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4. 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

Author

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

Subjects
MSM (Men who have sex with men) -- Health aspects -- Sexual behavior, Health behavior -- Evaluation, HIV infection -- Prevention, Health
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 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., INTRODUCTION To curtail the human immunodeficiency virus (HIV) epidemic across the world, tremendous efforts are being invested in various integrated preventive and treatment interventions. During recent decades, 117 million new [...]

Published
2023
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6. Prevalence and determinants of high-risk human papilloma virus among men who have sex with men in Benin: a cross-sectional study embedded in a demonstration project on pre-exposure prophylaxis against HIV

Author

Diabaté, Souleymane, primary, Behanzin, Luc, additional, Guédou, Fernand, additional, Olodo, Marius, additional, Goma-Matsetse, Aude Ella, additional, Aza-Gnandji, Marlène, additional, Dossouvo, Alban, additional, Akpaca, Axel, additional, Chagas, Elyote, additional, Gangbo, Flore Armande, additional, Zannou, Djimon Marcel, additional, and Alary, Michel, additional

Published
2023
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10. Mathematical Model Impact Analysis of a Real-Life Pre-exposure Prophylaxis and Treatment-As-Prevention Study Among Female Sex Workers in Cotonou, Benin

Author

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, Kêkê, René K., Bachabi, Moussa, Dramane, Kania, Lafrance, Christian, Affolabi, Dissou, Diabaté, Souleymane, Gagnon, Marie-Pierre, Zannou, Djimon M., Gangbo, Flore, Silhol, Romain, Cianci, Fiona, Vickerman, Peter, and Boily, Marie-Claude

Published
2021
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19. 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.

Author

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

Abstract

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.)

Published
2023

20. Monocyte Gene and Molecular Expression Profiles Suggest Distinct Effector and Regulatory Functions in Beninese HIV Highly Exposed Seronegative Female Commercial Sex Workers

Author

Blondin-Ladrie, Laurence, primary, Fourcade, Lyvia, additional, Modica, Alessandro, additional, Aranguren, Matheus, additional, de Montigny, Nicolas, additional, Labbé, Annie-Claude, additional, Alary, Michel, additional, Guédou, Fernand, additional, Poudrier, Johanne, additional, and Roger, Michel, additional

Published
2022
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22. Early antiretroviral therapy and daily pre‐exposure prophylaxis for HIV prevention among female sex workers in Cotonou, Benin: a prospective observational demonstration study

Author

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, and Alary, Michel

Subjects
Cotonou, Benin -- Health aspects, Antiviral agents -- Dosage and administration -- Statistics, Working women -- Drug therapy -- Statistics, Prostitutes -- Drug therapy -- Statistics, HIV infection -- Prevention -- Statistics, Health
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[sup.®]) 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, Introduction In sub‐Saharan Africa, despite all the preventive and therapeutic efforts accomplished so far, the HIV epidemic still persists in key populations. In 2016, approximately 64% of the 5000 new [...]

Published
2018
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26. 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

Author

Silhol, Romain, primary, Geidelberg, Lily, additional, Mitchell, Kate M., additional, Mishra, Sharmistha, additional, Dimitrov, Dobromir, additional, Bowring, Anna, additional, Béhanzin, Luc, additional, Guédou, Fernand, additional, Diabaté, Souleymane, additional, Schwartz, Sheree, additional, Billong, Serge C., additional, Njindam, Iliassou Mfochive, additional, Levitt, Daniel, additional, Mukandavire, Christinah, additional, Maheu-Giroux, Mathieu, additional, Rönn, Minttu M., additional, Dalal, Shona, additional, Vickerman, Peter, additional, Baral, Stefan, additional, Alary, Michel, additional, and Boily, Marie-Claude, additional

Published
2021
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27. Prevalence and factors associated with HIV and sexually transmitted infections among female sex workers in Bamako, Mali

Author

Guédou, Fernand Aimé, Téguété, Ibrahima, Alary, Michel, Tounkara, Fatoumata Korika, Keita, Bintou, Guédou, Fernand Aimé, Téguété, Ibrahima, Alary, Michel, Tounkara, Fatoumata Korika, and Keita, Bintou

Abstract

Background: We aimed to (1) estimate the prevalence of HIV and other sexually transmitted infections (STIs) among female sex workers (FSWs) in Bamako, Mali, and (2) identify factors associated with STIs including HIV infection in this population. Methods: We analyzed baseline data from a prospective observational cohort study on cervical cancer screening, human papillomavirus, and HIV infections among FSWs 18 years or older recruited in Bamako. Multivariable log-binomial regression was used to estimate the adjusted prevalence ratios (APRs) with 95% confidence interval (95% CI) for HIV infection and STIs versus associated factors. Results: Among 353 women participating in the study, mean age was 26.8 (±7.6) years. HIV prevalence was 20.4%, whereas 35.1% of the FSWs had at least one STI. Factors significantly associated with HIV were older age (P < 0.0001, test for trend), duration of sex work ≥6 years (APR, 1.92; 95% CI, 1.22-3.02), uneducated status (APR, 2.24; 95% CI, 1.16-4.34), less than 10 clients in the last 7 days (APR, 1.55; 95% CI, 1.02-2.34), and gonococcal (APR, 1.85; 95% CI, 1.21-2.82) and chlamydial (APR, 2.58; 95% CI, 1.44-4.62) infections. Younger age (P = 0.018, test for trend), having ≥10 clients in the last week (APR, 1.47; 95% CI, 1.11-1.94), and HIV infection (APR, 2.00; 95% CI, 1.49-2.69) were significantly associated with STIs. Conclusions: HIV and curable STI prevalence are high among FSWs in Bamako. There is thus a need to enhance the efficiency of interventions toward FSWs in Mali to reduce the burden of HIV and STIs among them and prevent HIV spread to the general population.

Published
2021

28. HIV prevention and treatment cascades among female sex workers in Benin, West Africa

Author

Guédou, Fernand Aimé, Diabate, Souleymane, Béhanzin, Luc, Kêkê, René Kpèmahouton, Morin, Laurianne, Bushman, Lane, Alary, Michel, Anderson, Peter L., Gangbo, Flore, Nagot, Nicolas, Guédou, Fernand Aimé, Diabate, Souleymane, Béhanzin, Luc, Kêkê, René Kpèmahouton, Morin, Laurianne, Bushman, Lane, Alary, Michel, Anderson, Peter L., Gangbo, Flore, and Nagot, Nicolas

Abstract

Background & Objectives Benin has a long-standing history of HIV prevention programs aimed at female sex workers (FSWs). We used data from a national survey among FSWs (2017) to assess the prevention and care cascades in this population. Methods FSWs were recruited through cluster sampling of sex work sites. A questionnaire was administered, and HIV tested. HIV-positive participants were asked to provide dried-blood spots (DBS), tested for ARV and viral load. We assessed two prevention cascades (HIV testing and safer sex) and the treatment cascade, using a combination of self-reported and biological variables. Results Mean age of the 1086 FSWs was 30 years. Half of them were Beninese and two-thirds had a primary school education level or less. Almost all FSWs had ever heard of HIV/AIDS. 79.1% had ever been tested, and 84.1% of the latter had been tested in the last year. In the previous six months, 90.1% were exposed to prevention messages. Women exposed to any HIV prevention message reported a higher level of consistent condom use in the last month (69.0%) than those who were not (48.5%, p<0.0001). HIV prevalence was 7.7%. Among HIV-positive women, 60.6% knew their status; among those, 90.5% were on ARV and 81.8% of them had a suppressed viral load. Conclusions Despite long-standing HIV prevention programs for FSWs, the prevention indicators were often low. Linkage to care was good, viral suppression was sub-optimal, but knowledge of HIV-positive status was low. Exposing women to prevention messages is necessary, as to increase HIV testing.

Published
2021

29. Reproductive History and Pregnancy Incidence of Malian and Beninese Sex Workers Before and Suring Sex Work Practice

Author

Sullivan, Gentiane Perrault, primary, Guédou, Fernand Aimé, additional, Tounkara, Fatoumata Korika, additional, Béhanzin, Luc, additional, Camara, Nana, additional, Aza-Gnandji, Marlène, additional, Dembele, Bintou Keita, additional, Azonnadou, Odette, additional, Théra, Ismaila, additional, Avery, Lisa, additional, and Alary, Michel, additional

Published
2021
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31. 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.

Author

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

Published
2022
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33. Human papillomavirus genotype distribution and factors associated among female sex workers in West Africa

Author

Tounkara, Fatoumata Korika, primary, Téguété, Ibrahima, additional, Guédou, Fernand A., additional, Goma-Matsétsé, Ella, additional, Koné, Amadou, additional, Béhanzin, Luc, additional, Traoré, Sidy, additional, Aza-Gnandji, Marlène, additional, Keita, Bintou, additional, Guenoun, Julie, additional, Coutlée, François, additional, and Alary, Michel, additional

Published
2020
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34. Mathematical Model Impact Analysis of a Real-Life Pre-exposure Prophylaxis and Treatment-As-Prevention Study Among Female Sex Workers in Cotonou, Benin

Author

Geidelberg, Lily, primary, Mitchell, Kate M., additional, Alary, Michel, additional, Mboup, Aminata, additional, Béhanzin, Luc, additional, Guédou, Fernand, additional, Geraldo, Nassirou, additional, Goma-Matsétsé, Ella, additional, Giguère, Katia, additional, Aza-Gnandji, Marlène, additional, Kessou, Léon, additional, Diallo, Mamadou, additional, Kêkê, René K., additional, Bachabi, Moussa, additional, Dramane, Kania, additional, Lafrance, Christian, additional, Affolabi, Dissou, additional, Diabaté, Souleymane, additional, Gagnon, Marie-Pierre, additional, Zannou, Djimon M., additional, Gangbo, Flore, additional, Silhol, Romain, additional, Cianci, Fiona, additional, Vickerman, Peter, additional, and Boily, Marie-Claude, additional

Published
2020
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35. Natural killer cell phenotype is altered in HIV-exposed seronegative women

Author

Zhao, Nancy Q., primary, Vendrame, Elena, additional, Ferreira, Anne-Maud, additional, Seiler, Christof, additional, Ranganath, Thanmayi, additional, Alary, Michel, additional, Labbé, Annie-Claude, additional, Guédou, Fernand, additional, Poudrier, Johanne, additional, Holmes, Susan, additional, Roger, Michel, additional, and Blish, Catherine A., additional

Published
2020
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36. Overview and factors associated with pregnancies and abortions occurring in sex workers in Benin

Author

Sullivan, Gentiane Perrault, primary, Guédou, Fernand Aimé, additional, Batona, Georges, additional, Kintin, Frédéric, additional, Béhanzin, Luc, additional, Avery, Lisa, additional, Bédard, Emmanuelle, additional, Gagnon, Marie-Pierre, additional, Zannou, Djimon Marcel, additional, Kpatchavi, Adolphe, additional, and Alary, Michel, additional

Published
2020
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40. Acceptability of pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) in Benin : a qualitative study

Author

Gning, Ndeye Ndiagna, Guédou, Fernand Aimé, Diabate, Souleymane, Hessou, Septime, Batona, Georges, Béhanzin, Luc, Alary, Michel, Ahouada, Carin, Zannou, Marcel D., Gning, Ndeye Ndiagna, Guédou, Fernand Aimé, Diabate, Souleymane, Hessou, Septime, Batona, Georges, Béhanzin, Luc, Alary, Michel, Ahouada, Carin, and Zannou, Marcel D.

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.

Published
2020

41. HIV treatment response among female sex workers participating in a treatment as prevention demonstration project in Cotonou, Benin

Author

Diallo, Mamadou, primary, Béhanzin, Luc, additional, Guédou, Fernand A., additional, Geraldo, Nassirou, additional, Goma-Matsétsé, Ella, additional, Kania, Dramane, additional, Kêkê, René Kpèmahouton, additional, Bachabi, Moussa, additional, Affolabi, Dissou, additional, Diabaté, Souleymane, additional, Gangbo, Flore, additional, Zannou, Marcel Djimon, additional, and Alary, Michel, additional

Published
2020
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42. A Mathematical Model Impact Analysis of a Pre-Exposure Prophylaxis and Treatment-As-Prevention Study Among Female Sex Workers in Cotonou, Benin

Author

Geidelberg, Lily, primary, Mitchell, Kate M., additional, Alary, Michel, additional, Mboup, Aminata, additional, Béhanzin, Luc, additional, Guédou, Fernand, additional, Geraldo, Nassirou, additional, Goma-Matsétsé, Ella, additional, Giguère, Katia, additional, Aza-Gnandji, Marlène, additional, Kessou, Léon, additional, Diallo, Mamadou, additional, Kêkê, René K., additional, Bachabi, Moussa, additional, Dramane, Kania, additional, Lafrance, Christian, additional, Affolabi, Dissou, additional, Diabaté, Souleymane, additional, Gagnon, Marie-Pierre, additional, Zannou, Djimon M., additional, Gangbo, Flore, additional, Silhol, Romain, additional, Cianci, Fiona, additional, Vickerman, Peter, additional, and Boily, Marie-Claude, additional

Published
2020
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43. Overview and factors associated with pregnancies and abortions occurring in sex workers in Benin

Author

Sullivan, Gentiane Perrault, primary, Guédou, Fernand Aimé, additional, Batona, Georges, additional, Kintin, Frédéric, additional, Béhanzin, Luc, additional, Avery, Lisa, additional, Bédard, Emmanuelle, additional, Gagnon, Marie-Pierre, additional, Zannou, Djimon Marcel, additional, Kpatchavi, Adolphe, additional, and Alary, Michel, additional

Published
2019
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44. TIGIT is upregulated by HIV-1 infection and marks a highly functional adaptive and mature subset of natural killer cells

Author

Vendrame, Elena, primary, Seiler, Christof, additional, Ranganath, Thanmayi, additional, Zhao, Nancy Q., additional, Vergara, Rosemary, additional, Alary, Michel, additional, Labbé, Annie-Claude, additional, Guédou, Fernand, additional, Poudrier, Johanne, additional, Holmes, Susan, additional, Roger, Michel, additional, and Blish, Catherine A., additional

Published
2019
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48. P719 Prevalence and type-specific distribution of oncogenic human papillomavirus among female sex workers in cotonou, west africa

Author

Guédou, Fernand, primary, Béhanzin, Luc, additional, Goma-Matsétsé, Ella, additional, Aza-Gnandji, Marlène, additional, Geraldo, Nassirou, additional, Tounkara, Fatoumata Korika, additional, Guenoun, Julie, additional, Coutlée, François, additional, Hounkpatin, Benjamin, additional, and Alary, Michel, additional

Published
2019
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49. P701 Time trends in prevalence and incidence of HIV, gonorrhea and chlamydia among female sex workers in benin, 2008–2018

Author

Alary, Michel, primary, Béhanzin, Luc, additional, Guédou, Fernand, additional, Goma-Matsétsé, Ella, additional, Aza-Gnandji, Marlène, additional, Zannou, Djimon Marcel, additional, Diabaté, Souleymane, additional, Affolabi, Dissou, additional, Kêkê, René, additional, Bachabi, Moussa, additional, and Gangbo, Flore, additional

Published
2019
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