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1. Factors associated with ART interruption during the COVID-19 crisis in Burundi (the EPIC community-based research program)

Author

Annabelle Niyongabo, Virginie Villes, Rokhaya Diagne, Juliana Castro Avila, Jean-Michel Mutima, Dévote Gakima, Pélagie Nimbona, Evangéline Niyoncuti, Elvis Rwamuco, Martin Manirakiza, Lucas Riegel, Nicolas Lorente, Rosemary M. Delabre, and Daniela Rojas Castro

Subjects
Medicine, Science
Abstract

Abstract With a national prevalence of 0.9%, Burundi is close to achieving UNAIDS’ 2025 targets. Despite this, different types of crises periodically disrupt its HIV health services. The community-based program EPIC measured the impact of the COVID-19 health crisis on people living with HIV (PLHIV) in Burundi in 2021. Specifically, it assessed ART interruption and associated factors since the beginning of the pandemic. The study questionnaire was administered to PLHIV in three cities between October and November 2021. Participants were recruited using convenience sampling. Logistic regression models helped identify factors associated with ART interruption. Of the 317 respondents, 37 (11.7%) reported interruption. The majority (79.2%) self-identified as belonging to key populations. Interruption was significantly associated with: fewer HIV medical follow-up visits (adjusted Odds Ratio, aOR = 7.80, p = 0.001) and forced HIV status disclosure (aOR = 4.10, p = 0.004). It was inversely associated with multi-month ART dispensing (aOR = 0.36, p = 0.017) since the beginning of the pandemic and the perception of not having been sufficiently informed by the HIV medical team about the risk of COVID-19 infection (aOR = 0.11, p

Published
2024
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2. How Community-Based Organizations Responded to the Covid-19 Crisis to Maintain HIV Services Among Vulnerable Populations in Burundi, Mauritania, and Lebanon: Qualitative Results From the Multicountry EPIC Program

Author

Marion Di Ciaccio PhD, Othmane Bourhaba PhD, Cécile Khoury MS, Ayman Assi MD, Sara Abu Zaki MS, Nicolas Lorente PhD, Juliana Castro Avila MS, Annabelle Niyongabo MD, Dévote Gakima MD, Aminata Diouh MS, Lucas Riegel MS, Amal Ben Moussa PhD, Gabriel Girard PhD, Mehdi Karkouri MD, Rosemary M. Delabre PhD, and Daniela Rojas Castro PhD

Subjects
Diseases of the genitourinary system. Urology, RC870-923
Abstract

Little is known about the adaption of community-based organizations (CBOs) during the COVID-19 crisis. This study aimed to study how HIV CBOs and their community health workers (CHWs) faced the COVID-19 outbreak. Semi-structured interviews (n = 53) were conducted among CHWs in Burundi, Mauritania, and Lebanon in 2021. A thematic content analysis was performed. Results showed that CBOs had succeeded in maintaining HIV services and integrated COVID-19 prevention and awareness in their activities. COVID-19 led to innovation in terms of HIV services (eg, telemedicine and online psychosocial support) and to opportunities to try new modalities of antiretroviral therapy dispensation. Field workers (a specific group among CHWs) were negatively impacted by the COVID-19 crisis and showed resilience in their adaptation to ensure the continuity of their activities. Considering the essential role of field workers during the crisis, their status and the sustainability of their activities should be clearly supported by health policies and programs.

Published
2024
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3. Resilience outcomes and associated factors among workers in community-based HIV care centres during the Covid-19 pandemic: A multi-country analysis from the EPIC program

Author

Marion Di Ciaccio, Nicolas Lorente, Virginie Villes, Axel Akpaka Maxence, Claudia Marcela Vargas Pelaez, José Rafael Guillen, Ingrid Castillo, Cinta Folch, Rokhaya Diagne, Lucas Riegel, Rosemary M. Delabre, and Daniela Rojas Castro

Subjects
CHW, COVID-19 crisis, Mental health, Resilience, HIV, Public aspects of medicine, RA1-1270
Abstract

Introduction: Community health workers (CHW) were integral in the COVID-19 response, particularly concerning services for populations vulnerable to HIV. Little is known regarding the mental health of CHW during the COVID-19 crisis. The objective of this study was to study resilience of CHW working in HIV non-governmental organizations. Methods: An anonymous online, cross-sectional questionnaire was implemented during 2021 among CHW in Benin, Colombia, Guatemala, and Spain. Three scales were used to assess mental health: the 6-item Brief-Resilience Scale, the 9-item Patient Scale Questionnaire and the 7‐item Generalized-Anxiety-Disorder scale. Logistic regression models were used to identify factors associated with “low” resilience vs “normal” or “high” resilience. Results: Among 295 respondents, the median standardized resilience score was 58.33 (IQR = [50.0–75.0], n = 267), 18.52 (IQR = [7.4–33.3], n = 282) for standardized depression score and 19.05 (IQR = [4.8–33.3], n = 274) for standardized anxiety score. Standardized resilience score was negatively correlated with standardized anxiety score (rho = -0.49, p

Published
2023
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4. Fear of stigma from health professionals and family/neighbours and healthcare avoidance among PLHIV in Morocco: results from the Stigma Index survey Morocco

Author

Rosemary M. Delabre, Amal Ben Moussa, Virginie Villes, Mohammed Elkhammas, Lahoucine Ouarsas, Daniela Castro Rojas Castro, and Mehdi Karkouri

Subjects
HIV, Stigma, Key Populations, Healthcare access, Morocco, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Enacted or anticipated stigma among people living with HIV (PLHIV) can negatively impact healthcare engagement. We identified factors associated with having avoided HIV health services for fear of stigma among PLHIV in Morocco. Methods The Stigma Index survey was conducted in Morocco in March-June 2016. Factors associated with avoiding HIV testing and treatment services for fear of stigma by (A) health personnel or family/neighbours and (B) health personnel and family/neighbours compared to people who did not avoid health services for fear of stigma from either of the two sources were assessed using multinomial logistic regression models. Results Among 583 respondents, 280 (48.0%) were women and median number of years living with HIV was 5[IQR:2–7]. Half of the respondents reported avoiding health services for fear of stigma by health personnel and/or family/neighbours: (A) n = 228, 39.1% and (B) n = 68, 11.7%. After adjustment on perceived health status, not having had easy access to antiretroviral treatment ((A) aRR [95% CI] = 1.76[1.16; 2.68]; (B) 2.18[1.11; 4.27]), discrimination by PLHIV ((A) 1.87[1.12; 3.13]; (B) 3.35[1.63; 6.88]) and exclusion from social activities ((A) 1.70[1.10; 2.61]; (B) 2.63[1.39; 5.00]) were associated with having avoided health services for fear of stigma by health personnel or/and family/neighbours. Being female (2.85[1.48; 5.47]), not having been referred for an HIV test for suspected symptoms 3.47[1.67; 7.22], having discussed sexual/reproductive health with a health professional (4.56[2.38; 8.71]), and not having the feeling to influence decisions on local projects for PLHIV (3.47[1.37; 7.83], were associated with having avoided health services for fear of stigma by both sources. Conclusion Results suggest a cumulative effect of fear of stigma and discrimination among PLHIV in Morocco. PLHIV who have experienced discrimination may seek to avoid similar situations at the expense of their health. These results should inform multi-level interventions and broader advocacy efforts to reduce stigma and discrimination.

Published
2022
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5. Determinants and effects or consequences of internal HIV-related stigma among people living with HIV in Morocco

Author

Amal Ben Moussa, Rosemary M. Delabre, Virginie Villes, Mohammed Elkhammas, Aziza Bennani, Lahoucine Ouarsas, Hind Filali, Kamal Alami, Mehdi Karkouri, and Daniela Rojas Castro

Subjects
HIV, Stigma, Vulnerable populations, Healthcare disparities, Morocco, Public aspects of medicine, RA1-1270
Abstract

Abstract Background HIV-related stigma and discrimination constitute a barrier to different intervention programs. Unlike external stigma, internal stigma is not well explored in in the Middle East and North African countries, while grasping this particular form of stigma is essential to limit its effects. The present study aims to measure internal stigma effects and to identify factors associated with this kind of stigma not yet documented among people living with HIV (PLHIV) in Morocco. Methods The PLHIV Stigma Index questionnaire (adapted and translated into French and Moroccan Arabic dialect “darija”) was used to collect information regarding the stigma and discrimination experienced by PLHIV across 8 cities in Morocco (September–October 2016). A randomly drawn cluster of 10 PLHIV, consisting of 5 men and 5 women, was drawn at each participating medical care center to achieve a nationally representative sample of PLHIV. Fifteen interviewers living with HIV and five supervisors were selected and trained to administer the questionnaire. An internal stigma score (range: 0–7), was calculated based on seven negative feelings/ beliefs. Negative binomial regression was used to identify characteristics associated with the internal stigma score. Results Among 626 PLHIV, internal stigma was reported by 88.2%. The median [IQR] internal stigma score was 4 [2–5]. Regarding internal stigma, 51% avoided going to the local clinic when needed and 44% chose not to attend social gatherings. Belonging to at least one key population (aIRR [95%CI] = 1.15 [1.03; 1.28]), experiencing discriminatory reactions from family following HIV status disclosure (1.28 [1.11; 1.49]), avoiding HIV services for fear of stigmatization by staff (1.16 [1.05; 1.28]) and being denied health services because of HIV status (1.16 [1.03;1.32]), are among the factors significantly associated with an increase of the internal stigma score. Conclusions Internal stigma is high among Moroccan PLHIV and significantly impacting their life decisions and their healthcare access. Multi-level interventions are needed to address internal stigma experienced by PLHIV in Morocco.

Published
2021
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6. La recherche communautaire en temps de pandémie : retour sur l’étude multi-pays EPIC

Author

Lucas Riegel, Marion Di Ciaccio, Amal Ben Moussa, Annie Velter, Maria Elena Acosta, Virginie Villes, Juliana Castro Avila, Nicolas Lorente, Teresa Cerveau, Ingrid Sikitu, Adam Yattassaye, Niloufer Khodabocus, David Michels, María Amelia Veras, Valérie Delpech, Bruno Spire, Rosemary M. Delabre, null Le groupe de travail EPIC, and Daniela Rojas Castro

Subjects
Public Health, Environmental and Occupational Health
Published
2022
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7. PrEP in the Context of Other HIV Risk Reduction Strategies Among Men Who Have Sex with Men: Results from the Flash! PrEP in Europe Survey

Author

Marion Di Ciaccio, Rosemary M. Delabre, Antoine Vilotitch, Giulio Maria Corbelli, Virginie Villes, Alejandro Ros Sánchez, Paul Zantkuijl, Holger Sweers, Flor Sanchez, Michael Meulbroek, Gus Cairns, Adeline Bernier, Jade Ghosn, Luìs Miguel Carvalho Rocha, Maria Luisa Cosmaro, Sascha Béla Duken, Monica Dan, Vincent Schlegel, Richard Stranz, Kai J. Jonas, Bruno Spire, Daniela Rojas Castro, Coalition PLUS [Pantin, France] (Community Research Laboratory Pantin), Groupe de Recherche en Psychologie Sociale (GRePS), Université Lumière - Lyon 2 (UL2), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des sciences de la santé publique [Marseille] (ISSPAM), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Plus [Rome, Italy], Soa Aids Nederland [Amsterdam, The Netherlands], Deutsche AIDS-Hilfe E.V. [Berlin, Germany], Universidad Autónoma de Madrid (UAM), Projecte dels NOMS - Hispanosida, NAM [London, UK], Services de Maladies Infectieuses et Tropicales [CHU Bichat], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Grupo de Ativistas em Tratamentos [Lisbon, Portugal] (GAT), Universidade Nova de Lisboa = NOVA University Lisbon (NOVA), Fondazione LILA Milano [Milan, Italy] (FLM), University of Amsterdam [Amsterdam] (UvA), Romanian Association Against AIDS [Bucharest, Romania] (ARAS), AIDES [Pantin, France] (Mission Innovation Recherche Expérimentation), Maastricht University [Maastricht], Klinische Psychologie (Psychologie, FMG), RS: FPN WSP II, and Section Applied Social Psychology

Subjects
Male, MESH: Sexual Behavior, Anti-HIV Agents, Sexual Behavior, [SDV]Life Sciences [q-bio], HIV prevention, HIV Infections, BEHAVIORS, Condoms, MESH: Homosexuality, Male, Sexual and Gender Minorities, MESH: Condoms, Arts and Humanities (miscellaneous), Community-based research, PREVENTION TASP, Humans, MESH: Sexual Partners, MSM, Homosexuality, Male, MESH: Anti-HIV Agents, General Psychology, POSTEXPOSURE PROPHYLAXIS, MESH: Humans, MESH: HIV Infections, PrEP, MESH: Male, Europe, MESH: Sexual and Gender Minorities, GAY, Sexual Partners, ACCEPTABILITY, MESH: Risk Reduction Behavior, PATTERNS, Sexual orientation, MESH: Europe, Risk Reduction Behavior, PREEXPOSURE PROPHYLAXIS
Abstract

International audience; Combination HIV prevention covers a range of biomedical, behavioral, and socio-structural interventions. Despite the growing availability of pre-exposure prophylaxis (PrEP), it is not always accessible in European Centre for Disease Prevention and Control reporting countries and may not meet the needs of all at-risk populations. Based on the Flash! PrEP in Europe data, multiple correspondence analysis and hierarchical clustering were used to identify patterns in HIV prevention strategies among 9980 men who have sex with men (MSM). PrEP interest was evaluated among four identified clusters: (A) "high condom use, sometimes Treatment as Prevention (TasP)"; (B) "mix of methods, infrequent condom use"; (C) "high condom use, tendency to choose partners based on serological status" and (D) "moderate use of condoms mixed with other prevention strategies". Clusters B and D had higher PrEP interest. These results suggest that MSM use a range of behavioral and biomedical risk reduction strategies that are often combined. On-demand PrEP may meet the needs of MSM who infrequently use condoms and other prevention methods.

Published
2022
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8. P283 Differences in risk perception and risk behavior between PrEP-using and non-PrEP-using MSM in the Netherlands

Author

D Rojas Castro, Rosemary M. Delabre, S Diexer, Kai J. Jonas, Mirjam Kretzschmar, and A Teslya

Subjects
Risk perception, Sexual behavior, business.industry, Human immunodeficiency virus (HIV), medicine, Risk behavior, Stigma (botany), Mean age, Affect (psychology), medicine.disease_cause, business, Men who have sex with men, Demography
Abstract

Background Pre-exposure prophylaxis (PrEP) uptake has remained low among men who have sex with men (MSM) eligible for PrEP in the Netherlands, which could partly be due to stigma associated with taking PrEP. Perceptions about PrEP users (e.g., PrEP users have an increased rate of (condomless) sexual encounters) may modify mixing behavior and subsequently affect dynamics of HIV and STIs. We investigated whether HIV and STI risk perception, risk behavior, and partner selection depend on PrEP usage. Methods We analyzed sexual behavior and PrEP data from 426 HIV-negative MSM who participated in the Flash! PrEP in Europe survey in the Netherlands in 2016. We distinguished between current PrEP users (n=29), men interested in PrEP (n=267), and men not interested in PrEP (n=130). We tested differences between these 3 groups in risk perception and sexual behavior variables using ANOVA and Chi-squared test. Results Mean age of participants was 42 yrs (range= 18–75); 85% were born in the Netherlands. PrEP users and men not interested in PrEP consider their risk of acquiring HIV low, while men interested in PrEP consider their risk higher (p Conclusion PrEP users engage in sexual behavior with higher risk of STI acquisition than non-PrEP users. Men not interested in PrEP are less open for sexual encounters with PrEP users than men in other groups. Therefore, perceptions of PrEP users and non-PrEP users may change mixing patterns and thus STI dynamics.

Published
2021
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9. Impact of the early 2020 COVID-19 crisis and lockdown on PrEP use among men who have sex with men (MSM) in France

Author

Marion Di Ciaccio, Virginie Villes, David Michels, Stéphane Morel, Rosemary M Delabre, Daniela Rojas Castro, and Annie Velter

Subjects
Male, Sexual and Gender Minorities, Psychotropic Drugs, Infectious Diseases, Cross-Sectional Studies, Sexual Behavior, Communicable Disease Control, Humans, COVID-19, HIV Infections, Pre-Exposure Prophylaxis, Dermatology, Homosexuality, Male
Abstract

ObjectiveTo describe changes in pre-exposure prophylaxis (PrEP) use during and following the COVID-19 lockdown in France (March–May 2020) and identify the factors associated with PrEP discontinuation among men who have sex with men (MSM) after the lockdown.MethodsData from the, an anonymous, cross-sectional internet survey among MSM in July 2020, were analysed. Among respondents who were using PrEP prior to the lockdown, a binary logistic regression model was used to compare participants who were still taking PrEP (current PrEP users) with those who were not taking PrEP at the time of the survey (former PrEP users).ResultsAmong 8345 respondents, 946 were PrEP users before the lockdown, of whom 58.8% (n=556) reported stopping PrEP during the lockdown and 15.4% (n=146) were not using PrEP at the time of the survey. Among the 556 who stopped PrEP during lockdown, 86.5% (n=481) reported no sexual activity; 76.8% (n=427) restarted PrEP after lockdown. Former PrEP users were more likely to be younger, not living with a stable male sexual partner, report moderate anxiety, report increased psychoactive drug use during the lockdown, and report not having tested for HIV or STI since the end of the lockdown because they did not know where to go, preferred to wait or for another reason. Reporting fewer male sexual partners in the last 6 months was also significantly associated with being a former PrEP user.ConclusionsMSM adapted PrEP use to their sexual activity during and after the French lockdown. After the lockdown, discontinued PrEP occurred more often among MSM who had fewer sexual partners and had mental health vulnerabilities. These factors could also be predictive of PrEP discontinuation in a more general context. PrEP users should be informed on how to safely stop/start PrEP and on the use of other prevention tools to reduce potential risk exposure during PrEP discontinuation.

Published
2021

10. 'Yes, I'm interested in taking PrEP!': PrEP interest among women respondents to the European community-based survey 'Flash! PrEP in Europe'

Author

Daniela Rojas Castro, Flor Sánchez, Antoine Vilotitch, Cary James, Coline Mey, Kai J. Jonas, Vincent Schlegel, Rosemary M. Delabre, Sascha B. Duken, Sophocles Chanos, Harriet Langanke, Adeline Bernier, Richard Stranz, Bruno Spire, Maria Luisa Cosmaro, Coalition PLUS [Pantin, France], Universidad Autónoma de Madrid (UAM), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Ath & Thess Checkpoints [Athens, Greece] (ATC), Fondazione LILA Milano [Milan, Italy] (FLM), Gemeinnützige Stiftung Sexualität und Gesundheit [Cologne, Germany] (GSSG), AIDES [Pantin, France], Terrence Higgins Trust [London, UK] (THT), University of Amsterdam [Amsterdam] (UvA), Maastricht University [Maastricht], Malbec, Odile, RS: FPN WSP II, Section Applied Social Psychology, UAM. Departamento de Psicología Social y Metodología, Klinische Psychologie (Psychologie, FMG), and Psychology Other Research (FMG)

Subjects
RNA viruses, Health Knowledge, Attitudes, Practice, US WOMEN, Younger age, Epidemiology, [SDV]Life Sciences [q-bio], Human immunodeficiency virus (HIV), HIV Infections, Surveys, medicine.disease_cause, Logistic regression, Pathology and Laboratory Medicine, Geographical Locations, Pre-exposure prophylaxis, Immunodeficiency Viruses, INFECTION, Medicine and Health Sciences, Public and Occupational Health, Multidisciplinary, ANTIRETROVIRAL PROPHYLAXIS, ORAL PREEXPOSURE PROPHYLAXIS, HIV diagnosis and management, MEN, Europe, [SDV] Life Sciences [q-bio], Medical Microbiology, Research Design, Viral Pathogens, Viruses, Infectious diseases, Medicine, Female, women, Pathogens, GENDER-BASED VIOLENCE, Research Article, Adult, Medical conditions, European community, Adolescent, TRANSMISSION, Science, Viral diseases, Hiv risk, Research and Analysis Methods, Microbiology, World health, Young Adult, Retroviruses, medicine, RISK SCORING TOOL, Humans, survey, European Union, FEMALE SEX WORKERS, Microbial Pathogens, pre-exposure prophylaxis, PERCEPTION, Survey Research, business.industry, Prophylaxis, Lentivirus, Organisms, Biology and Life Sciences, HIV, HIV PREVENTION, Patient Acceptance of Health Care, HIV infection, Health Surveys, PREVENTION, Diagnostic medicine, Sexual abuse, Medical Risk Factors, People and Places, Pre-Exposure Prophylaxis, Preventive Medicine, business, Sociología, HIV PREEXPOSURE PROPHYLAXIS, Demography
Abstract

The World Health Organization recommends pre-exposure prophylaxis (PrEP) for all populations at substantial risk of HIV infection, including women. However, data regarding PrEP interest among women is lacking, particularly in Europe. Factors associated with interest in using PrEP were assessed among women respondents to the Flash! PrEP in Europe (FPIE) survey. This community-based cross-sectional study, conducted in 12 European countries, aimed to assess PrEP knowledge and interest. “High objective risk” (HOR) was assessed using established risk criteria following EACS and CDC guidelines. Factors associated with interest in using PrEP were assessed in univariable and multivariable logistic regression models. Among 678 women, 12.5% (n = 85) were considered at HOR, 46.8% (n = 317) indicated prior PrEP knowledge and 18.0% (n = 122) reported interest in using PrEP. Among women at HOR, 40.0% (n = 34) were interested in PrEP. Factors significantly associated with PrEP interest in the final multivariable model were: younger age (18–29 years) (aOR 1.91[95CI: 1.07; 3.41]), bad self-perceived financial status (1.84[1.09; 3.11]), migrant status (south to north) (2.87[1.05; 7.89]), single or dating relationship status (1.93[1.23; 3.03]), sexual abuse history (1.86[1.17; 2.97]), “rather high”/ “high” self-perceived HIV risk (3.21[1.32; 7.81]), and HOR (2.49[1.42; 4.35]). These results show that women at HOR and those who perceived themselves to be at high risk are interested in using PrEP. There is a critical need for targeted information and improved access to PrEP to increase uptake of this HIV prevention tool to meet PrEP interest among women, KJJ received a grant from Dutch AIDS Fonds (Grant P-11302)

Published
2021
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11. Assessment of mental health outcomes and associated factors among workers in community-based HIV care centers in the early stage of the COVID-19 outbreak in Mali

Author

Bintou Dembélé Keita, Gwenaëlle Maradan, Michel Bourrelly, Luis Sagaon-Teyssier, Aliou Kamissoko, Mamadou Cisse, Fabrice Pouradier, Fodié Diallo, Rosemary M. Delabre, Bruno Spire, Adam Yattassaye, Laurent Vidal, Daniela Rojas Castro, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), ARCAD Santé PLUS [Bamako, Mali], Coalition PLUS [Pantin, France] (Community Research Laboratory Pantin), Hôpital Simone Veil [Eaubonne], Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), and Dupuis, Christine

Subjects
medicine.medical_specialty, [SDV]Life Sciences [q-bio], education, MEDLINE, Mali, Article, 03 medical and health sciences, 0302 clinical medicine, Health care, Medicine, Healthcare workers, 030212 general & internal medicine, Health policy, Depression (differential diagnoses), business.industry, Public health, Outbreak, COVID-19, HIV, Mental health, 3. Good health, [SDV] Life Sciences [q-bio], Family medicine, Anxiety, medicine.symptom, Public aspects of medicine, RA1-1270, business, 030217 neurology & neurosurgery
Abstract

International audience; Background and objectives: In Mali, the non-governmental association (NGO) ARCAD Santé PLUS launched the CovidPrev program in response to the COVID-19 outbreak to ensure continuity of HIV care-related activities. This study aimed to identify individual and structural factors associated with mental health disorders (MHD) in the NGO's healthcare workers (HCW) in the early stage of the outbreak.Methods: Data were collected between April 6 and 11, 2020 for 135 HCW in ARCAD Santé PLUS's 18 community-based HIV care centers. Outcomes corresponded to the PHQ-9, GAD-7 and ISI instruments for depression, anxiety and insomnia, respectively. A general mixture model with a negative binomial distribution was implemented.Results: Most HCW were men (60.7%) and median age was 40 years IQR[33-46]. Symptoms of depression, anxiety and insomnia were declared by 71.9, 73.3, and 77% participants, respectively. Women were at greater risk of MHD. A lack of personal protection equipment and human resources, especially nurses, was associated with a high risk of MHD.Conclusions: Health policy must place non-front line HCW, including those in NGOs, at the core of the healthcare system response to the COVID-19 outbreak, as they ensure continuity of care for many diseases including HIV. The efficacy of public health strategies depends on the capacity of HCW to fully with and competently perform their duties.

Published
2020
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12. Factors associated with post-seasonal serological titer and risk factors for infection with the pandemic A/H1N1 virus in the French general population.

Author

Nathanael Lapidus, Xavier de Lamballerie, Nicolas Salez, Michel Setbon, Rosemary M Delabre, Pascal Ferrari, Nanikaly Moyen, Marie-Lise Gougeon, Frédéric Vely, Marianne Leruez-Ville, Laurent Andreoletti, Simon Cauchemez, Pierre-Yves Boëlle, Eric Vivier, Laurent Abel, Michaël Schwarzinger, Michèle Legeas, Pierre Le Cann, Antoine Flahault, and Fabrice Carrat

Subjects
Medicine, Science
Abstract

The CoPanFlu-France cohort of households was set up in 2009 to study the risk factors for infection by the pandemic influenza virus (H1N1pdm) in the French general population. The authors developed an integrative data-driven approach to identify individual, collective and environmental factors associated with the post-seasonal serological H1N1pdm geometric mean titer, and derived a nested case-control analysis to identify risk factors for infection during the first season. This analysis included 1377 subjects (601 households). The GMT for the general population was 47.1 (95% confidence interval (CI): 45.1, 49.2). According to a multivariable analysis, pandemic vaccination, seasonal vaccination in 2009, recent history of influenza-like illness, asthma, chronic obstructive pulmonary disease, social contacts at school and use of public transports by the local population were associated with a higher GMT, whereas history of smoking was associated with a lower GMT. Additionally, young age at inclusion and risk perception of exposure to the virus at work were identified as possible risk factors, whereas presence of an air humidifier in the living room was a possible protective factor. These findings will be interpreted in light of the longitudinal analyses of this ongoing cohort.

Published
2013
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13. Are PrEP services in France reaching all those exposed to HIV who want to take PrEP? MSM respondents who are eligible but not using PrEP (EMIS 2017)

Author

Stéphane Morel, Annie Velter, David Michels, Virginie Villes, Rosemary M. Delabre, Margot Annequin, Tristan Alain, Axel J. Schmidt, Daniela Rojas Castro, Coalition PLUS [Pantin, France] (Community Research Laboratory Pantin), AIDES [Pantin, France], London School of Hygiene and Tropical Medicine (LSHTM), Santé publique France - French National Public Health Agency [Saint-Maurice, France], Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Dupuis, Christine

Subjects
Male, Health Knowledge, Attitudes, Practice, MESH: Sexual Behavior, Health (social science), pre-exposure prophylaxis (PrEP), [SDV]Life Sciences [q-bio], MESH: Health Knowledge, Attitudes, Practice, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Health Services Accessibility, Condoms, Health insurance system, 0302 clinical medicine, Surveys and Questionnaires, Medicine, 030212 general & internal medicine, MESH: Anti-HIV Agents, MESH: Health Services Accessibility, MESH: Patient Acceptance of Health Care, MESH: HIV Infections, 3. Good health, [SDV] Life Sciences [q-bio], PrEP delivery, France, 0305 other medical science, Adult, medicine.medical_specialty, Social Psychology, Anti-HIV Agents, Sexual Behavior, PrEP access, PrEP eligibility, MESH: Homosexuality, Male, 03 medical and health sciences, MESH: Condoms, MESH: Cross-Sectional Studies, Humans, MSM, Homosexuality, Male, MESH: Surveys and Questionnaires, 030505 public health, MESH: Humans, business.industry, Public Health, Environmental and Occupational Health, MESH: Adult, Patient Acceptance of Health Care, MESH: Male, MESH: France, Cross-Sectional Studies, Family medicine, Pre-Exposure Prophylaxis, business, MESH: Pre-Exposure Prophylaxis
Abstract

International audience; Pre-exposure prophylaxis (PrEP) is fully reimbursed by the French health insurance system since 2016. However, uptake of PrEP is slower than expected and little is known about men who have sex with men (MSM) who are eligible for PrEP according to French guidelines, but not using it. This study aims to (1) assess and describe MSM that are eligible to PrEP but not using it, and (2) identify potential individual and structural barriers of PrEP uptake among eligible MSM who are aware and intend to take PrEP. Data from EMIS-2017, a cross-sectional internet survey among gay, bisexual, and other MSM, were used. Among 7965 respondents without diagnosed HIV, 9.2% were PrEP users. Among 7231 non-PrEP users, 35.2% were eligible to PrEP and 15.2% were eligible, aware and intended to take PrEP. Eligible MSM who are not using PrEP are mostly younger, students, less "out", living in small cities, using condoms more frequently but still with low self-efficacy regarding safe sex and more distant from preventive health care and information than PrEP users. Despite free PrEP availability in France, results suggest that PrEP is not fully accessible and that there is a need to increase PrEP demand and decentralize PrEP delivery.

Published
2020
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14. Give PrEP a chance: moving on from the 'risk compensation' concept

Author

Rosemary M. Delabre, Jean-Michel Molina, Daniela Rojas Castro, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Coalition PLUS [Pantin, France], Service de maladies infectieuses et tropicales [Saint-Louis], Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Génétique et Ecologie des Virus, Génétique des Virus et Pathogénèse des Maladies Virales, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7), ANRS (France Recherche Nord&Sud Sida‐hiv Hépatites), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), and HAL AMU, Administrateur

Subjects
Male, Debate, Anti-HIV Agents, Sexual Behavior, Psychological intervention, Context (language use), HIV Infections, Developmental psychology, risk compensation, 03 medical and health sciences, Sexual and Gender Minorities, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), Argument, Medicine, Humans, 030212 general & internal medicine, Homosexuality, Male, sexually transmitted infections, Reproductive health, 030505 public health, business.industry, bio‐behavioural prevention, Public Health, Environmental and Occupational Health, sexual behaviour, HIV, medicine.disease, PrEP, 3. Good health, Risk compensation, Identification (information), Infectious Diseases, Sexual Partners, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Pre-Exposure Prophylaxis, Risk Adjustment, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 0305 other medical science, business, Social control
Abstract

International audience; Introduction: While bio-behavioural interventions (BIs) for sexually transmitted infections (STIs) and HIV prevention have shown their effectiveness (e.g. treatment for syphilis, HPV vaccination or pre-exposure prophylaxis [PrEP]), they have also aroused major concerns regarding behavioural changes that could counteract their benefit. Risk compensation (RC) fears concerning BIs in the HIV/STIs prevention field are intimately linked to representations, judgements and social control on sexual behaviour. With an increasing number of PrEP studies describing a rise in STIs due to RC, this paper argues for a shift away from the focus on RC and proposes a more constructive approach to respond to the needs of people living with HIV and populations most at risk. Discussion: The concept of RC, stemming from road safety and derived from economic theory, relies on rational theoretical models of human behaviour. Although widely applied in several contexts its use has been reasonably questioned. Major methodological issues regarding RC have been raised within HIV/AIDS literature. Although behavioural changes (e.g. condomless sex and number of sexual partners) are often erroneously assimilated with RC, there is no evidence that behavioural changes have undermined the effectiveness of previous and current BIs. Still, PrEP has not escaped RC concerns. Increases in condomless sex within the context of growing uptake of PrEP signals a continued need for integrated and innovative HIV and STI prevention strategies and a comprehensive sexual health approach. Routine HIV/STI testing, peer-led counselling, and identification of sexual health needs within the PrEP model of care could become a gold standard in the sexual health field for all populations. Conclusions: RC remains a frequent argument against the availability and provision of prevention methods for vulnerable populations. Individuals should be able to benefit from the full panel of BIs options available, to find and adapt methods according to their needs. Current, past and future PrEP users, with other stakeholders, may provide valuable insight into innovative solutions and programmes to control HIV and other STIs.

Published
2019
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15. Community engagement in the provision of culturally competent HIV and STI prevention services: lessons from the French experience in the era of PrEP

Author

Stéphane Morel, David Michels, Bruno Spire, Rosemary M. Delabre, Daniela Rojas Castro, HAL AMU, Administrateur, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Coalition PLUS [Pantin, France], and AIDES Association [France]

Subjects
HIV prevention, Human immunodeficiency virus (HIV), MEDLINE, medicine.disease_cause, community-based research, 03 medical and health sciences, Viewpoint, 0302 clinical medicine, Nursing, medicine, Culturally competent, 030212 general & internal medicine, key and vulnerable populations, Sti prevention, Community based research, 030505 public health, Community engagement, business.industry, Public Health, Environmental and Occupational Health, virus diseases, PrEP, 3. Good health, Infectious Diseases, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, community, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, STI, 0305 other medical science, business, community‐based research
Abstract

International audience; Communities have been a driving force in the response to the HIV epidemic, advocating for research, the access to treatment and healthcare, and human rights for key populations (KP) and people living with HIV (PLHIV). The importance of community engagement (CE) in the development and implementation of pertinent programmes throughout the HIV care continuum has been widely recognized 1-3. In the context of increasing pre‐exposure prophylaxis (PrEP) research, interest and access (though still limited), there is an opportunity to have a fresh look at CE regarding HIV/STI research and care delivery. France, where PrEP has been authorized and fully reimbursed since 2016, may provide key lessons for CE in the provision of comprehensive, culturally adapted HIV/STI prevention and treatment services.

Published
2019
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16. Factors associated with post-seasonal serological titer and risk factors for infection with the pandemic A/H1N1 virus in the French general population

Author

Nathanael Lapidus, Laurent Abel, Nicolas Salez, Pierre Le Cann, Pierre-Yves Boëlle, Nanikaly Moyen, Michaël Schwarzinger, Marianne Leruez-Ville, Simon Cauchemez, Xavier de Lamballerie, Eric Vivier, Pascal Ferrari, Laurent Andreoletti, Frédéric Vély, Fabrice Carrat, Antoine Flahault, Rosemary M. Delabre, Michèle Legeas, Marie-Lise Gougeon, Michel Setbon, Epidémiologie des maladies infectieuses et modélisation (ESIM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, Assistance Publique - Hôpitaux de Marseille (APHM), Emergence des Pathologies Virales (EPV), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Institut National de la Santé et de la Recherche Médicale (INSERM), École des Hautes Études en Santé Publique [EHESP] (EHESP), Centro Ricerche Produzioni Animali (CRPA), Immunité Anti-virale, Biothérapie et Vaccins (IABV), Institut Pasteur [Paris] (IP), Centre d'Immunologie de Marseille - Luminy (CIML), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Infections à Vih, Réservoirs, Pharmacologie des Antirétroviraux et Prévention de la Transmission Mère Enfant, Université Paris Descartes - Paris 5 (UPD5), Laboratoire de Virologie, CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire de Virologie Médicale et Moléculaire - EA 4684 (CardioVir), Université de Reims Champagne-Ardenne (URCA)-Centre Hospitalier Universitaire de Reims (CHU Reims)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Reims Champagne-Ardenne (URCA), Modélisation mathématique des maladies infectieuses, Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Centre d'études et de recherche en informatique et communications (CEDRIC), Ecole Nationale Supérieure d'Informatique pour l'Industrie et l'Entreprise (ENSIIE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Imagine - Institut des maladies génétiques (IMAGINE - U1163), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), ESIM - Déterminants Sociaux de la Santé et du Recours aux Soins (DS3), This study was supported by the Institut de Microbiologie et Maladies Infectieuses (IMMI-AVIESAN), the Institut de Santé Publique (ISP-AVIESAN), theFrench Ministry of Health and Assistance Publique Hôpitaux de Paris – PHRC 2010#AOM10199, the French Ministry of research and the Institut de Recherche enSante Publique (IReSP – TGIR 2009, Institut Pasteur [Paris], Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU), Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV), Centre National de la Recherche Scientifique (CNRS)-Institut Pasteur [Paris], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), Epidémiologie des maladies infectieuses et modélisation ( ESIM ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance Publique - Hôpitaux de Marseille ( APHM ), Emergence des Pathologies Virales ( EPV ), Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -Assistance Publique - Hôpitaux de Marseille ( APHM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), École des Hautes Études en Santé Publique [EHESP] ( EHESP ), Centro Ricerche Produzioni Animali ( CRPA ), Immunité Anti-virale, Biothérapie et Vaccins ( IABV ), Centre d'Immunologie de Marseille - Luminy ( CIML ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Aix Marseille Université ( AMU ) -Centre National de la Recherche Scientifique ( CNRS ), Université Paris Descartes - Paris 5 ( UPD5 ), Laboratoire de Virologie Médicale et Moléculaire ( CardioVir ), Université de Reims Champagne-Ardenne ( URCA ) -Centre Hospitalier Universitaire de Reims ( CHU Reims ) -SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne ( URCA ) -Université de Picardie Jules Verne ( UPJV ) -Université de Reims Champagne-Ardenne ( URCA ) -Université de Picardie Jules Verne ( UPJV ), Institut Pasteur [Paris]-Centre National de la Recherche Scientifique ( CNRS ), CHU Saint-Antoine [APHP], Institut Pierre Louis d'Epidémiologie et de Santé Publique ( iPLESP ), Centre d'étude et de recherche en informatique et communications ( CEDRIC ), Ecole Nationale Supérieure d'Informatique pour l'Industrie et l'Entreprise ( ENSIIE ) -Conservatoire National des Arts et Métiers [CNAM] ( CNAM ), Imagine - Institut des maladies génétiques ( IMAGINE - U1163 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Infection, Antimicrobiens, Modélisation, Evolution ( IAME ), Université Paris Diderot - Paris 7 ( UPD7 ) -Université Paris 13 ( UP13 ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut de recherche, santé, environnement et travail ( Irset ), Université d'Angers ( UA ) -Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -École des Hautes Études en Santé Publique [EHESP] ( EHESP ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ) -Université des Antilles ( UA ), Unité de Santé Publique, Assistance publique - Hôpitaux de Paris - AP-HP (FRANCE)-CHU Saint-Antoine [APHP], Epidémiologie, Systèmes dínformation et modélisation ( ESIM ), Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), and Epidémiologie, Systèmes dínformation et modélisation (ESIM)

Subjects
Male, Viral Diseases, Epidemiology, [SDV]Life Sciences [q-bio], lcsh:Medicine, MESH : Child, Preschool, France/epidemiology, Influenza A Virus, H1N1 Subtype/*pathogenicity, 0302 clinical medicine, Influenza A Virus, H1N1 Subtype, MESH : Child, Risk Factors, MESH: Risk Factors, MESH: Child, Pandemic, Medicine, MESH : Female, 030212 general & internal medicine, MESH : Influenza, Human, lcsh:Science, Child, Epidemiological Methods, 0303 health sciences, education.field_of_study, Multidisciplinary, MESH : Pandemics, MESH: Middle Aged, MESH: Influenza, Human, MESH : Infant, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Adult, Middle Aged, MESH : Risk Factors, MESH: Infant, 3. Good health, MESH : Influenza A Virus, H1N1 Subtype, Vaccination, Infectious Diseases, Influenza, Human/*epidemiology, MESH: Young Adult, Child, Preschool, Cohort, Female, France, Research Article, Adult, MESH: Pandemics, Adolescent, Clinical Research Design, MESH : Male, Population, Protective factor, MESH : Young Adult, Infectious Disease Epidemiology, MESH: Influenza A Virus, H1N1 Subtype, 03 medical and health sciences, Young Adult, MESH : Adolescent, Influenza, Human, Humans, MESH : Middle Aged, education, MESH : France, Biology, Pandemics, 030304 developmental biology, Asthma, MESH: Adolescent, MESH: Humans, [ SDV ] Life Sciences [q-bio], Population Biology, business.industry, MESH : Humans, lcsh:R, MESH: Child, Preschool, Infant, MESH: Adult, medicine.disease, Confidence interval, Influenza, MESH: Male, Risk perception, MESH: France, Cross-Sectional Studies, Immunology, lcsh:Q, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female, Demography
Abstract

International audience; The CoPanFlu-France cohort of households was set up in 2009 to study the risk factors for infection by the pandemic influenza virus (H1N1pdm) in the French general population. The authors developed an integrative data-driven approach to identify individual, collective and environmental factors associated with the post-seasonal serological H1N1pdm geometric mean titer, and derived a nested case-control analysis to identify risk factors for infection during the first season. This analysis included 1377 subjects (601 households). The GMT for the general population was 47.1 (95% confidence interval (CI): 45.1, 49.2). According to a multivariable analysis, pandemic vaccination, seasonal vaccination in 2009, recent history of influenza-like illness, asthma, chronic obstructive pulmonary disease, social contacts at school and use of public transports by the local population were associated with a higher GMT, whereas history of smoking was associated with a lower GMT. Additionally, young age at inclusion and risk perception of exposure to the virus at work were identified as possible risk factors, whereas presence of an air humidifier in the living room was a possible protective factor. These findings will be interpreted in light of the longitudinal analyses of this ongoing cohort.

Published
2012
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17. Integrative study of pandemic A/H1N1 influenza infections: design and methods of the CoPanFlu-France cohort

Author

Nicolas Salez, Nathanael Lapidus, Michel Setbon, Pierre-Yves Boëlle, Laurent Abel, Michèle Legeas, Marie-Lise Gougeon, Simon Cauchemez, Michaël Schwarzinger, Laurent Andreoletti, Pascal Ferrari, Pierre Le Cann, Rosemary M. Delabre, Antoine Flahault, Fabrice Carrat, Xavier de Lamballerie, Marianne Leruez-Ville, Frédéric Vély, Eric Vivier, Epidémiologie des maladies infectieuses et modélisation (ESIM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Emergence des Pathologies Virales (EPV), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Virologie, Assistance Publique - Hôpitaux de Marseille (APHM)-Pôle hospitalier de Microbiologie et Maladies Infectieuses, École des Hautes Études en Santé Publique [EHESP] (EHESP), Immunité Anti-virale, Biothérapie et Vaccins (IABV), Institut Pasteur [Paris] (IP), Centre d'Immunologie de Marseille - Luminy (CIML), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Infections à Vih, Réservoirs, Pharmacologie des Antirétroviraux et Prévention de la Transmission Mère Enfant, Université Paris Descartes - Paris 5 (UPD5), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire de Virologie Médicale et Moléculaire - EA 4684 (CardioVir), Université de Reims Champagne-Ardenne (URCA)-Centre Hospitalier Universitaire de Reims (CHU Reims)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Reims Champagne-Ardenne (URCA), Medical Research Council Centre for Outbreak Analysis and Modeling, Imperial College London-Department of Infectious Disease Epidemiology, CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Laboratory of Human Genetics of Infectious Diseases, Rockefeller University [New York]-Rockefeller Branch, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), This study was supported by the Institut de Microbiologie et Maladies Infectieuses (IMMI-AVIESAN), the Institut de Santé Publique (ISP-AVIESAN), the French Ministry of Health and Assistance Publique Hôpitaux de Paris - PHRC 2010 #AOM10199, the French Ministry of research and the Institut de Recherche en Sante Publique (IReSP - TGIR 2009)., Institut Pasteur [Paris], Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU), Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Laboratoire d'économie et de sociologie du travail (LEST), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), BMC, Ed., Université de Reims Champagne-Ardenne (URCA)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Centre Hospitalier Universitaire de Reims (CHU Reims), Rockefeller Branch-Rockefeller University [New York], Epidémiologie des maladies infectieuses et modélisation ( ESIM ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Emergence des Pathologies Virales ( EPV ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -Assistance Publique - Hôpitaux de Marseille ( APHM ), Assistance Publique - Hôpitaux de Marseille ( APHM ) -Pôle hospitalier de Microbiologie et Maladies Infectieuses, École des Hautes Études en Santé Publique [EHESP] ( EHESP ), Immunité Anti-virale, Biothérapie et Vaccins ( IABV ), Centre d'Immunologie de Marseille - Luminy ( CIML ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Aix Marseille Université ( AMU ) -Centre National de la Recherche Scientifique ( CNRS ), Université Paris Descartes - Paris 5 ( UPD5 ), Laboratoire de Virologie Médicale et Moléculaire ( CardioVir ), Université de Reims Champagne-Ardenne ( URCA ) -Centre Hospitalier Universitaire de Reims ( CHU Reims ) -SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne ( URCA ) -Université de Picardie Jules Verne ( UPJV ) -Université de Reims Champagne-Ardenne ( URCA ) -Université de Picardie Jules Verne ( UPJV ), Unité de Santé Publique, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Saint-Antoine [APHP], Rockefeller Branch-rockefeller university, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale ( SESSTIM - U912 INSERM - AMU - IRD ), Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Laboratoire d'économie et de sociologie du travail ( LEST ), and Aix Marseille Université ( AMU ) -Centre National de la Recherche Scientifique ( CNRS )

Subjects
[SHS.SOCIO] Humanities and Social Sciences/Sociology, medicine.disease_cause, France/epidemiology, [SHS]Humanities and Social Sciences, Cohort Studies, Study Protocol, [ QFIN ] Quantitative Finance [q-fin], Influenza A Virus, H1N1 Subtype, 0302 clinical medicine, Risk Factors, Epidemiology, Pandemic, Influenza A virus, 030212 general & internal medicine, 0303 health sciences, education.field_of_study, Family Characteristics, [SHS.SOCIO]Humanities and Social Sciences/Sociology, [QFIN]Quantitative Finance [q-fin], lcsh:Public aspects of medicine, virus diseases, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, [QFIN] Quantitative Finance [q-fin], 3. Good health, Influenza, Human/*epidemiology, Research Design, Population Surveillance, Cohort, Pandemics, [SHS] Humanities and Social Sciences, France, Cohort study, medicine.medical_specialty, Population, Population Surveillance/*methods, Context (language use), 03 medical and health sciences, Environmental health, [ SHS ] Humanities and Social Sciences, Influenza, Human, medicine, Humans, education, 030304 developmental biology, business.industry, Public Health, Environmental and Occupational Health, Influenza a virus H1N1 subtype,Cohort study,Risk factors,France, lcsh:RA1-1270, [ SHS.SOCIO ] Humanities and Social Sciences/Sociology, Influenza a virus H1N1 subtype, Virology, Risk factors, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Biostatistics, business
Abstract

Background The risk of influenza infection depends on biological characteristics, individual or collective behaviors and the environmental context. The Cohorts for Pandemic Influenza (CoPanFlu) France study was set up in 2009 after the identification of the novel swine-origin A/H1N1 pandemic influenza virus. This cohort of 601 households (1450 subjects) representative for the general population aims at using an integrative approach to study the risk and characteristics of influenza infection as a complex combination of data collected from questionnaires regarding sociodemographic, medical, behavioral characteristics of subjects and indoor environment, using biological samples or environmental databases. Methods/Design Households were included between December 2009 and July 2010. The design of this study relies on systematic follow-up visits between influenza seasons and additional visits during influenza seasons, when an influenza-like illness is detected in a household via an active surveillance system. During systematic visits, a nurse collects individual and environmental data on questionnaires and obtains blood samples from all members of the household. When an influenza-like-illness is detected, a nurse visits the household three times during the 12 following days, and collects data on questionnaires regarding exposure and symptoms, and biological samples (including nasal swabs) from all subjects in the household. The end of the follow-up period is expected in fall 2012. Discussion The large amount of data collected throughout the follow-up will permit a multidisciplinary study of influenza infections. Additional data is being collected and analyzed in this ongoing cohort. The longitudinal analysis of these households will permit integrative analyses of complex phenomena such as individual, collective and environmental risk factors of infection, routes of transmission, or determinants of the immune response to infection or vaccination.

Published
2012
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18. Increased natural killer cell activity in viremic HIV-1 infection

Author

Xu G. Yu, John Zaunders, Jessica Malenfant, Nicole C. Burgett, Galit Alter, Rosemary M. Delabre, Mathias Lichterfeld, and Marcus Altfeld

Subjects
Adult, Male, Chemokine, CD3 Complex, Immunology, Interleukin 21, Interferon-gamma, NK-92, Antigens, CD, Lysosomal-Associated Membrane Protein 1, Antiretroviral Therapy, Highly Active, Immunology and Allergy, Humans, Viremia, Acquired Immunodeficiency Syndrome, Lymphokine-activated killer cell, Innate immune system, biology, Tumor Necrosis Factor-alpha, Janus kinase 3, Lysosome-Associated Membrane Glycoproteins, Middle Aged, Virology, CD56 Antigen, Killer Cells, Natural, biology.protein, Interleukin 12, HIV-1, Cytokine secretion, Female
Abstract

NK cells are a subset of granular lymphocytes that are critical in the innate immune response to infection. These cells are capable of killing infected cells and secreting integral cytokines and chemokines. The role that this subset of cytolytic cells plays in HIV infection is not well understood. In this study, we dissected the function of NK cells in viremic and aviremic HIV-1-infected subjects, as well as HIV-1-negative control individuals. Despite reduced NK cell numbers in subjects with ongoing viral replication, these cells were significantly more active in secreting both IFN-γ and TNF-α than NK cells from aviremic subjects or HIV-1-negative controls. In addition, NK cells in subjects with detectable viral loads expressed significantly higher levels of CD107a, a marker of lysosomal granule exocytosis. The expression of CD107a correlated with NK cell-mediated cytokine secretion and cytolytic activity as well as with the level of viral replication, suggesting that CD107a represents a good marker for the functional activity of NK cells. Finally, killer Ig-related receptor+ NK cells were stable or elevated in viremic subjects, while the numbers of CD3−/CD56+/CD94+ and CD3−/CD56+/CD161+ NK cells were reduced. Taken together, these data demonstrate that viremic HIV-1 infection is associated with a reduction in NK cell numbers and a perturbation of NK cell subsets, but increased overall NK cell activity.

Published
2004

19. Impact of the COVID-19 Health Crisis on Key Populations at Higher Risk for, or Living With, HIV or Hepatitis C Virus and People Working With These Populations: Multicountry Community-Based Research Study Protocol (EPIC Program)

Author

Rosemary M Delabre, Marion Di Ciaccio, Nicolas Lorente, Virginie Villes, Juliana Castro Avila, Adam Yattassaye, César Bonifaz, Amal Ben Moussa, Ingrid-Zaïre Sikitu, Niloufer Khodabocus, Rosa Freitas, Bruno Spire, Maria Amélia Veras, Luis Sagaon-Teyssier, Gabriel Girard, Perrine Roux, Annie Velter, Valérie Delpech, Jade Ghosn, Lucas Riegel, and Daniela Rojas Castro

Subjects
Medicine, Computer applications to medicine. Medical informatics, R858-859.7
Abstract

BackgroundInformation concerning the impact of the COVID-19 health crisis on populations most affected by HIV and hepatitis C virus (HCV; or key populations [KP]), and those working with these populations in community settings, is limited. Community-based organizations working in the field of HIV and viral hepatitis are well placed to identify and meet the new needs of KP owing to the health crisis. ObjectiveThis study aims to describe the development and implementation of an exploratory and descriptive multicountry, community-based research program, EPIC (Enquêtes Pour évaluer l’Impact de la crise sanitaire covid en milieu Communautaire), within an international network of community-based organizations involved in the response to HIV and viral hepatitis. The EPIC program aimed to study the impact of the COVID-19 health crisis on KP or people living with HIV or HCV and people working with these populations at the community level (community health workers [CHWs]) and to identify the key innovations and adaptations in HIV and HCV services. MethodsA general protocol and study documents were developed and shared within the Coalition PLUS network. The protocol had a built-in flexibility that allowed participating organizations to adapt the study to local needs in terms of the target population and specific themes of interest. Data were collected using surveys or interviews. ResultsFrom July 2020 to May 2022, a total of 79 organizations participated in the EPIC program. Across 32 countries, 118 studies were conducted: 66 quantitative (n=12,060 among KP or people living with HIV or people living with HCV and n=811 among CHWs) and 52 qualitative (n=766 among KP or people living with HIV or people living with HCV and n=136 among CHWs). ConclusionsThe results of the EPIC program will provide data to describe the impact of the health crisis on KP and CHWs and identify their emerging needs. Documentation of innovative solutions that were put into place in this context may help improve the provision of services after COVID-19 and for future health crises. International Registered Report Identifier (IRRID)DERR1-10.2196/45204

Published
2023
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20. 'Yes, I'm interested in taking PrEP!': PrEP interest among women respondents to the European community-based survey 'Flash! PrEP in Europe'.

Author

Rosemary M Delabre, Adeline Bernier, Flor Sánchez, Antoine Vilotitch, Sophocles Chanos, Maria Luisa Cosmaro, Harriet Langanke, Coline Mey, Cary James, Sascha B Duken, Vincent Schlegel, Richard Stranz, Kai J Jonas, Bruno Spire, and Daniela Rojas Castro

Subjects
Medicine, Science
Abstract

The World Health Organization recommends pre-exposure prophylaxis (PrEP) for all populations at substantial risk of HIV infection, including women. However, data regarding PrEP interest among women is lacking, particularly in Europe. Factors associated with interest in using PrEP were assessed among women respondents to the Flash! PrEP in Europe (FPIE) survey. This community-based cross-sectional study, conducted in 12 European countries, aimed to assess PrEP knowledge and interest. "High objective risk" (HOR) was assessed using established risk criteria following EACS and CDC guidelines. Factors associated with interest in using PrEP were assessed in univariable and multivariable logistic regression models. Among 678 women, 12.5% (n = 85) were considered at HOR, 46.8% (n = 317) indicated prior PrEP knowledge and 18.0% (n = 122) reported interest in using PrEP. Among women at HOR, 40.0% (n = 34) were interested in PrEP. Factors significantly associated with PrEP interest in the final multivariable model were: younger age (18-29 years) (aOR 1.91[95CI: 1.07; 3.41]), bad self-perceived financial status (1.84[1.09; 3.11]), migrant status (south to north) (2.87[1.05; 7.89]), single or dating relationship status (1.93[1.23; 3.03]), sexual abuse history (1.86[1.17; 2.97]), "rather high"/ "high" self-perceived HIV risk (3.21[1.32; 7.81]), and HOR (2.49[1.42; 4.35]). These results show that women at HOR and those who perceived themselves to be at high risk are interested in using PrEP. There is a critical need for targeted information and improved access to PrEP to increase uptake of this HIV prevention tool to meet PrEP interest among women.

Published
2021
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