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Objective: In the COVID‐19 crisis context, the main objective of the study is to investigate factors associated with perceived concerns of change in long‐term cancer care in patients currently under treatment. Methods: A French population‐based cross‐sectional study was performed using an online questionnaire in April 2020. All persons currently receiving cancer treatment and belonging to the Seintinelles Association (https://www.seintinelles.com) were included in this present analysis. Individual sociodemographic characteristics, medical status and information regarding cancer care were collected. Multivariate binomial logistic regression analysis was performed. Results: We included 298 women in the analysis. Younger participants (OR = 0.96 [0.94–0.99]), the need to visit healthcare facilities to receive treatment (OR = 2.93 [1.16–8.52]), deterioration in the quality of communication with the medical team since the beginning of the COVID‐19 crisis (OR = 3.24 [1.61–7.02]) and being cared for by a university hospital or a public hospital (OR = 2.19 [1.16–4.23] versus comprehensive cancer centre) were associated with a perceived fear of change in long‐term cancer care. Conclusion: To address patients' concerns regarding changes in their long‐term cancer care, medical teams should consider the patients' own perceptions of the situation and provide clear, appropriate, precise information on cancer care, especially in the centres mostly affected by the COVID‐19 crisis. [ABSTRACT FROM AUTHOR]

The clinical trial ANRS-IPERGAY investigated the efficacy of sexual activity-based (i.e. on demand) HIV pre-exposure prophylaxis (PrEP). Using a qualitative method, we analysed the role of adherence as one of the main elements for PrEP effectiveness and its associated determinants. Data were collected in various French ANRS-IPERGAY sites during the double-blind (2012–2014) and open-label study (2015–2016) phases, through two individual interviews per participant, collective interviews and focus groups. A total of 83 participants participated in the present study. Our analysis included 32 individual interviews (with 16 participants), 13 collective interviews (n = 45) and 8 focus groups (n = 33). We investigated adherence to on-demand pill-intake schedule, focusing especially on PrEP integration into daily life. PrEP intake was regulated through coping strategies to simplify implementation and avoid stigmatizing reactions. We considered self-care and pharmaceuticalization of prevention as specific features of sexual activity-based PrEP. As PrEP is a prophylaxis for seronegative people, it is contributing to the emergence of a new identity in the HIV field. Health-care professionals should take into account the practical implementation of PrEP schedules into daily life, assist PrEP users in personal management of pill intake and, more generally, improve adherence to the prophylaxis. [ABSTRACT FROM AUTHOR]

ANRS-IPERGAY was a community-based randomized trial investigating the efficacy of sexual activity-based HIV pre-exposure prophylaxis (PrEP) in a population of males and transgender females who had sex with men and were at high risk of HIV infection. We qualitatively analyzed the support provided to participants by community-based health workers (CBHW) throughout the trial's double-blind and open-label extension phases. In particular, we showed that the relationship between participants and CBHW strongly influenced self-managed pill intake. The delicate construction of this relationship, balanced between trust and dependence, played an important role in PrEP adherence. CBHW had to deal with various issues surrounding participants' feelings of empowerment regarding their role in the trial, as well as related tensions between various logics and rationalities. They were essential to participants' continued involvement. [ABSTRACT FROM AUTHOR]

Pre-exposure prophylaxis (PrEP) is one of the most important milestones in HIV prevention for high-risk HIV-negative people. The introduction of PrEP into the HIV prevention package has raised the question of possible risk compensation, and in particular, a reduction in condom use. Although open-label extension (OLE) studies have enabled investigators to examine risk compensation in more real-life settings, results to date have been inconclusive regarding PrEP-induced behavioral changes. We aimed to identify behavioral trajectories over time for PrEP and condom use, and to investigate the link between these trajectories. Group-based trajectory modeling using logistic specification was implemented. Data of the 332 individuals participating in the double-blind and OLE phases of ANRS IPERGAY were used. Four distinct group trajectories were identified: 49.7% of the participants had "systematic adherence to PrEP," 19% had "high adherence to PrEP, 15.3% had "declining adherence to PrEP," and 16% had "low adherence to PrEP." Two condom trajectories were identified: 53% (n = 176) of the 332 participants were "low-level users" of condoms, and 47% were "high-level users." Among the former, 24.4% also belonged to the "low adherence to PrEP" group. This most-at-risk group represented 13% of all the participants. The effectiveness of offering sexual activity-based PrEP as part of the French HIV prevention package in the ANRS IPERGAY clinical trial is demonstrated by the relatively small proportion of participants that offset their low-level condom use with PrEP adherence. The results from this work may help in the future development of tailored prevention programs for high-risk HIV-negative people. [ABSTRACT FROM AUTHOR]

The aims of the study were to determine the level of satisfaction ofmen who have sex withmen (MSM) participatingin twocommunity-basednon-medicalized counseling and testingprograms(ANRS-DRAG andANRS-COM'TEST) offering HIV rapid tests (hereafter CBOffer), and to identify factors associated with satisfaction. Between 2009 and 2011, 436 participants voluntarily benefited from a CBOffer in the two programs. They completed self-administered questionnaires before and after testing. Psychosocial scores were constructed using principal component analyses to reflect the following dimensions: post-test satisfaction, avoidance of at-risk situations as a HIV risk-reduction strategy, and attitudes towards condom use. Logarithmic regression of the post-test satisfaction score was performed on these scores and on other selected explanatory variables, including the variable "self-identification as homosexual or bisexual". Post-test satisfaction ranged between 90-99 and below 90 for 50% and 25% of the participants, respectively. Post-test satisfaction with the CBOffer was independently associated with self-defined sexuality, meeting place for sexual partners, participants' attitudes about being HIV-positive, and condom use. The very high level of satisfaction was associated with both personal and socio-behavioral factors. Vulnerable MSM could be targeted better and, accordingly, could use this offer more frequently as a combined prevention tool. [ABSTRACT FROM AUTHOR]

Pleasure-seeking plays a role in prevention (means choices and use), and in the sexual quality of life of men who have sex with men (MSM). Since HIV is a major threat to MSM health, new means of prevention, like pre-exposure prophylaxis (PrEP), must meet the needs of MSM to be fully efficient. Using a psychosocial approach, we examined how pleasure-seeking plays a role in participation of MSM in "ANRS-IPERGAY," a community-based trial on sexual health which included sexual on-demand PrEP. Thirteen semistructured collective interviews were conducted with 45 participants. First, we analyzed participants' search for new prevention means due to previous failures in condom use. We found that participants perceived condoms as a barrier—both materially and symbolically—to pleasure and desire, causing anxiety and stress considering sexual intercourse. Second, we explored representations and attitudes concerning pleasure within the context of PrEP. We found that PrEP allowed participants to freely choose their desired sexual positions and to better enjoy intimacy. Third, we studied the sexual quality of life for PrEP users in ANRS-IPERGAY and found an improvement. Thanks to the community-based design of the trial, this new prevention tool became a means to develop agency and empowerment for participants, not only in negotiating individual prevention but also in opposing the normative and stigmatizing discourse on sexuality and HIV. In conclusion, pleasure-seeking appears to be an essential element of sexual fulfillment that needs to be integrated as a positive notion in the study of HIV prevention. [ABSTRACT FROM AUTHOR]