %T Introducing and implementing HIV self-testing in Cote d'Ivoire, Mali, and Senegal : what can we learn from ATLAS project activity reports in the context of the COVID-19 crisis ? %D 2021 %L fdi:010082638 %G ENG %J Frontiers in Public Health %K HIV self-testing ; COVID-19 ; West Africa ; Cote d'Ivoire ; Mali ; Senegal ; key populations %K COTE D'IVOIRE ; MALI ; SENEGAL %M ISI:000680320900001 %P 653565 [14 ] %R 10.3389/fpubh.2021.653565 %U https://www.documentation.ird.fr/hor/fdi:010082638 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2021-09/010082638.pdf %V 9 %W Horizon (IRD) %X Background: The ATLAS program promotes and implements HIVST in Cote d'Ivoire, Mali, and Senegal. Priority groups include members of key populations-female sex workers (FSW), men having sex with men (MSM), and people who use drugs (PWUD)-and their partners and relatives. HIVST distribution activities, which began in mid-2019, were impacted in early 2020 by the COVID-19 pandemic. Methods: This article, focusing only on outreach activities among key populations, analyzes quantitative, and qualitative program data collected during implementation to examine temporal trends in HIVST distribution and their evolution in the context of the COVID-19 health crisis. Specifically, we investigated the impact on, the adaptation of and the disruption of field activities. Results: In all three countries, the pre-COVID-19 period was marked by a gradual increase in HIVST distribution. The period corresponding to the initial emergency response (March-May 2020) witnessed an important disruption of activities: a total suspension in Senegal, a significant decline in Cote d'Ivoire, and a less pronounced decrease in Mali. Secondary distribution was also negatively impacted. Peer educators showed resilience and adapted by relocating from public to private areas, reducing group sizes, moving night activities to the daytime, increasing the use of social networks, integrating hygiene measures, and promoting assisted HIVST as an alternative to conventional rapid testing. From June 2020 onward, with the routine management of the COVID-19 pandemic, a catch-up phenomenon was observed with the resumption of activities in Senegal, the opening of new distribution sites, a rebound in the number of distributed HIVST kits, a resurgence in larger group activities, and a rebound in the average number of distributed HIVST kits per primary contact. Conclusions: Although imperfect, the program data provide useful information to describe changes in the implementation of HIVST outreach activities over time. The impact of the COVID-19 pandemic on HIVST distribution among key populations was visible in the monthly activity reports. Focus groups and individual interviews allowed us to document the adaptations made by peer educators, with variations across countries and populations. These adaptations demonstrate the resilience and learning capacities of peer educators and key populations. %$ 050 ; 052 ; 108 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Boye, Sokhna %A Bouare, S. %A Ky-Zerbo, O. %A Rouveau, Nicolas %A Simo Fotso, Arlette %A D'Elbee, M. %A Silhol, R. %A Maheu-Giroux, M. %A Vautier, A. %A Breton, G. %A Keita, A. %A Bekelynck, A. %A Desclaux, Alice %A Larmarange, Joseph %A Pourette, Dolores %A ATLAS Team %T Challenges of HIV self-test distribution for index testing when HIV status disclosure is low : preliminary results of a qualitative study in Bamako (Mali) as part of the ATLAS project %D 2021 %L fdi:010082121 %G ENG %J Frontiers in Public Health %K HIV self-testing ; index testing ; knowledge of HIV status ; HIV status ; disclosure ; Mali ; partners of PLHIV ; people living with HIV ; screening %K MALI %M ISI:000656850000001 %P 653543 [11 ] %R 10.3389/fpubh.2021.653543 %U https://www.documentation.ird.fr/hor/fdi:010082121 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2021-07/010082121.pdf %V 9 %W Horizon (IRD) %X Context: The rate of HIV status disclosure to partners is low in Mali, a West African country with a national HIV prevalence of 1.2%. HIV self-testing (HIVST) could increase testing coverage among partners of people living with HIV (PLHIV). The AutoTest-VIH, Libre d'acceder a la connaissance de son Statut (ATLAS) program was launched in West Africa with the objective of distributing nearly half a million HIV self-tests from 2019 to 2021 in Cote d'Ivoire, Mali, and Senegal. The ATLAS program integrates several research activities. This article presents the preliminary results of the qualitative study of the ATLAS program in Mali. This study aims to improve our understanding of the practices, limitations and issues related to the distribution of HIV self-tests to PLHIV so that they can offer the tests to their sexual partners. Methods: This qualitative study was conducted in 2019 in an HIV care clinic in Bamako. It consisted of (i) individual interviews with eight health professionals involved in the distribution of HIV self-tests; (ii) 591 observations of medical consultations, including social service consultations, with PLHIV; (iii) seven observations of peer educator-led PLHIV group discussions. The interviews with health professionals and the observations notes have been subject to content analysis. Results: HIVST was discussed in only 9% of the observed consultations (51/591). When HIVST was discussed, the discussion was almost always initiated by the health professional rather than PLHIV. HIVST was discussed infrequently because, in most of the consultations, it was not appropriate to propose partner HIVST (e.g., when PLHIV were widowed, did not have partners, or had delegated someone to renew their prescriptions). Some PLHIV had not disclosed their HIV status to their partners. Dispensing HIV self-tests was time-consuming, and medical consultations were very short. Three main barriers to HIVST distribution when HIV status had not been disclosed to partners were identified: (1) almost all health professionals avoided offering HIVST to PLHIV when they thought or knew that the PLHIV had not disclosed their HIV status to partners; (2) PLHIV were reluctant to offer HIVST to their partners if they had not disclosed their HIV-positive status to them; (3) there was limited use of strategies to support the disclosure of HIV status. Conclusion: It is essential to strengthen strategies to support the disclosure of HIV+ status. It is necessary to develop a specific approach for the provision of HIV self-tests for the partners of PLHIV by rethinking the involvement of stakeholders. This approach should provide them with training tailored to the issues related to the (non)disclosure of HIV status and gender inequalities, and improving counseling for PLHIV. %$ 052 ; 056 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A d'Elbee, M. %A Traore, M. M. %A Badiane, K. %A Vautier, A. %A Simo Fotso, Arlette %A Kabemba, O. K. %A Rouveau, Nicolas %A Godfrey-Faussett, P. %A Maheu-Giroux, M. %A Boily, M. C. %A Medley, G. F. %A Larmarange, Joseph %A Terris-Prestholt, F. %A ATLAS Team, %T Costs and scale-up costs of integrating HIV self-testing into civil society organisation-led programmes for key populations in Cote d'Ivoire, Senegal, and Mali %D 2021 %L fdi:010082052 %G ENG %J Frontiers in Public Health %K costs and cost analysis ; scale-up ; HIV self-testing ; key populations ; knowledge of HIV status ; diagnosis ; screening ; West Africa %K COTE D'IVOIRE ; SENEGAL ; MALI %M ISI:000658299800001 %P 653612 [13 ] %R 10.3389/fpubh.2021.653612 %U https://www.documentation.ird.fr/hor/fdi:010082052 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2021-07/010082052.pdf %V 9 %W Horizon (IRD) %X Despite significant progress on the proportion of individuals who know their HIV status in 2020, Cote d'Ivoire (76%), Senegal (78%), and Mali (48%) remain far below, and key populations (KP) including female sex workers (FSW), men who have sex with men (MSM), and people who use drugs (PWUD) are the most vulnerable groups with a HIV prevalence at 5-30%. HIV self-testing (HIVST), a process where a person collects his/her own specimen, performs a test, and interprets the result, was introduced in 2019 as a new testing modality through the ATLAS project coordinated by the international partner organisation Solthis (IPO). We estimate the costs of implementing HIVST through 23 civil society organisations (CSO)-led models for KP in Cote d'Ivoire (N = 7), Senegal (N = 11), and Mali (N = 5). We modelled costs for programme transition (2021) and early scale-up (2022-2023). Between July 2019 and September 2020, a total of 51,028, 14,472, and 34,353 HIVST kits were distributed in Cote d'Ivoire, Senegal, and Mali, respectively. Across countries, 64-80% of HIVST kits were distributed to FSW, 20-31% to MSM, and 5-8% to PWUD. Average costs per HIVST kit distributed were $15 for FSW (Cote d'Ivoire: $13, Senegal: $17, Mali: $16), $23 for MSM (Cote d'Ivoire: $15, Senegal: $27, Mali: $28), and $80 for PWUD (Cote d'Ivoire: $16, Senegal: $144), driven by personnel costs (47-78% of total costs), and HIVST kits costs (2-20%). Average costs at scale-up were $11 for FSW (Cote d'Ivoire: $9, Senegal: $13, Mali: $10), $16 for MSM (Cote d'Ivoire: $9, Senegal: $23, Mali: $17), and $32 for PWUD (Cote d'Ivoire: $14, Senegal: $50). Cost reductions were mainly explained by the spreading of IPO costs over higher HIVST distribution volumes and progressive IPO withdrawal at scale-up. In all countries, CSO-led HIVST kit provision to KP showed relatively high costs during the study period related to the progressive integration of the programme to CSO activities and contextual challenges (COVID-19 pandemic, country safety concerns). In transition to scale-up and integration of the HIVST programme into CSO activities, this model shows large potential for substantial economies of scale. Further research will assess the overall cost-effectiveness of this model. %$ 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 Kone, M. %A Danel, C. %A Desgrées du Loû, Annabel %A Larmarange, Joseph %A Res Team, Anrs Dod-Ci %T Telephone peer recruitment and interviewing during a respondent-driven sampling (RDS) survey : feasibility and field experience from the first phone-based RDS survey among men who have sex with men in Cote d'Ivoire %D 2021 %L fdi:010081048 %G ENG %J BMC Medical Research Methodology %K Phone-based survey ; Respondent-driven sampling ; Men who have sex with men ; Côte d'Ivoire %K COTE D'IVOIRE %M ISI:000617382400001 %N 1 %P 25 [12 ] %R 10.1186/s12874-021-01208-x %U https://www.documentation.ird.fr/hor/fdi:010081048 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers21-03/010081048.pdf %V 21 %W Horizon (IRD) %X Background Many respondent-driven sampling (RDS) methodologies have been employed to investigate hard-to-reach populations; however, these methodologies present some limits. We describe a minimally investigated RDS methodology in which peer recruitment and interviewing are phone-based. The feasibility of the methodology, field experiences, validity of RDS assumptions and characteristics of the sample obtained are discussed. Methods We conducted a phone-based RDS survey among men who have sex with men (MSM) aged 18 or above and living in Cote d'Ivoire. Eight initial MSM across Cote d'Ivoire were selected. Participants were asked to call a hotline to be registered and interviewed by phone. After the participants completed the questionnaire, they were asked to recruit a maximum of 3 MSM from their acquaintances. Results During the 9 months of the survey, 576 individuals called the hotline, and 518 MSM completed the questionnaire. The median delay between the invitation to participate and the completion of the questionnaire by peer-recruited MSM was 4 days [IQR: 1-12]. The recruitment process was not constant, with high variation in the number of people who called the hotline during the survey period. RDS chain convergence to equilibrium was reached within 6 waves for most of the selected variables. For the network size estimation assumption, participants who incorrectly estimated their network size were observed. Regarding the sample obtained, MSM were recruited from all the regions of Cote d'Ivoire with frequent interregional recruitment; 23.5% of MSM were recruited by someone who does not live in the same region. Compared to the MSM who participated in two other surveys in Cote d'Ivoire, the MSM in our sample were less likely to know about an MSM non-governmental organisation. However, MSM aged 30 years old and above and those with a low level of education were underrepresented in our sample. Conclusion We show that phone-based RDS surveys among MSM are feasible in the context of sub-Saharan Africa. Compared to other classical RDS survey methodologies, the phone-based RDS methodology seems to reduce selection bias based on geography and proximity with the MSM community. However, similar to other methodologies, phone-based RDS fails to reach older and less-educated MSM. %$ 056 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Rouveau, Nicolas %A Ky-Zerbo, O. %A Boye, Sokhna %A Fotso, A. S. %A d'Elbee, M. %A Maheu-Giroux, M. %A Silhol, R. %A Kouassi, A. K. %A Vautier, A. %A Doumenc-Aidara, C. %A Breton, G. %A Keita, A. %A Ehui, E. %A Ndour, C. T. %A Boilly, M. C. %A Terris-Prestholt, F. %A Pourette, Dolores %A Desclaux, Alice %A Larmarange, Joseph %A Boily, M. C. %T Describing, analysing and understanding the effects of the introduction of HIV self-testing in West Africa through the ATLAS programme in Cote d'Ivoire, Mali and Senegal %D 2021 %L fdi:010080991 %G ENG %J BMC Public Health %K HIV ; AIDS ; HIV self-testing ; West Africa ; Senegal ; Cote d'Ivoire ; Mali %K SENEGAL ; COTE D'IVOIRE ; MALI %M ISI:000613023200009 %N 1 %P 181 [14 ] %R 10.1186/s12889-021-10212-1 %U https://www.documentation.ird.fr/hor/fdi:010080991 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers21-03/010080991.pdf %V 21 %W Horizon (IRD) %X BackgroundThe ATLAS programme aims to promote and implement HIV self-testing (HIVST) in three West African countries: Cote d'Ivoire, Mali, and Senegal. During 2019-2021, in close collaboration with the national AIDS implementing partners and communities, ATLAS plans to distribute 500,000 HIVST kits through eight delivery channels, combining facility-based, community-based strategies, primary and secondary distribution of HIVST.Considering the characteristics of West African HIV epidemics, the targets of the ATLAS programme are hard-to-reach populations: key populations (female sex workers, men who have sex with men, and drug users), their clients or sexual partners, partners of people living with HIV and patients diagnosed with sexually transmitted infections and their partners.The ATLAS programme includes research support implementation to generate evidence for HIVST scale-up in West Africa.The main objective is to describe, analyse and understand the social, health, epidemiological effects and cost-effectiveness of HIVST introduction in Cote d'Ivoire, Mali and Senegal to improve the overall HIV testing strategy (accessibility, efficacy, ethics).MethodsATLAS research is organised into five multidisciplinary workpackages (WPs): qualitative surveys (individual in-depth interviews, focus group discussions) conducted with key actors, key populations, and HIVST users.Key Populations WP: ethnographic observation of three HIV care services introducing HIVST for partner testing.Index testing WP: an anonymous telephone survey of HIVST users.Coupons survey WP: incremental economic cost analysis of each delivery model using a top-down costing with programmatic data, complemented by a bottom-up costing of a representative sample of HIVST distribution sites, and a time-motion study for health professionals providing HIVST.Cost study WP: Adaptation, parameterisation and calibration of a dynamic compartmental model that considers the varied populations targeted by the ATLAS programme and the different testing modalities and strategies.DiscussionATLAS is the first comprehensive study on HIV self-testing in West Africa. The ATLAS programme focuses particularly on the secondary distribution of HIVST. This protocol was approved by three national ethic committees and the WHO's Ethical Research Committee. %$ 056 ; 052 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Fiorentino, M. %A Nishimwe, M. %A Protopopescu, C. %A Iwuji, C. %A Okesola, N. %A Spire, B. %A Orne-Gliemann, J. %A McGrath, N. %A Pillay, D. %A Dabis, F. %A Larmarange, Joseph %A Boyer, S. %A ANRS 12249 TaSP Study Group %T Early ART initiation improves HIV status disclosure and social support in people living with HIV, linked to care within a universal test and treat program in rural South Africa (ANRS 12249 TasP Trial) %D 2021 %L fdi:010080000 %G ENG %J AIDS and Behavior %@ 1090-7165 %K HIV ; Early antiretroviral treatment ; Test and treat ; HIV status disclosure ; Social support ; South africa %K AFRIQUE DU SUD %M ISI:000590510200001 %N 4 %P 1306-1322 %R 10.1007/s10461-020-03101-y %U https://www.documentation.ird.fr/hor/fdi:010080000 %> https://www.documentation.ird.fr/intranet/publi/2020/12/010080000.pdf %V 25 %W Horizon (IRD) %X We investigated the effect of early antiretroviral treatment (ART) initiation on HIV status disclosure and social support in a cluster-randomized, treatment-as-prevention (TasP) trial in rural South Africa. Individuals identified HIV-positive after home-based testing were referred to trial clinics where they were invited to initiate ART immediately irrespective of CD4 count (intervention arm) or following national guidelines (control arm). We used Poisson mixed effects models to assess the independent effects of (a) time since baseline clinical visit, (b) trial arm, and (c) ART initiation on HIV disclosure (n = 182) and social support (n = 152) among participants with a CD4 count > 500 cells/mm(3) at baseline. Disclosure and social support significantly improved over follow-up in both arms. Disclosure was higher (incidence rate ratio [95% confidence interval]: 1.24 [1.04; 1.48]), and social support increased faster (1.22 [1.02; 1.46]) in the intervention arm than in the control arm. ART initiation improved both disclosure and social support (1.50 [1.28; 1.75] and 1.34 [1.12; 1.61], respectively), a stronger effect being seen in the intervention arm for social support (1.50 [1.12; 2.01]). Besides clinical benefits, early ART initiation may also improve psychosocial outcomes. This should further encourage countries to implement universal test-and-treat strategies. %$ 056 ; 052 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture non répertoriées par l'AERES %A Inghels, M. %A Kouassi, Arsène Kra %A Niangoran, S. %A Bekelynck, A. %A Carillon, S. %A Sika, L. %A Danel, C. %A Koné, M. %A Desgrées du Loû, Annabel %A Larmarange, Joseph %T Pratiques et facteurs associés au dépistage récent du VIH en population générale, Côte d'Ivoire : résultats de l'étude ANRS 12323 DOD-CI %D 2020 %L fdi:010087001 %G FRE %J Bulletin de la Société de Pathologie Exotique %@ 0037-9085 %K COTE D'IVOIRE %N 5 %P 268-277 %R 10.3166/bspe-2021-0154 %U https://www.documentation.ird.fr/hor/fdi:010087001 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2022-12/010087001.pdf %V 113 %W Horizon (IRD) %X Avec 2,9 % de sa population infectée par le VIH, la Côte d'Ivoire fait partie des pays d'Afrique de l'Ouest les plus touchés par l'épidémie à VIH. On estime que seules 63 % des personnes infectées par le VIH connaissent leur statut. Une enquête transversale, par téléphone, a été réalisée auprès d'un échantillon représentatif de 3 867 personnes afin de décrire les pratiques et les facteurs associés à la réalisation récente (inf. ou eg. 1 an) d'un dépistage du VIH en Côte d'Ivoire. Les données collectées concernaient le dernier test réalisé ainsi que les caractéristiques sociodémographiques, comportements sexuels, accès à l'information, perceptions, capacités, autonomies ainsi que l'environnement social et géographique des participants. Des modèles de régression logistique ont été réalisés afin d'identifier les facteurs associés à la réalisation récente d'un test du VIH (inf. ou eg. 1 an). Le manque d'information est l'un des principaux freins au dépistage (seuls 60 % des individus connaissent un lieu où réaliser un test). Chez les hommes, malgré la gratuité du dépistage, une faible condition économique semble être un frein à la réalisation d'un test. L'environnement social, notamment l'influence des pairs, semble aussi avoir un effet sur le recours au dépistage chez les hommes. Chez les femmes, le dépistage est associé à leurs perceptions d'exposition au VIH. L'offre de dépistage actuelle en Côte d'Ivoire nécessite de repenser la communication autour du test ainsi que d'identifier des incitatifs économiques ou sociaux permettant de lever les freins au dépistage. %$ 052MALTRA03 ; 108DEMOG1 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES %A Iwuji, C. %A Chimukuche, R. S. %A Zuma, T. %A Plazy, M. %A Larmarange, Joseph %A Orne-Gliemann, J. %A Siedner, M. %A Shahmanesh, M. %A Seeley, J. %T Test but not treat : community members' experiences with barriers and facilitators to universal antiretroviral therapy uptake in rural KwaZulu-Natal, South Africa %D 2020 %L fdi:010080450 %G ENG %J PLoS One %@ 1932-6203 %K AFRIQUE DU SUD %K KWAZULU NATAL %M ISI:000576265600094 %N 9 %P e0239513 [14 ] %R 10.1371/journal.pone.0239513 %U https://www.documentation.ird.fr/hor/fdi:010080450 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers20-12/010080450.pdf %V 15 %W Horizon (IRD) %X Introduction Antiretroviral therapy (ART) has revolutionised the care of HIV-positive individuals resulting in marked decreases in morbidity and mortality, and markedly reduced transmission to sexual partners. However, these benefits can only be realised if individuals are aware of their HIV-positive status, initiated and retained on suppressive lifelong ART. Framed using the socio-ecological model, the present study explores factors contributing to poor ART uptake among community members despite high acceptance of HIV-testing within a Treatment as Prevention (TasP) trial. In this paper we identify barriers and facilitators to treatment across different levels of the socio-ecological framework covering individual, community and health system components. Methods This research was embedded within a cluster-randomised trial (ClinicalTrials.gov, number NCT01509508) of HIV treatment as Prevention in rural KwaZulu-Natal, South Africa. Data were collected between January 2013 and July 2014 from resident community members. Ten participants contributed to repeat in-depth interviews whilst 42 participants took part in repeat focus group discussions. Data from individual interviews and focus group discussions were triangulated using community walks to give insights into community members' perception of the barriers and facilitators of ART uptake. We used thematic analysis guided by a socio-ecological framework to analyse participants' narratives from both individual interviews and focus group discussions. Results Barriers and facilitators operating at the individual, community and health system levels influence ART uptake. Stigma was an over-arching barrier, across all three levels and expressed variably as fear of HIV disclosure, concerns about segregated HIV clinical services and negative community religious perceptions. Other barriers were individual (substance misuse, fear of ART side effects), community (alternative health beliefs). Facilitators cited by participants included individual (expectations of improved health and longer life expectancy following ART, single tablet regimens), community (availability of ART in the community through mobile trial facilities) and health system factors (fast and efficient service provided by friendly staff). Discussion We identified multiple barriers to achieving universal ART uptake. To enhance uptake in HIV care services, and achieve the full benefits of ART requires interventions that tackle persistent HIV stigma, and offer people with HIV respectful, convenient and efficient services. These interventions require evaluation in appropriately designed studies. %$ 052 ; 050 ; 056 %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 https://www.documentation.ird.fr/hor/fdi:010078851 %> https://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 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 %N 12 %P 3491-3500 %R 10.1007/s10461-020-02923-0 %U https://www.documentation.ird.fr/hor/fdi:010078075 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2022-05/010078075.pdf %V 24 %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 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 ] %R 10.1136/bmjopen-2018-028508 %U https://www.documentation.ird.fr/hor/fdi:010078925 %> https://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 ] %R 10.1002/jia2.25455 %U https://www.documentation.ird.fr/hor/fdi:010078031 %> https://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 https://www.documentation.ird.fr/hor/fdi:010077495 %> https://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 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 2020 %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 2 %P 163-169 %R 10.1080/09540121.2019.1626339 %U https://www.documentation.ird.fr/hor/fdi:010076093 %> https://www.documentation.ird.fr/intranet/publi/2019/07/010076093.pdf %V 32 %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 Book Section %9 OS CH : Chapitres d'ouvrages scientifiques %A Larmarange, Joseph %T Prévention du VIH : introduction %B VIH, hépatites virales, santé sexuelle %C Les Ulis %D 2020 %E Katlama, C. %E Ghosn, J. %E Wandeler, G. %L fdi:010082469 %G FRE %I EDP Sciences %@ 978-2-7598-2403-8 %K MONDE %P 683-686 %U https://www.documentation.ird.fr/hor/fdi:010082469 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2021-10/010082469.pdf %W Horizon (IRD) %$ 052MALTRA03 ; 056POLSAN %0 Book Section %9 OS CH : Chapitres d'ouvrages scientifiques %A Larmarange, Joseph %T Le traitement antirétroviral comme moyen de prévention (TasP) %B VIH, hépatites virales, santé sexuelle %C Les Ulis %D 2020 %E Katlama, C. %E Ghosn, J. %E Wandeler, G. %L fdi:010082470 %G FRE %I EDP Sciences %@ 978-2-7598-2403-8 %K EUROPE ; AMERIQUE DU NORD ; AFRIQUE SUBSAHARIENNE ; BOTSWANA ; KENYA ; OUGANDA ; ZAMBIE ; MALAWI ; AFRIQUE DU SUD %P 702-711 %U https://www.documentation.ird.fr/hor/fdi:010082470 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2021-10/010082470.pdf %W Horizon (IRD) %$ 052MALTRA03 ; 056POLSAN %0 Book Section %9 OS CH : Chapitres d'ouvrages scientifiques %A Gantner, P. %A Laurent, Christian %A Larmarange, Joseph %A Ghosn, J. %T Prophylaxie préexposition (PrEP) %B VIH, hépatites virales, santé sexuelle %C Les Ulis %D 2020 %E Katlama, C. %E Ghosn, J. %E Wandeler, G. %L fdi:010082471 %G FRE %I EDP Sciences %@ 978-2-7598-2403-8 %K ETATS UNIS ; AFRIQUE DE L'EST ; AFRIQUE AUSTRALE ; KENYA ; AFRIQUE DU SUD ; OUGANDA ; ZIMBABWE ; LESOTHO ; AUSTRALIE ; ROYAUME UNI ; BELGIQUE ; CANADA ; BRESIL %P 715-726 %U https://www.documentation.ird.fr/hor/fdi:010082471 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2021-10/010082471.pdf %W Horizon (IRD) %$ 052MALTRA03 ; 050EPID ; 056POLSAN %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 ] %R 10.1002/jia2.25424 %U https://www.documentation.ird.fr/hor/fdi:010077777 %> https://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 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 %@ 1758-2652 %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 ] %R 10.1002/jia2.25402 %U https://www.documentation.ird.fr/hor/fdi:010077311 %> https://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 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] %R 10.1684/mst.2019.0926 %U https://www.documentation.ird.fr/hor/fdi:010076848 %> https://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 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 fdi:010087821 %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 https://www.documentation.ird.fr/hor/fdi:010087821 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-08/010087821.pdf %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 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 https://www.documentation.ird.fr/hor/fdi:010076589 %> https://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 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 ] %R 10.1002/jia2.25128 %U https://www.documentation.ird.fr/hor/fdi:010073698 %> https://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 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 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 %U https://www.documentation.ird.fr/hor/fdi:010073712 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010072498 %> https://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 https://www.documentation.ird.fr/hor/fdi:010072500 %> https://www.documentation.ird.fr/intranet/publi/2018/04/010072500.pdf %V 32 %W Horizon (IRD) %$ 052 ; 050 %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 https://www.documentation.ird.fr/hor/fdi:010076319 %> https://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 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 en ligne] %U https://www.documentation.ird.fr/hor/fdi:010070396 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010076320 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010072385 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010070598 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010070398 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010076321 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010069478 %> https://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 ] %R 10.1371/journal.pmed.1002107 %U https://www.documentation.ird.fr/hor/fdi:010068181 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010067746 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010067745 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010067744 %> https://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 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 ] %R 10.1016/j.respe.2016.02.008 %U https://www.documentation.ird.fr/hor/fdi:010067346 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010067564 %> https://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 %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 https://www.documentation.ird.fr/hor/fdi:010067565 %> https://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 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 + annexes, 9 ] %R 10.7448/IAS.19.1.20913 %U https://www.documentation.ird.fr/hor/fdi:010067455 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-06/010067455.pdf %V 19 %W Horizon (IRD) %X Introduction : We aimed to quantify and identify associated factors of linkage to HIV care following home-based HIV counselling and testing (HBHCT) in the ongoing ANRS 12249 treatment-as-prevention (TasP) cluster-randomized trial in rural KwaZulu-Natal, South Africa. Methods : Individuals ?16 years were offered HBHCT; those who were identified HIV positive were referred to cluster-based TasP clinics and offered antiretroviral treatment (ART) immediately (five clusters) or according to national guidelines (five clusters). HIV care was also available in the local Department of Health (DoH) clinics. Linkage to HIV care was defined as TasP or DoH clinic attendance within three months of referral among adults not in HIV care at referral. Associated factors were identified using multivariable logistic regression adjusted for trial arm. Results : Overall, 1323 HIV-positive adults (72.9% women) not in HIV care at referral were included, of whom 36.9% (n=488) linked to care <3 months of referral (similar by sex). In adjusted analyses (n=1222), individuals who had never been in HIV care before referral were significantly less likely to link to care than those who had previously been in care (<33% vs. >42%, p<0.001). Linkage to care was lower in students (adjusted odds-ratio [aOR]=0.47; 95% confidence interval [CI] 0.24-0.92) than in employed adults, in adults who completed secondary school (aOR=0.68; CI 0.49-0.96) or at least some secondary school (aOR=0.59; CI 0.41-0.84) versus ? primary school, in those who lived at 1 to 2 km (aOR=0.58; CI 0.44-0.78) or 2-5 km from the nearest TasP clinic (aOR=0.57; CI 0.41-0.77) versus <1 km, and in those who were referred to clinic after ?2 contacts (aOR=0.75; CI 0.58-0.97) versus those referred at the first contact. Linkage to care was higher in adults who reported knowing an HIV-positive family member (aOR=1.45; CI 1.12-1.86) versus not, and in those who said that they would take ART as soon as possible if they were diagnosed HIV positive (aOR=2.16; CI 1.13-4.10) versus not. Conclusions : Fewer than 40% of HIV-positive adults not in care at referral were linked to HIV care within three months of HBHCT in the TasP trial. Achieving universal test and treat coverage will require innovative interventions to support linkage to HIV care. %$ 056 ; 052 %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 https://www.documentation.ird.fr/hor/fdi:010067180 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010066573 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-03/010066573.pdf %V 30 %W Horizon (IRD) %X Strengthening universal HIV 'test-and-treat' approaches with social science research The recent publication of new WHO guidelines, including a call for antiretroviral therapy for everyone diagnosed with HIV regardless of CD4 þ cell count and preexposure prophylaxis for people at substantial risk of HIV infection [1], marks an important moment for taking stock of what will be needed to take biomedical HIV prevention approaches to scale, and sustain them. As the author of a recent editorial in The Lancet [2] observes, these guidelines are 'welcome but ambitious. [.. .] No studies exist that address how such a strategy can be executed on a global scale' (p. 1420). We, a multidisciplinary group of social scientists working as part of five large-scale 'universal test-and-treat' (UTT) trials being implemented across six African countries, would argue that successful large-scale expansion of treatment and preexposure prophylaxis will require an indepth understanding of the heterogeneous community and health systems' contexts of the rollout. %$ 056 %0 Journal Article %9 ACL : 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 https://www.documentation.ird.fr/hor/fdi:010070399 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers17-08/010070399.pdf %V 24 sept. %W Horizon (IRD) %$ 095DEVEL ; 056POLSAN %0 Journal Article %9 ACL : 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 https://www.documentation.ird.fr/hor/fdi:010066646 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010064887 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010064888 %> https://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 ] %R 10.1371/journal.pone.0123345 %U https://www.documentation.ird.fr/hor/fdi:010064170 %> https://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 ] %R 10.1186/s12889-015-1344-y %U https://www.documentation.ird.fr/hor/fdi:010063987 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010070397 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010063533 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010063442 %> https://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 https://www.documentation.ird.fr/hor/fdi:010063252 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010063819 %> https://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 https://www.documentation.ird.fr/hor/fdi:010063820 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010063490 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010063381 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010063383 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010063384 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010063385 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010063393 %> https://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 https://www.documentation.ird.fr/hor/fdi:010063395 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010063745 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010063765 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers15-04/010063765.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 https://www.documentation.ird.fr/hor/fdi:010063766 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers15-04/010063766.pdf %W Horizon (IRD) %$ 108 ; 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 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 https://www.documentation.ird.fr/hor/fdi:010059973 %> https://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 %K AFRIQUE SUBSAHARIENNE %P 29 %U https://www.documentation.ird.fr/hor/fdi:010057891 %> https://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 %$ 050EPID ; 052MALTRA03 %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 https://www.documentation.ird.fr/hor/fdi:010057892 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-03/010057892.pdf %V 149 %W Horizon (IRD) %X Après le 'scoop' des résultats de l'essai HPTN 052 à la conférence de l'IAS de Rome en juillet 2011, la question de l'utilisation du TasP (treatment as prevention) reste très présente. L'occasion derevenir sur les questions posées sur son indiscutable efficacité, au moins sur les couples sérodiscordants en Afrique. %B Conférence Internationale sur le Sida : Inverser le Cours de l'Epidémie Tous Ensemble %8 2012/07/22-27 %$ 052MALTRA03 ; 056POLSAN %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 https://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 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 https://www.documentation.ird.fr/hor/fdi:010059399 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers19-12/010059399.pdf %W Horizon (IRD) %$ 108DEMOG1 %0 Journal Article %9 ACL : Articles dans des revues avec comité de lecture non 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 : Revue Européenne de Géographie %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 https://www.documentation.ird.fr/hor/fdi:010053205 %> https://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 non 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 : Revue Européenne de Géographie %@ 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 https://www.documentation.ird.fr/hor/fdi:010052060 %> https://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 non répertoriées par l'AERES %A Larmarange, Joseph %T Homo-bisexuels masculins au Sud : il est temps d'agir ! %B Compte rendu de la 18ème conférence internationale sur le sida %D 2010 %L fdi:010087038 %G FRE %J Transcriptases %@ 1965-2607 %K PAYS DU SUD %P 68-70 %U https://www.documentation.ird.fr/hor/fdi:010087038 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-07/010087038.pdf %V 144 %W Horizon (IRD) %B Conférence Internationale sur le Sida : Vienne Rights Here Right Now ! %8 2010/07/18-23 %$ 050EPID ; 052MALTRA03 %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 https://www.documentation.ird.fr/hor/fdi:010050914 %> https://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 https://www.documentation.ird.fr/hor/fdi:010048898 %> https://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 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 https://www.documentation.ird.fr/hor/fdi:010049404 %> https://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 Unpublished Work %9 AP : Autres productions %A Larmarange, Joseph %A Diop, A. %A Diop, O. %A Gueye, K. %A Enel, C. %A Mboup, S. %A Diallo, P. N. %A Kane, N. C. T. %A Ba, S. %A Sene, A. %A Marra, A. %A Wade, A. S. %A Desgrées du Loû, Annabel %T Évaluer les interventions de prévention des IST et du VIH auprès des homosexuels masculins au Sénégal (projet ANRS 12139) : rapport scientifique %C Paris %D 2010 %L fdi:010087300 %G FRE %I CEPED %K SENEGAL %N 6 %P 110 multigr. %U https://www.documentation.ird.fr/hor/fdi:010087300 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-08/010087300.pdf %W Horizon (IRD) %X L'enquête ELIHoS réalisée en 2007 au Sénégal avait pour objectifs principaux de mesurer les prévalences du VIH et des IST (infections sexuellement transmissibles) et les comportements sexuels parmi les hommes ayant des rapports sexuels avec d'autres hommes (HSH), afin d'observer les évolutions depuis 2004 (enquête précédente) pour évaluer les effets des programmes d'intervention en cours auprès de cette population. Cette enquête a été réalisée sur l'initiative de la division Sida/IST de l'Institut d'Hygiène Sociale à Dakar , avec le plein accord du Ministère de la Santé du Sénégal. Elle a fait l'objet d'un partenariat entre deux équipes sénégalaises (la division Sida/IST de l'Institut d'Hygiène Sociale à Dakar dirigée par le Dr A. S. Wade et le laboratoire de virologie de l'Hôpital Le Dantec à Dakar dirigé par le Pr. S. Mboup) et une équipe française de chercheurs en sciences sociales conduite par A. Desgrées du Loû (CEPED). Comme pour la première enquête menée en 2004, le mode de recrutement adopté pour 2007 a été la méthode dite « boule de neige ». Le recrutement était effectué par des leaders du milieu HSH, sur trois sites (Dakar, la capitale, Mbour / Thiès, deux villes proches de la côte touristique, et Saint-Louis, ville moyenne au nord du Sénégal). Ce recrutement a été effectué dans différents types de lieux (bars de rencontre HSH, associations HSH) et par bouche à oreille dans divers réseaux de socialisation. Le questionnaire socio-comportemental a été administré à 501 hommes (306 hommes à Dakar, 100 à Mbour/Thiès et 95 à Saint-Louis). Il s'agit d'un échantillon jeune (80 % ont moins de trente ans, âge moyen : 24,7 ans) et plutôt instruit (47 % ont atteint le niveau secondaire ou supérieur). 90 % habitent avec leur famille et 41 % se déclarent membre d'une association d'HSH. Cette enquête quantitative a été complétée par un volet qualitatif consacré aux comportements bisexuels. Douze entretiens ont été menés auprès d'hommes déclarant une ou plusieurs partenaires féminines et douze autres auprès de femmes déclarées partenaires féminines par des HSH. %$ 056 ; 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 https://www.documentation.ird.fr/hor/fdi:010048894 %> https://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 non répertoriées par l'AERES %A Larmarange, Joseph %T Comment les prévalences du VIH sont-elles estimées en Afrique subsaharienne ? %D 2009 %L fdi:010087042 %G FRE %J Chronique du CEPED %@ 1157-4186 %K BURKINA FASO ; CAMEROUN ; COTE D'IVOIRE ; ETHIOPIE ; GHANA ; GUINEE ; KENYA ; LESOTHO ; MALAWI ; MALI ; OUGANDA ; RWANDA ; SENEGAL ; TANZANIE ; ZAMBIE %P 4 %U https://www.documentation.ird.fr/hor/fdi:010087042 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-07/010087042.pdf %V 58 %W Horizon (IRD) %X Tous les deux ans, le programme commun des Nations unies sur le VIH/Sida (ONUSIDA) publie des estimations détaillées du nombre de personnes infectées par le VIH. Dans la dernière édition du rapport, le nombre de personnes (adultes et enfants) infectées par le VIH dans le monde est estimé à 33 millions en 2007, dont 22 millions en Afrique subsaharienne. Cette estimation, largement reprise par les médias et les acteurs de la lutte contre le Sida, a été révisée à maintes reprises ces dernières années, donnant l'impression que le nombre de personnes infectées a diminué alors qu'en réalité il a augmenté. Ces révisions successives ont semé le doute sur la qualité des estimations produites. Petit retour sur l'évolution des sources et des techniques. %$ 052MALTRA03 ; 108DEMOG1 ; 050EPID %0 Journal Article %9 ACL : 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 https://www.documentation.ird.fr/hor/fdi:010047224 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers19-11/010047224.pdf %W Horizon (IRD) %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 https://www.documentation.ird.fr/hor/fdi:010049807 %> https://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 sub-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 https://www.documentation.ird.fr/hor/fdi:010045404 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-03/010045404.pdf %V 25 %W Horizon (IRD) %$ 056POLSAN ; 052MALTRA03 %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 multigr. %U https://www.documentation.ird.fr/hor/fdi:010047153 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers12-11/010047153.pdf %W Horizon (IRD) %$ 052MALTRA03 %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 https://www.documentation.ird.fr/hor/PAR00007143 %W Horizon (IRD) %$ 108 ; 052 %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 https://www.documentation.ird.fr/hor/fdi:010045402 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-03/010045402.pdf %W Horizon (IRD) %$ 056SOCSAN ; 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 https://www.documentation.ird.fr/hor/fdi:010045403 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers16-03/010045403.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 %K PROSPECTIVE %K AFRIQUE SUBSAHARIENNE %P 169-189 %U https://www.documentation.ird.fr/hor/fdi:010045400 %> https://www.documentation.ird.fr/intranet/publi/depot/2009-07-16/010045400.pdf %W Horizon (IRD) %$ 052MALTRA03 ; 056POLSAN %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 https://www.documentation.ird.fr/hor/fdi:010056256 %> https://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 fdi:010085591 %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 %P 582 multigr. %U https://www.documentation.ird.fr/hor/fdi:010085591 %> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2023-02/010085591.pdf %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