12 results on '"Guédou, Fernand"'
Search Results
2. HIV self-testing implementation, distribution and use among female sex workers in Cotonou, Benin: a qualitative evaluation of acceptability and feasibility
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Boisvert Moreau, Marianne, Kintin, Frédéric D., Atchekpe, Septime, Batona, Georges, Béhanzin, Luc, Guédou, Fernand A., Gagnon, Marie-Pierre, and Alary, Michel
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- 2022
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3. Acceptability of pre-exposure prophylaxis for HIV prevention: facilitators, barriers and impact on sexual risk behaviors among men who have sex with men in Benin
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Ahouada, Carin, Diabaté, Souleymane, Mondor, Myrto, Hessou, Septime, Guédou, Fernand A., Béhanzin, Luc, Batona, Georges, Gning, Ndeye Ndiagna, Zannou, D. Marcel, and Alary, Michel
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- 2020
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4. Prévalence des hépatites virales B et C chez les hommes ayant des rapports sexuels avec d'autres hommes mobilisés pour une étude de démonstration de la prophylaxie préexposition au VIH à Cotonou, au Bénin.
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Béhanzin, Luc, Diabaté, Souleymane, Guédou, Fernand Aimé, Matsétsé, Ella Goma, Olodo, Marius, Dossouvo, Alban, Aza-Gnandji, Marlène, Akpaka, Axel, Chagas, Elyote, Gangbo, Flore, Zannou, Djimon Marcel, and Alary, Michel
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Copyright of Pan African Medical Journal is the property of Pan African Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2023
5. Pre‐exposure prophylaxis in real life: experience from a prospective, observational and demonstration project among men who have sex with men in Benin, West Africa.
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Diabaté, Souleymane, Béhanzin, Luc, Guédou, Fernand A., Goma‐Matsétsé, Ella, Olodo, Marius, Aza‐Gnandji, Marlène, Dossouvo, Alban, Akpaka, Axel, Chagas, Elyote, Gangbo, Flore, Zannou, Djimon Marcel, and Alary, Michel
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PRE-exposure prophylaxis ,UNSAFE sex ,PILOT projects ,CHLAMYDIA trachomatis ,HIV prevention - Abstract
Introduction: Since many countries in sub‐Saharan Africa are willing to implement HIV oral pre‐exposure prophylaxis (PrEP) for men who have sex with men (MSM), data are needed to assess its feasibility and relevance in real life. The study objectives were to assess drug uptake, adherence, condom use and number of sexual partners, HIV incidence and trends in the prevalence of gonorrhoea and chlamydia. Methods: In this oral PrEP demonstration study conducted prospectively in Benin, a combination of tenofovir disoproxil fumarate‐TDF 300 mg and emtricitabine‐FTC 200 mg (TDF‐FTC) was offered daily or on‐demand to MSM. Participants were recruited from 24 August to 24 November 2020 and followed over 12 months. At enrolment, month‐6 and month‐12, participants answered to a face‐to‐face questionnaire, underwent a physical examination and provided blood samples for HIV, gonorrhoea and chlamydia. Results: Overall, 204 HIV‐negative men initiated PrEP. The majority of them (80%) started with daily PrEP. Retention rates at month‐3, 6, 9 and 12 were 96%, 88%, 86% and 85%, respectively. At month‐6 and month‐12, respectively, 49% and 51% of the men on daily PrEP achieved perfect adherence (self‐reported), that is seven pills taken during the last week. For event‐driven PrEP, the corresponding proportions for perfect adherence (last seven at‐risk sexual episodes covered) were 81% and 80%, respectively. The mean number (standard deviation) of male sexual partners over the last 6 months was 2.1 (1.70) at baseline and 1.5 (1.27) at month‐12 (p‐value for trend <0.001). Consistent condom use during the last 6 months was 34% (enrolment), 37% (month‐6) and 36% (month‐12). Three HIV seroconversions (2‐daily and 1‐event‐driven) were recorded. Crude HIV incidence (95% confidence interval) was 1.53 (0.31−4.50)/100 person‐years. Neisseria gonorrhoeae and/or Chlamydia trachomatis prevalence at the anal and/or pharyngeal and/or urethral sites was 28% at baseline and 18% at month‐12 (p‐value = 0.017). Conclusions: In West Africa, oral PrEP introduction in routine practice as a component of a holistic HIV prevention package is feasible and may not result in a significant increase in condomless sex among MSM. Since HIV incidence was still higher, additional interventions, such as culturally tailored adherence counselling, may be needed to optimize the benefits of PrEP. [ABSTRACT FROM AUTHOR]
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- 2023
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6. Early antiretroviral therapy and daily pre-exposure prophylaxis for HIV prevention among female sex workers in Cotonou, Benin: a prospective observational demonstration study
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Mboup, Aminata, Béhanzin, Luc, Guédou, Fernand A, Geraldo, Nassirou, Goma‐Matsétsé, Ella, Giguère, Katia, Aza‐Gnandji, Marlène, Kessou, Léon, Diallo, Mamadou, Kêkê, René K, Bachabi, Moussa, Dramane, Kania, Geidelberg, Lily, Cianci, Fiona, Lafrance, Christian, Affolabi, Dissou, Diabaté, Souleymane, Gagnon, Marie‐Pierre, Zannou, Djimon M, Gangbo, Flore, Boily, Marie‐Claude, Vickerman, Peter, Alary, Michel, and Bill & Melinda Gates Foundation
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DYNAMICS ,AFRICA ,Adult ,Safe Sex ,retention ,Anti-HIV Agents ,Sexual Behavior ,Immunology ,HIV prevention ,HIV Infections ,ADHERENCE ,Benin ,Emtricitabine ,Humans ,Prospective Studies ,Tenofovir ,female sex workers ,Research Articles ,pre‐exposure prophylaxis ,DECLINE ,Science & Technology ,Sex Workers ,virus diseases ,1199 Other Medical And Health Sciences ,SEXUALLY-TRANSMITTED DISEASES ,PREVALENCE ,Infectious Diseases ,INFECTIONS ,SAFETY ,Female ,Pre-Exposure Prophylaxis ,early antiretroviral therapy ,Life Sciences & Biomedicine ,Research Article ,INTERVENTIONS - Abstract
INTRODUCTION: In sub-Saharan Africa, HIV prevalence remains high, especially among key populations. In such situations, combination prevention including clinical, behavioural, structural and biological components, as well as adequate treatment are important. We conducted a demonstration project at the Dispensaire IST, a clinic dedicated to female sex workers (FSWs) in Cotonou, on early antiretroviral therapy (E-ART, or immediate "test-and-treat") and pre-exposure prophylaxis (PrEP). We present key indicators such as uptake, retention and adherence.METHODS: In this prospective observational study, we recruited FSWs from October 4th 2014 to December 31st 2015 and followed them until December 31st 2016. FSWs were provided with daily tenofovir disoproxil fumarate/emtricitabine (Truvada® ) for PrEP or received a first-line antiretroviral regimen as per Benin guidelines. We used generalized estimating equations to assess trends in adherence and sexual behaviour.RESULTS: Among FSWs in the catchment area, HIV testing coverage within the study framework was 95.5% (422/442). At baseline, HIV prevalence was 26.3% (111/422). Among eligible FSWs, 95.5% (105/110) were recruited for E-ART and 88.3% (256/290) for PrEP. Overall retention at the end of the study was 59.0% (62/105) for E-ART and 47.3% (121/256) for PrEP. Mean (±SD) duration of follow-up was 13.4 (±7.9) months for E-ART and 11.8 (±7.9) months for PrEP. Self-reported adherence was over 90% among most E-ART participants. For PrEP, adherence was lower and the proportion with 100% adherence decreased over time from 78.4% to 56.7% (p-trend < 0.0001). During the 250.1 person-years of follow-up among PrEP initiators, two seroconversions occurred (incidence 0.8/100 person-years (95% confidence interval: 0.3 to 1.9/100 person-years)). The two seroconverters had stopped using PrEP for at least six months before being found HIV-infected. In both groups, there was no evidence of reduced condom use.CONCLUSIONS: This study provides data on key indicators for the integration of E-ART and PrEP into the HIV prevention combination package already offered to FSWs in Benin. PrEP may be more useful as an individual intervention for adherent FSWs rather than a specific public health intervention. E-ART was a more successful intervention in terms of retention and adherence and is now offered to all key populations in Benin.STUDY REGISTRATION: ClinicalTrials.gov NCT02237.
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- 2018
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7. Acceptability of pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) in Benin: a qualitative study.
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Ahouada, Carin, Diabaté, Souleymane, Gning, Ndeye Ndiagna, Hessou, Septime, Batona, Georges, Guédou, Fernand A., Béhanzin, Luc, Zannou, Marcel D., and Alary, Michel
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DIAGNOSIS of HIV infections ,HIV prevention ,HIV infection risk factors ,FOCUS groups ,HEALTH services accessibility ,MEDICAL care costs ,PREVENTIVE medicine ,PATIENT safety ,QUALITATIVE research ,THEMATIC analysis ,UNSAFE sex ,HEALTH literacy ,MEN who have sex with men ,SEXUAL partners - Abstract
In Benin, consistent condom use among men who have sex with men (MSM) is relatively low and providing them with Pre-exposure prophylaxis (PrEP) could be of great relevance. We aimed to describe PrEP knowledge and intention to use it; identify key facilitators and barriers to PrEP; and describe the perceived impact of PrEP on unsafe sexual behavior. MSM, 18 years or older, HIV-negative or of unknown status, were enrolled in five cities of Benin. Intention to use PrEP was assessed through five focus groups (FG). Data were analyzed using manual thematic sorting. Thirty MSM (six per city) participated in the FG. Mean age (standard deviation) was 27.1 (5.0) years. All participants expressed the intention to use PrEP if made available. Facilitators of PrEP use were: availability of medication, safety, absence of constraints as well as freedom to have multiple sex partners and sex with HIV-positive friends. Barriers were: complex procedures for obtaining medication, size and taste of medication, cost of medication, poor PrEP awareness.. Eighteen men admitted that PrEP could lead to decrease in or even abandonment of condom use. In conclusion, MSM showed openness to use PrEP if available, although they recognized that it could lead to risk compensation. [ABSTRACT FROM AUTHOR]
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- 2020
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8. Structural determinants of health: a qualitative study on female sex workers in Benin.
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Dugas, Marylène, Bédard, Emmanuelle, Kpatchavi, Adolphe C., Guédou, Fernand A., Béhanzin, Luc, and Alary, Michel
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CONCEPTUAL structures ,HIV infections ,HUMAN rights ,INTERVIEWING ,SEX work ,WOMEN'S health ,ETHNOLOGY research ,QUALITATIVE research ,SOCIAL support ,SOCIOECONOMIC factors ,HEALTH & social status - Abstract
The objective of this paper is to expose those socio-structural contexts revealing the social injustice and human rights violations that sub-Saharan women face every day when forced into sex work by unemployment or sickness. Results of a qualitative study highlighting some key structural determinants of sex work and HIV infection among FSWs will be presented and examined through the lens of the WHO conceptual framework for action on the social determinants of health. The results showed that most FSWs had lacked the necessary financial support at some point in their lives. Also, both the socioeconomic and political context failed to provide proper support to prevent involvement in sex work and the consequent risks of HIV. The cultural and societal values placed on the health and well-being of FSWs in Benin appear to depend on the degree to which sexual violence and adultery are perceived as a collective social concern. This portrait of FSWs calls for both long-term interventions through a structural determinant approach to HIV prevention, targeting all the women who could face such a financial situation well before their entry into sex work, while maintaining short and medium-term interventions on the intermediary determinants. [ABSTRACT FROM AUTHOR]
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- 2019
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9. Assessing the Potential Impact of Disruptions Due to COVID-19 on HIV Among Key and Lower-Risk Populations in the Largest Cities of Cameroon and Benin.
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Silhol, Romain, Geidelberg, Lily, Mitchell, Kate M., Mishra, Sharmistha, Dimitrov, Dobromir, Bowring, Anna, Béhanzin, Luc, Guédou, Fernand, Diabaté, Souleymane, Schwartz, Sheree, Billong, Serge C., Njindam, Iliassou Mfochive, Levitt, Daniel, Mukandavire, Christinah, Maheu-Giroux, Mathieu, Rönn, Minttu M., Dalal, Shona, Vickerman, Peter, Baral, Stefan, and Alary, Michel
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Supplemental Digital Content is Available in the Text. Background: The COVID-19 pandemic indirectly impacts HIV epidemiology in Central/West Africa. We estimated the potential impact of COVID–19-related disruptions to HIV prevention/treatment services and sexual partnerships on HIV incidence and HIV-related deaths among key populations including female sex workers (FSW), their clients, men who have sex with men, and overall. Setting: Yaoundé (Cameroon) and Cotonou (Benin). Methods: We used mathematical models of HIV calibrated to city population–specific and risk population–specific demographic/behavioral/epidemic data. We estimated the relative change in 1-year HIV incidence and HIV-related deaths for various disruption scenarios of HIV prevention/treatment services and decreased casual/commercial partnerships, compared with a scenario without COVID-19. Results: A 50% reduction in condom use in all partnerships over 6 months would increase 1-year HIV incidence by 39%, 42%, 31%, and 23% among men who have sex with men, FSW, clients, and overall in Yaoundé, respectively, and 69%, 49%, and 23% among FSW, clients, and overall, respectively, in Cotonou. Combining a 6-month interruption of ART initiation and 50% reduction in HIV prevention/treatment use would increase HIV incidence by 50% and HIV-related deaths by 20%. This increase in HIV infections would be halved by a simultaneous 50% reduction in casual and commercial partnerships. Conclusions: Reductions in condom use after COVID-19 would increase infections among key populations disproportionately, particularly FSW in Cotonou, who need uninterrupted condom provision. Disruptions in HIV prevention/treatment services have the biggest impacts on HIV infections and deaths overall, only partially mitigated by equal reductions in casual/commercial sexual partnerships. Maintaining ART provision must be prioritized to minimize short-term excess HIV-related deaths. [ABSTRACT FROM AUTHOR]
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- 2022
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10. Assessing the Potential Impact of Disruptions Due to COVID-19 on HIV Among Key and Lower-Risk Populations in the Largest Cities of Cameroon and Benin.
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Silhol, Romain, Geidelberg, Lily, Mitchell, Kate M., Mishra, Sharmistha, Dimitrov, Dobromir, Bowring, Anna, Béhanzin, Luc, Guédou, Fernand, Diabaté, Souleymane, Schwartz, Sheree, Billong, Serge C., Njindam, Iliassou Mfochive, Levitt, Daniel, Mukandavire, Christinah, Maheu-Giroux, Mathieu, Rönn, Minttu M., Dalal, Shona, Vickerman, Peter, Baral, Stefan, and Alary, Michel
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Background: The COVID-19 pandemic indirectly impacts HIV epidemiology in Central/West Africa. We estimated the potential impact of COVID-19-related disruptions to HIV prevention/treatment services and sexual partnerships on HIV incidence and HIV-related deaths among key populations including female sex workers (FSW), their clients, men who have sex with men, and overall. Setting: Yaoundé (Cameroon) and Cotonou (Benin). Methods: We used mathematical models of HIV calibrated to city population-specific and risk population-specific demographic/behavioral/epidemic data. We estimated the relative change in 1-year HIV incidence and HIV-related deaths for various disruption scenarios of HIV prevention/treatment services and decreased casual/commercial partnerships, compared with a scenario without COVID-19. Results: A 50% reduction in condom use in all partnerships over 6 months would increase 1-year HIV incidence by 39%, 42%, 31%, and 23% among men who have sex with men, FSW, clients, and overall in Yaoundé, respectively, and 69%, 49%, and 23% among FSW, clients, and overall, respectively, in Cotonou. Combining a 6-month interruption of ART initiation and 50% reduction in HIV prevention/treatment use would increase HIV incidence by 50% and HIV-related deaths by 20%. This increase in HIV infections would be halved by a simultaneous 50% reduction in casual and commercial partnerships. Conclusions: Reductions in condom use after COVID-19 would increase infections among key populations disproportionately, particularly FSW in Cotonou, who need uninterrupted condom provision. Disruptions in HIV prevention/treatment services have the biggest impacts on HIV infections and deaths overall, only partially mitigated by equal reductions in casual/commercial sexual partnerships. Maintaining ART provision must be prioritized to minimize short-term excess HIV-related deaths. [ABSTRACT FROM AUTHOR]
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- 2021
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11. Mathematical Model Impact Analysis of a Real-Life Pre-exposure Prophylaxis and Treatment-As-Prevention Study Among Female Sex Workers in Cotonou, Benin.
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Geidelberg, Lily, Mitchell, Kate M., Alary, Michel, Mboup, Aminata, Béhanzin, Luc, Guédou, Fernand, Geraldo, Nassirou, Goma-Matsétsé, Ella, Giguère, Katia, Aza-Gnandji, Marlène, Kessou, Léon, Diallo, Mamadou, Affolabi, Dissou, Diabaté, Souleymane, Gagnon, Marie-Pierre, Zannou, Djimon M., Gangbo, Flore, Silhol, Romain, Cianci, Fiona, and Vickerman, Peter
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Background: Daily pre-exposure prophylaxis (PrEP) and treatment-as-prevention (TasP) reduce HIV acquisition and transmission risk, respectively. A demonstration study (2015-2017) assessed TasP and PrEP feasibility among female sex workers (FSW) in Cotonou, Benin. Setting: Cotonou, Benin. Methods: We developed a compartmental HIV transmission model featuring PrEP and antiretroviral therapy (ART) among the high-risk (FSW and clients) and low-risk populations, calibrated to historical epidemiological and demonstration study data, reflecting observed lower PrEP uptake, adherence and retention compared with TasP. We estimated the population-level impact of the 2-year study and several 20-year intervention scenarios, varying coverage and adherence independently and together. We report the percentage [median, 2.5th-97.5th percentile uncertainty interval (95% UI)] of HIV infections prevented comparing the intervention and counterfactual (2017 coverages: 0% PrEP and 49% ART) scenarios. Results: The 2-year study (2017 coverages: 9% PrEP and 83% ART) prevented an estimated 8% (95% UI 6-12) and 6% (3-10) infections among FSW over 2 and 20 years, respectively, compared with 7% (3-11) and 5% (2-9) overall. The PrEP and TasP arms prevented 0.4% (0.2-0.8) and 4.6% (2.2-8.7) infections overall over 20 years, respectively. Twenty-year PrEP and TasP scale-ups (2035 coverages: 47% PrEP and 88% ART) prevented 21% (17-26) and 17% (10-27) infections among FSW, respectively, and 5% (3-10) and 17% (10-27) overall. Compared with TasP scale-up alone, PrEP and TasP combined scale-up prevented 1.9· and 1.2· more infections among FSW and overall, respectively. Conclusions: The demonstration study impact was modest, and mostly from TasP. Increasing PrEP adherence and coverage improves impact substantially among FSW, but little overall. We recommend TasP in prevention packages. [ABSTRACT FROM AUTHOR]
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- 2021
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12. Outreach Strategies for the Promotion of HIV Testing and Care: Closing the Gap Between Health Services and Female Sex Workers in Benin.
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Dugas, Marylène, Bédard, Emmanuelle, Batona, Georges, Kpatchavi, Adolphe C., Guédou, Fernand A., Dubé, Eric, and Alary, Michel
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- 2015
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