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1. What is the effect of self-identified HIV activism in willingness to participate in HIV cure-related clinical trials? Results from the ANRS-APSEC study

Author: Marion Fiorentino, Christel Protière, Luis Sagaon-Teyssier, Mohamed Mimi, Lisa Fressard, MichaelP Arnold, Olivier Lambotte, Janine Barbot, Sylvie Fainzang, Laurence Meyer, Cécile Goujard, Marie Préau, Bruno Spire, and Marie Suzan-Monti
Subjects: willingness to participate in clinical trials, cure trial, HIV, activism, cure research, France, Microbiology, QR1-502, Public aspects of medicine, RA1-1270
Abstract: Objectives: Enrolling people living with HIV with undetectable viral load into HIV cure-related clinical trials (HCRCT) is challenging. Few data are currently available about the individual factors that influence willingness to participate in HCRCT (WPHCRCT). We hypothesised that WPHCRCT would be more frequent among people living with HIV considering themselves HIV activists. The objective of this study was to investigate the individual characteristics associated with both WPHCRCT and self-identification as an HIV activist. Methods: The study enrolled 195 long-term ART-treated and virologically suppressed people living with HIV, followed-up in 19 French HIV services, 2016–2017. A Bayesian model averaging approach was used to assess correlates of both outcomes i.e. WPHCRCT and self-identified HIV activism. Results: WPHCRCT was reported by 43% of participants and was positively associated with self-identification as an HIV activist (adjusted odds ratio [aOR] 2.90 95% confidence interval [CI] 2.17–3.63], P0.75, indicating strong evidence. Conclusions: WPHCRCT is strongly related to HIV activism, and also to positive psychosocial characteristics as a person living with HIV, especially regarding relationships with others. The desire to contribute to the fight against HIV for the sake of the HIV community and society should be taken into account to improve participation in upcoming HCRCT.
Published: 2019
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2. A generalized additive model to disentangle age and diagnosis-specific cohort effects in psychological and behavioral outcomes in people living with HIV: the French cross-sectional ANRS-VESPA2 survey

Author: Luis Sagaon-Teyssier, Antoine Vilotitch, Marion Mora, Gwenaëlle Maradan, Valérie Guagliardo, Marie Suzan-Monti, Rosemary Dray-Spira, Bruno Spire, and VESPA2 study group
Subjects: Age, Cohort effects, Quality of life, Material and moral support, HIV-status disclosure, Semi-parametric GAM, Public aspects of medicine, RA1-1270
Abstract: Abstract Background Unlike their younger counterparts, some of today’s older HIV patients were diagnosed before the advent of highly active antiretroviral therapy (HAART). The psychosocial and behavioral outcomes of people living with HIV (PLWH) have been widely studied, and associated factors are well known. However, their evolution both in terms of age and diagnosis-specific cohort effects is not well understood. Methods Data from the ANRS-VESPA2 cross-sectional survey, representative of French PLWH, were used to investigate whether psychosocial and behavioral outcomes such as quality of life, need for support and HIV status disclosure, evolve under both the influence of patients’ age and diagnosis-specific cohort effects. A semi-parametric generalized additive model (GAM) was employed. The physical and mental components of health-related quality of life, the need for material and moral support, and HIV-status disclosure, constituted our outcomes. Results Non-linear diagnosis-specific cohort effects were found for physical and mental QoL and HIV-status disclosure. Overall, physical QoL was better in recently diagnosed patients than in those diagnosed in the early 1980s. An increasing influence of diagnosis-specific cohort effects between 1983 and 1995 was observed. No cohort effects were noticeable between 1996 and 2000, while an increasing influence was apparent for patients diagnosed with HIV from 2000 to 2011 (year of study). For mental QoL, the only increase was observed in participants diagnosed with HIV between 1983 and 2000. The relationship between diagnosis-specific cohort effects and HIV status disclosure was negative overall: participants diagnosed after 2000 were much less likely to disclose than those diagnosed before 1995. The effect of age was significantly associated with all outcomes, with a non-linear influence on mental QoL and with the need for material/moral support. Conclusions Psychosocial and behavioral outcomes are complex processes which can be explained in different ways by a combination of the clinical and social contexts which PLWH are exposed to at the time of diagnosis, and by developmental characteristics. A greater understanding of these processes could inform healthcare policy-making for specific HIV generations and different HIV age groups.
Published: 2019
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3. Intimate partner violence against HIV-positive Cameroonian women: Prevalence, associated factors and relationship with antiretroviral therapy discontinuity—results from the ANRS-12288 EVOLCam survey

Author: Marion Fiorentino, Luis Sagaon-Teyssier, Khadim Ndiaye, Marie Suzan-Monti, Marie-Thérèse Mengue, Laurent Vidal, Christopher Kuaban, Laura March, Christian Laurent, Bruno Spire, and Sylvie Boyer
Subjects: Medicine
Abstract: Background: Intimate partner violence in its various forms increases HIV exposure in female victims and potentially jeopardizes the HIV treatment cascade, for instance, by impeding engagement in and adherence to care. Elevated rates of HIV and intimate partner violence are reported in Central Africa. Evidence on the effect of intimate partner violence on antiviral therapy interruption is lacking in Cameroon, where only 330,000 women live with HIV and only 19% of HIV-positive people are virally suppressed. This study aimed to assess the prevalence and factors of intimate partner violence against HIV-positive women and its relationship with antiretroviral therapy interruption ⩾1 month. Methods: The EVOLCam cross-sectional survey was conducted in 19 hospitals in the Center and Littoral regions. The study sample comprised antiviral therapy–treated women declaring at least one sexual partner in the previous year. Scores of recent emotional, physical, extreme physical and sexual intimate partner violence were built using principal component analysis and categorized under no, occasional or frequent intimate partner violence. Multivariate logistic analyses were performed to investigate the relationship between intimate partner violence and recent antiretroviral therapy interruption ⩾1 month, and associated factors. Results: Among the 894 analyzed women, the prevalence of intimate partner violence was 29% (emotional), 22% (physical), 13% (extreme physical) and 18% (sexual). Frequent physical intimate partner violence was a significant risk factor of antiretroviral therapy interruption ⩾1 month (adjusted odds ratio = 2.42 (95% confidence interval = 1.00; 5.87)). It was also associated with HIV-related stigma (2.53 (1.58; 4.02)), living with a main partner (2.03 (1.20; 3.44) and non-defensive violence against this partner (5.75 (3.53; 9.36)). Conclusion: Intimate partner violence is a potential barrier to antiviral therapy continuity and aggravates vulnerability of Cameroonian HIV-positive women. The prevention and detection of intimate partner violence by HIV services might help to reach the last “90” of the 90-90-90 targets.
Published: 2019
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4. Pleasure and PrEP: Pleasure-Seeking Plays a Role in Prevention Choices and Could Lead to PrEP Initiation

Author: Xavier Mabire, Costanza Puppo, Stéphane Morel, Marion Mora, Daniela Rojas Castro, Julie Chas, Eric Cua, Claire Pintado, Marie Suzan-Monti, Bruno Spire, Jean-Michel Molina, and Marie Préau
Subjects: Medicine
Abstract: 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.
Published: 2019
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5. Characterization of Physicians That Might Be Reluctant to Propose HIV Cure-Related Clinical Trials with Treatment Interruption to Their Patients? The ANRS-APSEC Study

Author: Christel Protiere, Lisa Fressard, Marion Mora, Laurence Meyer, Marie Préau, Marie Suzan-Monti, Jean-Daniel Lelièvre, Olivier Lambotte, Bruno Spire, and the APSEC Study Group
Subjects: HIV cure research, HIV cure-related clinical trials, physicians, viewpoints, analytical treatment interruption studies, principal component analysis, Medicine
Abstract: HIV cure-related clinical trials (HCRCT) with analytical antiretroviral treatment interruptions (ATIs) have become unavoidable. However, the limited benefits for participants and the risk of HIV transmission during ATI might negatively impact physicians’ motivations to propose HCRCT to patients. Between October 2016 and March 2017, 164 French HIV physicians were asked about their level of agreement with four viewpoints regarding HCRCT. A reluctance score was derived from their answers and factors associated with reluctance identified. Results showed the highest reluctance to propose HCRCT was among physicians with a less research-orientated professional activity, those not informing themselves about cure trials through scientific literature, and those who participated in trials because their department head asked them. Physicians’ perceptions of the impact of HIV on their patients’ lives were also associated with their motivation to propose HCRCT: those who considered that living with HIV means living with a secret were more motivated, while those worrying about the negative impact on person living with HIV’s professional lives were more reluctant. Our study highlighted the need to design a HCRCT that minimizes constraints for participants and for continuous training programs to help physicians keep up-to-date with recent advances in HIV cure research.
Published: 2020
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6. Suicide risk in a representative sample of people receiving HIV care: Time to target most-at-risk populations (ANRS VESPA2 French national survey).

Author: Maria Patrizia Carrieri, Fabienne Marcellin, Lisa Fressard, Marie Préau, Luis Sagaon-Teyssier, Marie Suzan-Monti, Valérie Guagliardo, Marion Mora, Perrine Roux, Rosemary Dray-Spira, Bruno Spire, and ANRS-VESPA2 Study Group
Subjects: Medicine, Science
Abstract: BACKGROUND:Suicide risk is high among people living with HIV (PLHIV). This study aimed to identify major correlates of suicide risk in a representative sample of PLHIV in France, in order to help target individuals who would benefit from suicide risk screening and psychiatric care. METHODS:The ANRS VESPA2 cross-sectional survey (April 2011-January 2012) collected socio-demographic, medical and behavioral data from 3,022 PLHIV recruited in 73 French HIV hospital departments. The study sample comprised the 2,973 participants with available self-reported data on suicide risk (defined as having either thought about and planned to commit suicide during the previous 12 months or attempted suicide during the same period of time) and medical data on comorbidities. Weighted Poisson models adjusted for HCV co-infection and significant clinical variables were used to estimate the relationship between suicide risk and HIV transmission groups, experience with HIV disease and other psychosocial factors. RESULTS:Suicide risk was reported by 6.3% of PLHIV in the study sample. After adjustment for HIV immunological status and HCV co-infection, women (IRR [95%CI]:1.93 [1.17; 3.19]) and men who have sex with men (MSM) (1.97 [1.22; 3.19]) had a higher suicide risk than the rest of the sample. Moreover, the number of discrimination-related social contexts reported (1.39 [1.19; 1.61]), homelessness (4.87 [1.82; 13.02]), and reporting a feeling of loneliness (4.62 [3.06; 6.97]) were major predictors of suicide risk. CONCLUSIONS:Reducing the burden of precarious social conditions and discrimination is an important lever for preventing suicide risk among PLHIV in France. Comprehensive care models involving peer/community social interventions targeted at women and MSM need to be implemented to lower the risk of suicide in these specific subgroups of PLHIV.
Published: 2017
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7. Patterns of patient and healthcare provider viewpoints regarding participation in HIV cure-related clinical trials. Findings from a multicentre French survey using Q methodology (ANRS-APSEC).

Author: Christel Protière, Bruno Spire, Marion Mora, Isabelle Poizot-Martin, Marie Préau, Marjolaine Doumergue, Philippe Morlat, David Zucman, Cécile Goujard, François Raffi, Olivier Lambotte, and Marie Suzan-Monti
Subjects: Medicine, Science
Abstract: Despite huge advances in the fight against HIV concerning diagnosis, clinical efficacy of antiretroviral treatments (ART), patient survival and quality of life, there is still no cure. Recent developments in HIV cure research have opened the way for clinical trials which could lead to a temporary or definitive end to ART. However, ethical questions exist about related trial-participation risks. The main goal of the ANRS-APSEC survey was, using Q-methodology, to investigate the viewpoints of people living with HIV (PLWH) and HIV healthcare providers (HHP) regarding motivations for and barriers to participation in HIV Cure-related clinical trials (HCRCT).Thirty-three statements were defined encompassing seven dimensions: treatment and follow-up; risks; benefits; patient-physician relationship; beliefs and attitudes; information; target population. Forty-one PLWH and 41 HHP from five French HIV services were asked to rank-order the statements.Five main viewpoints were elicited from "the most motivated" to "the most reluctant" vis-à-vis HCRCT participation. All placed importance on the wish to participate in HIV research. This result is in line with the HIV-specific culture of joint mobilization. For some viewpoints, the motivation to participate in/propose HCRCT was primarily conditioned by side-effects and/or by constraints, which overall were more accepted by PLWH than HHP. Some viewpoints placed particular importance on HCRCT recruitment strategies. Finally, some expressed a high acceptance of risks and constraints but emphasized the need for information.HIV cure research clinical trials (HCRCT) constitute a risky yet unavoidable step towards the goal of finding a cure. To improve future HCRCT and informed consent designs, based on PLWH and HHP preferences and expectations, we need greater knowledge about how these populations perceive the risks and the benefits of HCRCT. Our results confirmed the importance of careful, studied HCRCT design, management and communication, to ensure PLWH and HHP acceptability and convergence of their expectations.
Published: 2017
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8. Sexual risk behaviour among people living with HIV according to the biomedical risk of transmission: results from the ANRS‐VESPA2 survey

Author: Marie Suzan‐Monti, Nicolas Lorente, Baptiste Demoulin, Fabienne Marcellin, Marie Préau, Rosemary Dray‐Spira, France Lert, Bruno Spire, and the ANRS‐VESPA2 Study Group
Subjects: HIV, successful ART, biomedical risk of HIV transmission, sexual risk behaviour, Immunologic diseases. Allergy, RC581-607
Abstract: Introduction People living with HIV (PLHIV) on antiretroviral therapy (ART), with sustained undetectable viral load (sUVL) and no history of sexually transmitted infections for at least six months, are considered to have a low risk of HIV transmission (LRT). We aimed to characterize, in a representative sample of French PLHIV, the sexual behaviour of LRT PLHIV compared with non‐LRT PLHIV. Methods The cross‐sectional ANRS‐VESPA2 survey was conducted on adult PLHIV attending French hospitals in 2011. The LRT PLHIV group included participants with sUVL and no sexually transmitted infection for at least 12 months. Socio‐behavioural and medical data were collected. Chi‐square tests helped compare sexual risk indicators between LRT and non‐LRT PLHIV. The survey's retrospective nature allowed us to perform complementary category‐based analyses of LRT PLHIV according to whether they had sUVL for at least 18, 24 or 36 months in three socio‐epidemiological groups: men who have sex with men (MSM), other men and women. Results Analysis included 2638 PLHIV diagnosed >12 months with available viral load data. The proportion of LRT PLHIV varied from 58% (≥12 months sUVL) to 38% (≥36 months sUVL). Irrespective of sUVL duration, we found the following: 1) LRT men (MSM and other men) were more likely to report having no sexual partner than their non‐LRT counterparts. Among men having sexual partners in the previous 12 months, no significant difference was seen between LRT and non‐LRT men in the number of sexual partners. LRT women were less likely to report having more than one sexual partner than non‐LRT women; 2) LRT MSM were more likely to report being in sexually inactive couples than their non‐LRT counterparts; 3) among sexually active participants, no difference was observed between LRT and non‐LRT PLHIV concerning condom use with their serodiscordant steady partner or with their most recent casual sexual partners. Conclusions LRT PLHIV with sUVL ≥12 months did not report more sexual risk behaviours than their non‐LRT counterparts. Because the same result was obtained for those having a sUVL ≥36 months, the hypothesis of increased sexual risk behaviour over time in PLHIV meeting non‐transmission biomedical criteria is not supported.
Published: 2016
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9. Increased Uptake of HCV Testing through a Community-Based Educational Intervention in Difficult-to-Reach People Who Inject Drugs: Results from the ANRS-AERLI Study.

Author: Perrine Roux, Daniela Rojas Castro, Khadim Ndiaye, Marie Debrus, Camélia Protopopescu, Jean-Marie Le Gall, Aurélie Haas, Marion Mora, Bruno Spire, Marie Suzan-Monti, and Patrizia Carrieri
Subjects: Medicine, Science
Abstract: AIMS:The community-based AERLI intervention provided training and education to people who inject drugs (PWID) about HIV and HCV transmission risk reduction, with a focus on drug injecting practices, other injection-related complications, and access to HIV and HCV testing and care. We hypothesized that in such a population where HCV prevalence is very high and where few know their HCV serostatus, AERLI would lead to increased HCV testing. METHODS:The national multisite intervention study ANRS-AERLI consisted in assessing the impact of an injection-centered face-to-face educational session offered in volunteer harm reduction (HR) centers ("with intervention") compared with standard HR centers ("without intervention"). The study included 271 PWID interviewed on three occasions: enrolment, 6 and 12 months. Participants in the intervention group received at least one face-to-face educational session during the first 6 months. MEASUREMENTS:The primary outcome of this analysis was reporting to have been tested for HCV during the previous 6 months. Statistical analyses used a two-step Heckman approach to account for bias arising from the non-randomized clustering design. This approach identified factors associated with HCV testing during the previous 6 months. FINDINGS:Of the 271 participants, 127 and 144 were enrolled in the control and intervention groups, respectively. Of the latter, 113 received at least one educational session. For the present analysis, we selected 114 and 88 participants eligible for HCV testing in the control and intervention groups, respectively. In the intervention group, 44% of participants reported having being tested for HCV during the previous 6 months at enrolment and 85% at 6 months or 12 months. In the control group, these percentages were 51% at enrolment and 78% at 12 months. Multivariable analyses showed that participants who received at least one educational session during follow-up were more likely to report HCV testing, compared with those who did not receive any intervention (95%[CI] = 4.13[1.03;16.60]). CONCLUSION:The educational intervention AERLI had already shown efficiency in reducing HCV at-risk practices and associated cutaneous complications and also seems to have a positive impact in increasing HCV testing in PWID.
Published: 2016
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10. Correction: Expanding Access to Non-Medicalized Community-Based Rapid Testing to Men Who Have Sex with Men: An Urgent HIV Prevention Intervention (The ANRS-DRAG Study).

Author: Nicolas Lorente, Marie Preau, Chantal Vernay-Vaisse, Marion Mora, Jerome Blanche, Joanne Otis, Alain Passeron, Jean-Marie Le Gall, Philippe Dhotte, Maria Patrizia Carrieri, Marie Suzan-Monti, and Bruno Spire
Subjects: Medicine, Science
Published: 2013
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11. Impact of HIV comprehensive care and treatment on serostatus disclosure among Cameroonian patients in rural district hospitals.

Author: Marie Suzan-Monti, Charles Kouanfack, Sylvie Boyer, Jérôme Blanche, Renée-Cécile Bonono, Eric Delaporte, Patrizia M Carrieri, Jean-Paul Moatti, Christian Laurent, Bruno Spire, and Stratall ANRS 12-110/ESTHER Study Group
Subjects: Medicine, Science
Abstract: This work aimed to analyze the rate of disclosure to relatives and friends over time and to identify factors affecting disclosure among seropositive adults initiating antiretroviral therapy (ART) in rural district hospitals in the context of decentralized, integrated HIV care and task-shifting to nurses in Cameroon. Stratall was a 24-month, randomized, open-label trial comparing the effectiveness of clinical monitoring alone with laboratory plus clinical monitoring on treatment outcomes. It enrolled 459 HIV-infected ART-naive adults in 9 rural district hospitals in Cameroon. Participants in both groups were sometimes visited by nurses instead of physicians. Patients with complete data both at enrolment (M0) and at least at one follow-up visit were included in the present analysis. A mixed Poisson regression was used to estimate predictors of the evolution of disclosure index over 24 months (M24).The study population included 385 patients, accounting for 1733 face-to-face interviews at follow-up visits from M0 to M24. The median [IQR] number of categories of relatives and friends to whom patients had disclosed was 2 [1]-[3] and 3 [2]-[5] at M0 and M24 (p-trend
Published: 2013
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12. Expanding access to non-medicalized community-based rapid testing to men who have sex with men: an urgent HIV prevention intervention (the ANRS-DRAG study).

Author: Nicolas Lorente, Marie Preau, Chantal Vernay-Vaisse, Marion Mora, Jerome Blanche, Joanne Otis, Alain Passeron, Jean-Marie Le Gall, Philippe Dhotte, Maria Patrizia Carrieri, Marie Suzan-Monti, Bruno Spire, and ANRS-DRAG Study Group
Subjects: Medicine, Science
Abstract: BACKGROUND: Little is known about the public health benefits of community-based, non-medicalized rapid HIV testing offers (CBOffer) specifically targeting men who have sex with men (MSM), compared with the standard medicalized HIV testing offer (SMOffer) in France. This study aimed to verify whether such a CBOffer, implemented in voluntary counselling and testing centres, could improve access to less recently HIV-tested MSM who present a risk behaviour profile similar to or higher than MSM tested with the SMOffer. METHOD: This multisite study enrolled MSM attending voluntary counselling and testing centres' during opening hours in the SMOffer. CBOffer enrolees voluntarily came to the centres outside of opening hours, following a communication campaign in gay venues. A self-administered questionnaire was used to investigate HIV testing history and sexual behaviours including inconsistent condom use and risk reduction behaviours (in particular, a score of "intentional avoidance" for various at-risk situations was calculated). A mixed logistic regression identified factors associated with access to the CBOffer. RESULTS: Among the 330 participants, 64% attended the CBOffer. Percentages of inconsistent condom use in both offers were similar (51% CBOffer, 50% SMOffer). In multivariate analyses, those attending the CBOffer had only one or no test in the previous two years, had a lower intentional avoidance score, and met more casual partners in saunas and backrooms than SMOffer enrolees. CONCLUSION: This specific rapid CBOffer attracted MSM less recently HIV-tested, who presented similar inconsistent condom use rates to SMOffer enrolees but who exposed themselves more to HIV-associated risks. Increasing entry points for HIV testing using community and non-medicalized tests is a priority to reach MSM who are still excluded.
Published: 2013
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13. Structural studies of the giant mimivirus.

Author: Chuan Xiao, Yurii G Kuznetsov, Siyang Sun, Susan L Hafenstein, Victor A Kostyuchenko, Paul R Chipman, Marie Suzan-Monti, Didier Raoult, Alexander McPherson, and Michael G Rossmann
Subjects: Biology (General), QH301-705.5
Abstract: Mimivirus is the largest known virus whose genome and physical size are comparable to some small bacteria, blurring the boundary between a virus and a cell. Structural studies of Mimivirus have been difficult because of its size and long surface fibers. Here we report the use of enzymatic digestions to remove the surface fibers of Mimivirus in order to expose the surface of the viral capsid. Cryo-electron microscopy (cryoEM) and atomic force microscopy were able to show that the 20 icosahedral faces of Mimivirus capsids have hexagonal arrays of depressions. Each depression is surrounded by six trimeric capsomers that are similar in structure to those in many other large, icosahedral double-stranded DNA viruses. Whereas in most viruses these capsomers are hexagonally close-packed with the same orientation in each face, in Mimivirus there are vacancies at the systematic depressions with neighboring capsomers differing in orientation by 60 degrees . The previously observed starfish-shaped feature is well-resolved and found to be on each virus particle and is associated with a special pentameric vertex. The arms of the starfish fit into the gaps between the five faces surrounding the unique vertex, acting as a seal. Furthermore, the enveloped nucleocapsid is accurately positioned and oriented within the capsid with a concave surface facing the unique vertex. Thus, the starfish-shaped feature and the organization of the nucleocapsid might regulate the delivery of the genome to the host. The structure of Mimivirus, as well as the various fiber components observed in the virus, suggests that the Mimivirus genome includes genes derived from both eukaryotic and prokaryotic organisms. The three-dimensional cryoEM reconstruction reported here is of a virus with a volume that is one order of magnitude larger than any previously reported molecular assembly studied at a resolution of equal to or better than 65 Angstroms.
Published: 2009
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14. Ultrastructural characterization of the giant volcano-like virus factory of Acanthamoeba polyphaga Mimivirus.

Author: Marie Suzan-Monti, Bernard La Scola, Lina Barrassi, Leon Espinosa, and Didier Raoult
Subjects: Medicine, Science
Abstract: Acanthamoeba polyphaga Mimivirus is a giant double-stranded DNA virus defining a new genus, the Mimiviridae, among the Nucleo-Cytoplasmic Large DNA Viruses (NCLDV). We used utrastructural studies to shed light on the different steps of the Mimivirus replication cycle: entry via phagocytosis, release of viral DNA into the cell cytoplasm through fusion of viral and vacuolar membranes, and finally viral morphogenesis in an extraordinary giant cytoplasmic virus factory (VF). Fluorescent staining of the AT-rich Mimivirus DNA showed that it enters the host nucleus prior to the generation of a cytoplasmic independent replication centre that forms the core of the VF. Assembly and filling of viral capsids were observed within the replication centre, before release into the cell cytoplasm where progeny virions accumulated. 3D reconstruction from fluorescent and differential contrast interference images revealed the VF emerging from the cell surface as a volcano-like structure. Its size dramatically grew during the 24 h infectious lytic cycle. Our results showed that Mimivirus replication is an extremely efficient process that results from a rapid takeover of cellular machinery, and takes place in a unique and autonomous giant assembly centre, leading to the release of a large number of complex virions through amoebal lysis.
Published: 2007
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15. Sex work among female workers in the traditional mining sector in Mali – results from the ANRS-12339 Sanu Gundo cross-sectional study in 2015

Author: Cheick Haïballa Kounta, Luis Sagaon-Teyssier, Fodié Diallo, Bruno Spire, Marie Suzan-Monti, Nikos Kalampalikis, Bintou Dembélé Keita, Hubert Balique, Marion Mora, Michel Bourrelly, Kalampalikis, Nikos, 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), ARCAD-SIDA [Bamako, Mali], Université Lumière - Lyon 2 (UL2), Groupe de Recherche en Psychologie Sociale (GRePS), and ANRS-12339 Sanu Gundo
Subjects: Safe Sex, Cross-sectional study, Human immunodeficiency virus (HIV), [SHS.PSY]Humanities and Social Sciences/Psychology, HIV Infections, Mali, urologic and male genital diseases, medicine.disease_cause, miners, [SHS]Humanities and Social Sciences, West africa, Condoms, 0302 clinical medicine, 5. Gender equality, immune system diseases, Surveys and Questionnaires, Prevalence, 030212 general & internal medicine, virus diseases, Female sex, female sex workers, female non-sex workers, miners, Mali, STI/ HIV, West Africa, General Medicine, Sexual Partners, Infectious Diseases, Geography, population characteristics, Female, female non-sex workers, [SHS] Humanities and Social Sciences, 0305 other medical science, Adult, Gold mining, Adolescent, [SHS.PSY] Humanities and Social Sciences/Psychology, Young Adult, 03 medical and health sciences, Virology, Environmental health, West Africa, medicine, Humans, Poverty, female sex workers, Sex work, Sex Workers, 030505 public health, Unsafe Sex, business.industry, Public Health, Environmental and Occupational Health, HIV, social sciences, Sex Work, Cross-Sectional Studies, Logistic Models, STI, business, Very high risk
Abstract: Female sex workers (FSW) in mining sites are considered to be at very high risk of HIV infection. We aimed to characterize FSW at the Kôkôyô artisanal gold mining site in Mali, and identify factors associated with sex work using data from ANRS-12339 Sanu Gundo, a cross-sectional survey conducted in 2015 at the mine by ARCAD-SIDA, a Malian non-governmental organisation. People attending HIV-prevention activities were invited to participate in the quantitative and qualitative parts of the survey. A probit logistic regression was used for data analysis. Of 101 women who participated in the survey, 26.7% reported sex work as their main activity. Multivariate analysis showed that the probability of sex work as a main activity decreased by 1% per 1-year age increase (p = 0.020). Sex work was significantly more likely to be reported by single, divorced and widowed women (25.4% probability; p = 0.007). FSW were significantly more likely to be non-Malian (36.3% probability; p = 0.003), more likely to have a secondary activity (77% probability; p = 0.002), to work fewer than 56h/week (40.2% probability; p = 0.001) and to be in good health (12.1% probability; p = 0.016). In addition, being aware of the existence of sexually transmitted infection, using psychoactive substances, and having unprotected receptive anal sex during the previous six months were significantly associated with sex work (50.2%; p = 0.006; 45.6%, p = 0.003; and 7.4%, p = 0.016 probability, respectively). Qualitative findings confirm that poverty and boyfriends’ refusal to use condoms remain key barriers to systematic condom use among FSW.Keywords: female sex workers, female non-sex workers, miners, Mali, STI/ HIV, West Africa
Published: 2019

16. Becoming adherent to a preventive treatment for HIV: a qualitative approach

Author: Claire Pintado, Eric Cua, Julie Chas, Costanza Puppo, Bruno Spire, Marie Suzan-Monti, Vanessa Laguette, Jean-Michel Molina, Xavier Mabire, Daniela Rojas Castro, Marie Préau, Stéphane Morel, Hôpital l'Archet, Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Groupe de Recherche en Psychologie Sociale (GRePS), Université Lumière - Lyon 2 (UL2), AIDES Association [France], Centre de Recherche en Psychologie : Cognition, Psychisme et Organisations - UR UPJV 7273 (CRP-CPO), Université de Picardie Jules Verne (UPJV), 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], CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Universitaire de Nice (CHU Nice), Service de maladies infectieuses et tropicales [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], ANRS (France Recherche Nord & Sud Sida-HIV Hépatites) and funded by the ANRS and the Fonds de dotation Pierre Bergé pour la Prévention – SIDACTION, Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], and HAL AMU, Administrateur
Subjects: Adult, Male, medicine.medical_specialty, Anti-HIV Agents, Human immunodeficiency virus (HIV), HIV Infections, coping strategies, medicine.disease_cause, Medication Adherence, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, prevention, stigmatization, On demand, medicine, Humans, adherence, 030212 general & internal medicine, PrEP intake, Qualitative Research, ComputingMilieux_MISCELLANEOUS, Applied Psychology, 030505 public health, business.industry, HIV, Focus Groups, 3. Good health, Clinical trial, Psychiatry and Mental health, Clinical Psychology, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Family medicine, Pre-Exposure Prophylaxis, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 0305 other medical science, business, qualitative methods, Qualitative research
Abstract: 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 (
Published: 2019

17. Impact of HIV risk perception on both pre-exposure prophylaxis and condom use

Author: Claire Pintado, Mohamed Mimi, Laurence Meyer, Bruno Spire, Jean-Michel Molina, Daniela Rojas Castro, Luis Sagaon-Teyssier, Marie Suzan-Monti, Christel Protière, Marie Préau, Marion Di Ciaccio, Gilles Pialoux, 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), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de maladies infectieuses et tropicales [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service des maladies infectieuses et tropicales [CHU Tenon], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], HAL AMU, Administrateur, Service de Maladies infectieuses et tropicales [CHU Tenon], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Male, media_common.quotation_subject, Human immunodeficiency virus (HIV), men who have sex with men, HIV Infections, condom use, medicine.disease_cause, Hiv risk, law.invention, Men who have sex with men, Condoms, Sexual and Gender Minorities, 03 medical and health sciences, Pre-exposure prophylaxis, 0302 clinical medicine, Condom, law, risk perception, Perception, medicine, Humans, trajectories, adherence, 030212 general & internal medicine, Homosexuality, Male, pre-exposure prophylaxis, Applied Psychology, Reproductive health, media_common, 030505 public health, business.industry, HIV, Risk perception, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, pre-exposure prophylaxis adherence, Pre-Exposure Prophylaxis, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 0305 other medical science, business, Demography
Abstract: Risk perception is one of the several important factors impacting sexual health behaviours. This study investigated the evolution of HIV risk perception on pre-exposure prophylaxis adherence and condom use in men who have sex with men at high risk of HIV and associated factors. Group-based trajectory modelling helped in identifying patterns of risk perception, pre-exposure prophylaxis adherence and condom use over time. The association between the former and the latter two dimensions was then investigated. An estimated 61 per cent ( p
Published: 2021

18. On-demand pre-exposure prophylaxis with tenofovir disoproxil fumarate plus emtricitabine among men who have sex with men with less frequent sexual intercourse: a post-hoc analysis of the ANRS IPERGAY trial

Author: Laurence Meyer, Julie Chas, Jean-Guy Baril, Véronique Doré, Michel Morin, Jean-Pierre Aboulker, Marine Saouzanet, Isabelle Durant-Zaleski, Marie Suzan-Monti, Emmanuelle Netzer, Françoise Euphrasie, Nathalie Bajos, Séverine Gibowski, Soizic Le Mestre, Gilles Peytavin, Jean-François Delfraissy, Constance Delaugerre, David Thompson, Brigitte Guillon, Gilles Pialoux, Alpha Diallo, Nicolas Etien, Christian Chidiac, Michel Besnier, Isabelle Charreau, Benoit Trottier, Baptiste Demoulin, Julie Timsit, Bruno Spire, Joanne Otis, Laurent Cotte, Julien Fonsart, W. Rozenbaum, Mark A. Wainberg, Gabriel Girard, Eric Cua, Guillemette Antoni, Daniela Rojas Castro, Catherine Capitant, Luis Sagaon-Teyssier, Antoine Cheret, Marie-Christine Simon, Cécile Tremblay, Nicolas Leturque, Johan Binesse, Diane Carette, Valérie Foubert, Anaïs Mennecier, Grégoire Cattin, Jean-Michel Molina, Yacine Saïdi, Nicolas Lorente, Elias Choucair, François Raffi, Cecile Rabian, Armelle Pasquet, Marie Préau, Thomas Huleux, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Essais Thérapeutiques et Maladies Infectieuses, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CR CHUM), Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal (UdeM)-Université de Montréal (UdeM), Génomes, biologie cellulaire et thérapeutiques (GenCellDi (UMR_S_944)), Collège de France (CdF (institution))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Hôpital Archet 2 [Nice] (CHU), Coalition PLUS [Pantin, France] (Community Research Laboratory Pantin), 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), Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Gustave Dron [Tourcoing], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), ANRS (France Recherche Nord and Sud Sida-HIV Hépatites), the Canadian HIV Trials Network, Fonds Pierre Bergé (Sidaction), Gilead Sciences, and the Bill & Melinda Gates Foundation., ANRS IPERGAY study group: Jean-Pierre Aboulker, Nathalie Bajos, Jean-Guy Baril, Michel Besnier, Johan Binesse, Diane Carette, Grégoire Cattin, Antoine Chéret, Christian Chidiac, Elias Choucair, Jean-François Delfraissy, Baptiste Demoulin, Alpha Diallo, Isabelle Durant-Zaleski, Véronique Doré, Nicolas Etien, Françoise Euphrasie, Julien Fonsart, Valérie Foubert, Séverine Gibowski, Gabriel Girard, Brigitte Guillon, Soizic Le Mestre, France Lert, Nicolas Leturque, Nicolas Lorente, Anaïs Mennecier, Michel Morin, Emmanuelle Netzer, Joanne Otis, Armelle Pasquet, Gilles Peytavin, Gilles Pialoux, Marie Préau, Cécile Rabian, Willy Rozenbaum, Luis Sagaon-Teyssier, Yacine Saïdi, Marine Saouzanet, Marie-Christine Simon, Marie Suzan-Monti, David Thompson, Julie Timsit, Benoît Trottier, Mark Wainberg, Dupuis, Christine, Génomes, biologie cellulaire et thérapeutiques (GenCellDi (U944 / UMR7212)), Collège de France (CdF (institution))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: 0301 basic medicine, Male, MESH: Sexual Behavior, Epidemiology, [SDV]Life Sciences [q-bio], HIV Infections, Men who have sex with men, MESH: HIV-1, Pre-exposure prophylaxis, Sexual and Gender Minorities, 0302 clinical medicine, MESH: Tenofovir, Medicine, MESH: Double-Blind Method, 030212 general & internal medicine, MESH: Incidence, MESH: Anti-HIV Agents, education.field_of_study, Incidence (epidemiology), Incidence, MESH: HIV Infections, 3. Good health, [SDV] Life Sciences [q-bio], MESH: Sexual and Gender Minorities, Infectious Diseases, Pill, France, medicine.drug, Adult, medicine.medical_specialty, Canada, Anti-HIV Agents, Sexual Behavior, Immunology, Population, Placebo, Emtricitabine, Medication Adherence, MESH: Homosexuality, Male, 03 medical and health sciences, Double-Blind Method, MESH: Canada, Virology, Internal medicine, Humans, Homosexuality, Male, education, Tenofovir, MESH: Humans, business.industry, MESH: Adult, MESH: Medication Adherence, 030112 virology, MESH: Male, MESH: France, Sexual intercourse, HIV-1, Pre-Exposure Prophylaxis, business, MESH: Pre-Exposure Prophylaxis
Abstract: Summary Background ANRS IPERGAY found that on-demand pre-exposure prophylaxis (PrEP) with oral tenofovir disoproxil fumarate plus emtricitabine was associated with an 86% relative reduction of HIV-1 incidence compared with placebo among men who have sex with men at high risk of HIV. We aimed to investigate whether on-demand PrEP was similarly effective among individuals with lower exposure to HIV risk. Methods Participants in the ANRS IPERGAY trial were randomly assigned to receive PrEP (fixed-dose combination of 300 mg tenofovir disoproxil fumarate and 200 mg emtricitabine per pill) or placebo. The primary endpoint was the diagnosis of HIV-1 infection. Pill uptake was assessed by counting returned pills at each follow-up and by estimating tenofovir concentration from frozen plasma samples. Participants were interviewed at each visit to assess the pattern of PrEP use. All participants enrolled in the modified intention-to-treat population of the double-blind phase of the ANRS IPERGAY trial were eligible for this post-hoc analysis. We calculated the total follow-up time for periods of less frequent sexual intercourse with high PrEP adherence (15 pills or fewer per month taken systematically or often during sexual intercourse). To estimate the time of HIV acquisition, fourth-generation HIV-1/2 ELISA assays, plasma HIV-1 RNA assays, and western blot analyses were done with use of frozen samples, and the stage of HIV infection was defined according to Fiebig staging. HIV incidence was compared between the two treatment groups among individuals who had less frequent sexual intercourse with high PrEP adherence. The ANRS IPERGAY trial is registered with ClinicalTrials.gov , NCT01473472 . Findings 400 participants who were randomly assigned to receive PrEP (n=199) or placebo (n=201) between Feb 22, 2012, and Oct 17, 2014, were included in this analysis. 270 participants had at least one period of less frequent sexual intercourse with high PrEP adherence during the study, representing 134 person-years of follow-up and 31% of the total study follow-up. During these periods, participants in both groups reported a median of 5·0 (IQR 2·0–10·0) episodes of sexual intercourse per month and used a median of 9·5 (6·0–13·0) pills per month. Six HIV-1 infections were diagnosed in the placebo group (HIV incidence of 9·2 per 100 person-years; 95% CI 3·4–20·1) and none were diagnosed in the tenofovir disoproxil fumarate plus emtricitabine arm (HIV incidence of 0 per 100 person-years; 0–5·4; p=0·013), with a relative reduction of HIV incidence of 100% (95% CI 39–100). Interpretation A choice between daily or on-demand PrEP regimens could be offered to men who have sex with men who have less frequent sexual intercourse. Funding ANRS (France Recherche Nord and Sud Sida-HIV Hepatites), the Canadian HIV Trials Network, Fonds Pierre Berge (Sidaction), Gilead Sciences, and the Bill & Melinda Gates Foundation.
Published: 2019

19. Changes in Sexual Behaviors in Men Who Have Sex with Men: A Comparison Between the Double-Blind and Open-Label Extension Phases of the ANRS-IPERGAY Trial

Author: Cécile Tremblay, Marie Suzan-Monti, Christian Chidiac, Jean-Michel Molina, Daniela Rojas Castro, Christel Protière, Mohamed Mimi, Laurence Meyer, Bruno Spire, Marion Di Ciaccio, Catherine Capitant, Luis Sagaon-Teyssier, Marie Préau, 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), Groupe de Recherche en Psychologie Sociale (GRePS), Université Lumière - Lyon 2 (UL2), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), AIDES [Pantin, France], Coalition Internationale Sida [Pantin, France] (Programme Recherche Communautaire), Essais Thérapeutiques et Maladies Infectieuses, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CR CHUM), Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal (UdeM)-Université de Montréal (UdeM), Service de Maladies Infectieuses et Tropicales [Hôpital de la Croix-Rousse - HCL], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service des Maladies Infectieuses et Tropicales [CHU Saint Louis], Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), ANRS IPERGAY Study Group: J-M Molina, C Capitant, B Spire, G Pialoux, L Cotte, I Charreau, C Tremblay, J-M Le Gall, E Cua, A Pasquet, F Raffi, C Pintado, C Chidiac, J Chas, P Charbonneau, C Delaugerre, M Suzan-Monti, B Loze, J Fonsart, G Peytavin, A Cheret, J Timsit, G Girard, N Lorente, M Préau, J F Rooney, M A Wainberg, D Thompson, W Rozenbaum, V Doré, L Marchand, M-C Simon, N Etien, J-P Aboulker, L Meyer, J-F Delfraissy, C Pintado, B Loze, C Delaugerre, P Charbonneau, C Gatey, D Ponscarme, P Penot, L Niedbalski, R Veron, J Delgado, E Dalle, S Parlier, I Madelaine, J Fonsart, M Danet, N Mahjoub, N Mezreb, K Moudachirou, S Morel, G Conort, F Lorho, M Meunier, W Rozenbaum, J M Molina, J Chas, C Monfort, J Foucoin, B Boissavy, S Cousseau, S Huon, M Danet, A Djessima, V Berrebi, A Adda, S le Nagat, L Zarka, J Berdougo, G Pialoux, C Chidiac, N Mzoughi, F Clement, A Decouty, C Chapolard, M Godinot, C Adouard-Groslafeige, J Koffi, A Pansu, A Becker, S Pailhes, F Bonnet, F Jeanblanc, C Brochier, X Teruin, S Rouby, L Gilly, L Cotte, C Beauvais, P Arlotto, C Fortin, A Talbot, A Chamberland, A McKenzie, M Blanchette, R Rousseau, K Montheuth, D Thompson, M Morin, M Wainberg, C Tremblay, C Etienne, F Tolonin, S Breaud, V Péchenot, S Bagge, T Cepitelli, P M Roger, E Rosenthal, E Cua, A Cheret, P Cornavin, S Vandamme, J Lambec, N Dumon, O Leclanche, T Huleux, R Biekre, O Robineau, H Melliez, H Bazus, A Pasquet, C Bernaud, M Besnier, B Bonnet, N Hall, M Cavellec, H Hue, L Larmet, M Colas, R Choquet, F Raffi, Dupuis, Christine, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Sud - Paris 11 (UP11)
Subjects: Male, Safe Sex, MESH: Sexual Behavior, [SDV]Life Sciences [q-bio], HIV Infections, Gee, law.invention, Men who have sex with men, 0302 clinical medicine, law, Medicine, MESH: Sexual Partners, MESH: Double-Blind Method, 030212 general & internal medicine, MESH: Anti-HIV Agents, Generalized estimating equation, MESH: Middle Aged, MESH: HIV Infections, Middle Aged, PrEP, 3. Good health, [SDV] Life Sciences [q-bio], Sexual Partners, Infectious Diseases, Sexual behavior, MESH: Risk-Taking, MESH: Young Adult, MESH: Risk Reduction Behavior, France, Open label, 0305 other medical science, Adult, Canada, Social Psychology, Anti-HIV Agents, ANRS-IPERGAY trial, Sexual Behavior, MESH: Safe Sex, Double blind, MESH: Homosexuality, Male, Young Adult, 03 medical and health sciences, Risk-Taking, Double-Blind Method, Condom, MESH: Canada, Humans, MSM, Homosexuality, Male, 030505 public health, MESH: Humans, business.industry, Public Health, Environmental and Occupational Health, HIV risk management, MESH: Adult, Odds ratio, MESH: Male, MESH: France, Behaviors, Pre-Exposure Prophylaxis, business, Risk Reduction Behavior, Demography, MESH: Pre-Exposure Prophylaxis
Abstract: International audience; Pre-Exposure Prophylaxis (PrEP) is changing the landscape of HIV prevention, and may bring changes in sexual behaviors. The double-blind phase (DBP) and open-label extension (OLE) study of the ANRS-IPERGAY trial allowed us to assess changes in sexual behavior of men who have sex with men (MSM) taking sexual activity-based (i.e., on-demand) PrEP. Generalized Estimating Equation (GEE) models found a significant decrease in the number of sexual partners (Coefficient [CI95%], p value; - 0.37[- 0.70 to - 0.04], p = 0.03) between the DBP and OLE as well as in the number of sexual relations (- 0.25 [- 0.49 to 0.00], 0.04). GEE estimates also showed that respondents' most recent sexual relation was less likely to have been with an unknown casual partner during the OLE than during the DBP (Odds Ratio [CI95%], p value: 0.75[0.62-0.92], 0.005). Furthermore, they showed an increase in the proportion of condomless anal sex in the OLE (1.32[1.04-1.67], 0.02), a decrease in the proportion of 'suboptimal PrEP adherence' over time (0.75[0.58-0.97], p = 0.03), a decrease in PrEP only use (0.73[0.55-0.96], 0.03) and in both PrEP and condom use over time (0.70[0.51-0.95], 0.02) and finally, a decrease in alcohol consumption between the DBP and OLE (0.74[0.61-0.90], 0.002). We observed both protective and risky behaviors in terms of HIV and STI risk after on-demand PrEP uptake in the OLE phase. Our findings are consistent with results from previous PrEP trials.
Published: 2020

20. Characterization of Physicians That Might Be Reluctant to Propose HIV Cure-Related Clinical Trials with Treatment Interruption to Their Patients? The ANRS-APSEC Study

Author: Marie Suzan-Monti, Laurence Meyer, Lisa Fressard, Christel Protière, Marion Mora, Bruno Spire, Marie Préau, Jean-Daniel Lelièvre, Olivier Lambotte, 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), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Groupe de Recherche en Psychologie Sociale (GRePS), Université Lumière - Lyon 2 (UL2), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Immunologie des maladies virales, auto-immunes, hématologiques et bactériennes (IMVA-HB), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Service de Médecine Interne - Immunologie Clinique [AP-HP Bicêtre], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Infectious Diseases Models for Innovative Therapies (IDMIT), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay, Institut des Maladies Emergentes et des Thérapies Innovantes (IMETI), The Apsec Study Group, and Dupuis, Christine
Subjects: 0301 basic medicine, medicine.medical_specialty, physicians, principal component analysis, [SDV]Life Sciences [q-bio], Immunology, Human immunodeficiency virus (HIV), HIV cure-related clinical trials, lcsh:Medicine, Scientific literature, medicine.disease_cause, Article, analytical treatment interruption studies, 03 medical and health sciences, 0302 clinical medicine, Drug Discovery, medicine, Antiretroviral treatment, Pharmacology (medical), 030212 general & internal medicine, Hiv transmission, Pharmacology, business.industry, lcsh:R, Viewpoints, Continuous training, 3. Good health, HIV cure research, [SDV] Life Sciences [q-bio], Clinical trial, 030104 developmental biology, Infectious Diseases, Treatment interruption, Family medicine, multivariable linear regression, business, viewpoints
Abstract: International audience; HIV cure-related clinical trials (HCRCT) with analytical antiretroviral treatment interruptions (ATIs) have become unavoidable. However, the limited benefits for participants and the risk of HIV transmission during ATI might negatively impact physicians' motivations to propose HCRCT to patients. Between October 2016 and March 2017, 164 French HIV physicians were asked about their level of agreement with four viewpoints regarding HCRCT. A reluctance score was derived from their answers and factors associated with reluctance identified. Results showed the highest reluctance to propose HCRCT was among physicians with a less research-orientated professional activity, those not informing themselves about cure trials through scientific literature, and those who participated in trials because their department head asked them. Physicians' perceptions of the impact of HIV on their patients' lives were also associated with their motivation to propose HCRCT: those who considered that living with HIV means living with a secret were more motivated, while those worrying about the negative impact on person living with HIV's professional lives were more reluctant. Our study highlighted the need to design a HCRCT that minimizes constraints for participants and for continuous training programs to help physicians keep up-to-date with recent advances in HIV cure research.
Published: 2020

21. Who are the persons living with HIV who might refuse to participate in HIV cure-related clinical trials with treatment interruption?

Author: Marie Préau, Jean-Daniel Lelièvre, Olivier Lambotte, Abdourahmane Sow, Bruno Spire, Lisa Fressard, Marion Mora, Marie Suzan-Monti, Christel Protière, Marion Fiorentino, and Laurence Meyer
Subjects: 0301 basic medicine, medicine.medical_specialty, Biomedical Research, Anti-HIV Agents, Immunology, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Immunology and Allergy, Medicine, Humans, In patient, 030212 general & internal medicine, Intensive care medicine, Clinical Trials as Topic, business.industry, Therapeutic Human Experimentation, 3. Good health, Clinical trial, 030104 developmental biology, Infectious Diseases, Treatment interruption, Patient Participation, business
Abstract: Achieving a HIV cure has become a research priority. As any improvement of knowledge, which could help scientists design new HIV cure-related clinical trials (HCRCT) depends on the risks potential participants are willing to accept, it is important to understand who will agree or refuse to participate and in which proportions. By providing insights into factors associated with reluctance toward HCRCT participation, our results may help clinicians in patient recruitment.
Published: 2020

22. What are the situational and behavioral factors associated with condomless anal sex without pre-exposure prophylaxis in MSM?

Author: Christian Chidiac, Mohamed Mimi, Marie Préau, Christel Protière, Catherine Capitant, Luis Sagaon-Teyssier, Jean-Michel Molina, Daniela Rojas Castro, Laurence Meyer, Cécile Tremblay, Marion Di Ciaccio, Bruno Spire, Marie Suzan-Monti, Dupuis, Christine, 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), Groupe de Recherche en Psychologie Sociale (GRePS), Université Lumière - Lyon 2 (UL2), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), AIDES [Pantin, France] (Mission Innovation Recherche Expérimentation), Coalition Internationale Sida [Pantin, France] (Programme Recherche Communautaire), Essais Thérapeutiques et Maladies Infectieuses, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal (UdeM), Service de Maladies Infectieuses et Tropicales [Hôpital de la Croix-Rousse - HCL], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service de maladies infectieuses et tropicales [Saint-Louis], 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)-Université Paris Cité (UPCité), Department of Infectious Diseases [Paris], Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Sud - Paris 11 (UP11), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université de Paris (UP)
Subjects: Male, Safe Sex, 0301 basic medicine, Sexual partner, MESH: Sexual Behavior, [SDV]Life Sciences [q-bio], HIV Infections, Gee, law.invention, Condoms, Pre-exposure prophylaxis, 0302 clinical medicine, law, Immunology and Allergy, Medicine, MESH: Sexual Partners, 030212 general & internal medicine, MESH: Anti-HIV Agents, Generalized estimating equation, MESH: Middle Aged, MESH: HIV Infections, Middle Aged, 3. Good health, [SDV] Life Sciences [q-bio], Sexual Partners, Infectious Diseases, MESH: Risk-Taking, MESH: Young Adult, Viral load, Adult, Anti-HIV Agents, MESH: Unsafe Sex, Sexual Behavior, Immunology, MESH: Safe Sex, MESH: Homosexuality, Male, Young Adult, 03 medical and health sciences, MESH: Condoms, Risk-Taking, Condom, Humans, Homosexuality, Male, MESH: Humans, Unsafe Sex, business.industry, MESH: Adult, MESH: Male, Sexual intercourse, 030104 developmental biology, Attributable risk, Pre-Exposure Prophylaxis, business, Demography, MESH: Pre-Exposure Prophylaxis
Abstract: International audience; Objective: This study aimed to identify situational and behavioral factors associated with condomless anal sex without on-demand PrEP in the open-label extension (OLE) study of the ANRS-IPERGAY trial.Methods: Univariable and multivariable modified Poisson regressions with a generalized estimating equation (GEE) were used. The attributable risk percentage for each explanatory variable and for condomless anal sex without PrEP was calculated.Results: In the OLE, 19% of anal intercourses were unprotected (i.e. no PrEP or condom). Of these, 85% were attributable to sexual intercourse with main partners and 47% with HIV-negative partners. The following factors were positively associated with condomless anal sex without PrEP: a depressive episode in the previous 12 months [aR (95% CI), P-value: 1.49 (1.02--2.17), 0.039], a higher number of sexual intercourses during the previous 4 weeks [1.01 [1.002--1.02], 0.014], and sexual intercourses under the influence of alcohol [1.45 (1.10--1.92), 0.008]. By contrast, condomless anal sex without PrEP was less frequent during sexual intercourses with known casual, unknown casual and multiple partners [0.20 (0.14--0.30)
Published: 2020

23. Changements de pratiques d'injection de drogues supervisées à la suite d'une intervention éducationnelle communautaire : une analyse longitudinale

Author: Marie Debrus, Patrizia Carrieri, Salim Mezaache, Daniel Rojas Castro, Perrine Roux, Stéphane Morel, Camelia Protopopescu, Marie Suzan-Monti, Marion Mora, 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), Médecins du Monde [Paris, France] (Association médicale militante de solidarité internationale), AIDES [Pantin, France], Groupe de Recherche en Psychologie Sociale (GRePS), Université Lumière - Lyon 2 (UL2), Coalition PLUS [Pantin, France], and This study received external funding from the French National Agency for Research for AIDS and Viral Hepatitis (ANRS).
Subjects: Adult, Male, medicine.medical_specialty, Hand washing, 030508 substance abuse, Intervention, Toxicology, Drug injecting, Education, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Intervention (counseling), Humans, Medicine, Pharmacology (medical), Longitudinal Studies, 030212 general & internal medicine, Substance Abuse, Intravenous, Health Education, Pharmacology, Community based, Harm reduction, business.industry, Skin and soft tissue infections, Odds ratio, Middle Aged, Checklist, Confidence interval, 3. Good health, Needle-Exchange Programs, Psychiatry and Mental health, Family medicine, Injecting drug use, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Independent Living, Injecting practices, 0305 other medical science, business
Abstract: Background People who inject drugs face several health issues because of unsafe injecting practices. We aimed to evaluate changes in supervised drug-injecting practices following the implementation of a face-to-face educational intervention. Methods The national study ANRS-AERLI was conducted in 17 harm reduction (HR) facilities in France between 2011 and 2013. Eight offered the intervention and nine did not. We conducted a pre-post analysis focusing on injecting practices data, collected in the 8 HR facilities providing the intervention. The intervention consisted of providing face-to-face educational sessions including direct observation of injecting practices, counseling about safer injecting, and shared discussion. Injecting practices were collected following a checklist and classified as safe or unsafe. To assess changes in injecting practices, practices were compared before (at baseline) and after at least one educational session. Findings Mixed logistic models showed that the 78 participants included were more likely to improve in the following drug-use steps: setting up a clean preparation area (Adjusted Odds Ratio (AOR) = 3.4, 95% Confidence Interval (95% CI) = 1.6–7.6), hand washing (AOR = 7.2, 95% CI = 3.1–16.4), skin cleaning (AOR = 5.6, 95% CI = 2.5–12.1), choice of safe injection site (AOR = 6.5, 95% CI = 1.5–28.8) and post-injection bleeding management (AOR = 12.8, 95% CI = 5.5–29.9). Furthermore, participants were less likely to lick their needles before injecting (AOR = 8.1, 95% CI = 1.5–43.4) and to perform booting/flushing (AOR = 2.5, 95% CI = 1.2–5.3). Conclusions The AERLI intervention seems to be effective in increasing safe drug-injecting practices.
Published: 2018

24. Assessement of Awareness of, Concerns and Attitudes Towards HIV-Related Court-Case Sentences in France in a Representative Sample of People Living with HIV (ANRS VESPA2 Survey)

Author: Marie Suzan-Monti, Bruno Spire, Antoine Vilotitch, Rosemary Dray-Spira, Patrick Yeni, Michel Celse, Baptiste Demoulin, Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), 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), Conseil national du sida et des hépatites virales [Paris, France], Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Université Paris Diderot - Paris 7 (UPD7), Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), The VESPA2 survey was sponsored and funded by the French National Agency for Research on Aids and Viral Hepatitis (ANRS), Grant No. 2010-176., ANRS VESPA2 study group : Lert F, Spire B, Carrieri P, Dray-Spira R, Hamelin C, Lorente N, Préau M, Suzan-Monti M, Mora M, Le Strat Y, Cuzin L, Meyer L, Rojas-Castro D, Fischer H, Allègre T, Mours P, Riou JM, Sordage M, Chennebault JM, Fialaire P, Rabier V, Froidure M, Huguet D, Leduc D, Pichancourt G, Wajsbrot A, Bourdeaux C, Foltzer A, Hoen B, Hustache-Mathieu L, Abgrall S, Barruet R, Bouchaud O, Chabrol A, Mattioni S, Mechai F, Jeantils V, Bernard N, Bonnet F, Hessamfar M, Lacoste D, Malvy D, Mercié P, Morlat P, Paccalin F, Pertusa MC, Pistone T, Receveur MC, Vandenhende MA, Dupont C, Freire Maresca A, Leporrier J, Rouveix E, Dargere S, de la Blanchardière A, Martin A, Noyon V, Verdon R, Rogeaux O, Beytout J, Gourdon F, Laurichesse H, Meier F, Mortier E, Simonpoli AM, Cordier F, Delacroix I, Garrait V, Elharrar B, Dominguez S, Lascaux AS, Lelièvre JD, Levy Y, Melica G, Buisson M, Piroth L, Waldner A, Gruat N, Leprêtre A, de Truchis P, Le Du D, Melchior JC, Sehouane R, Troisvallets D, Blanc M, Boccon-Gibod I, Bosseray A, Brion JP, Durand F, Leclercq P, Marion F, Pavese P, Brottier-Mancini E, Faba L, Roncato-Saberan M, Bollengier-Stragier O, Esnault JL, Leautez-Nainville S, Perré P, Froguel E, Nguessan M, Simon P, Colardelle P, Doll J, Godin-Collet C, Roussin-Bretagne S, Delfraissy JF, Duracinsky M, Goujard C, Peretti D, Quertainmont Y, Marionneau J, Aissi E, Van Grunderbeeck N, Denes E, Ducroix-Roubertou S, Genet C, Weinbreck P, Augustin-Normand C, Boibieux A, Cotte L, Ferry T, Koffi J, Miailhes P, Perpoint T, Peyramond D, Schlienger I, Brunel JM, Carbonnel E, Chiarello P, Livrozet JM, Makhloufi D, Dhiver C, Husson H, Madrid A, Ravaux I, de Severac ML, Thierry Mieg M, Tomei C, Hakoun S, Moreau J, Mokhtari S, Soavi MJ, Faucher O, Ménard A, Orticoni M, Poizot-Martin I, Atoui N, Baillat V, Faucherre V, Favier C, Jacquet JM, Le Moing V, Makinson A, Mansouri R, Merle C, Elforzli N, Allavena C, Aubry O, Besnier M, Billaud E, Bonnet B, Bouchez S, Boutoille D, Brunet C, Feuillebois N, Lefebvre M, Morineau-Le Houssine P, Mounoury O, Point P, Raffi F, Reliquet V, Talarmin JP, Ceppi C, Cua E, Dellamonica P, De Salvador-Guillouet F, Durant J, Ferrando S, Mondain-Miton V, Perbost I, Pillet S, Prouvost-Keller B, Pradier C, Pugliese P, Rahelinirina V, Roger PM, Rosenthal E, Sanderson F, Hocqueloux L, Niang M, Prazuck T, Arsac P, Barrault-Anstett MF, Ahouanto M, Bouvet E, Castanedo G, Charlois-Ou C, Dia Kotuba A, Eid-Antoun Z, Jestin C, Jidar K, Joly V, Khuong-Josses MA, Landgraf N, Landman R, Lariven S, L'hériteau F, Machado M, Matheron S, Michard F, Morau G, Pahlavan G, Phung BC, Prévot MH, Rioux C, Yéni P, Bani-Sadr F, Calboreanu A, Chakvetadze E, Salmon D, Silbermann B, Batisse D, Beumont M, Castiel P, Derouineau J, Eliaszewicz M, Gonzalez G, Jayle D, Karmochkine M, Kousignian P, Pavie J, Pierre I, Weiss L, Badsi E, Bendenoun M, Cervoni J, Diemer M, Durel A, Rami A, Sellier P, Ait-Mohand H, Amirat N, Bonmarchand M, Bourdillon F, Breton G, Caby F, Grivois JP, Katlama C, Kirstetter M, Paris L, Pichon F, Roudière L, Schneider L, Samba MC, Seang S, Simon A, Stitou H, Tubiana R, Valantin MA, Bollens D, Bottero J, Bui E, Campa P, Fonquernie L, Fournier S, Girard PM, Goetschel A, Guyon HF, Lacombe K, Lallemand F, Lefebvre B, Maynard JL, Meyohas MC, Ouazene Z, Pacanowski J, Picard O, Raguin G, Roussard P, Tourneur M, Tredup J, Valin N, Balkan S, Clavel F, de Verdière NC, De Castro N, de Lastours V, Ferret S, Gallien S, Gérard L, Goguel J, Lafaurie M, Lascoux-Combe C, Molina JM, Oksenhendler E, Pintado C, Ponscarme D, Rozenbaum W, Scemla A, Bonnard P, Lassel L, Lebrette MG, Lyavanc T, Mariot P, Missonnier R, Ohayon M, Pialoux G, Treilhou MP, Vincensini JP, Gilquin J, Hadacek B, Nait-Ighil L, Nguyen TH, Sobel A, Viard JP, Zak Dit Zbar O, Aumaître H, Eden A, Ferreyra M, Lopez F, Medus M, Neuville S, Saada M, Blum L, Perfezou P, Arvieux C, Chapplain JM, Revest M, Souala F, Tattevin P, Bord S, Borsa-Lebas F, Caron F, Chapuzet C, Debab Y, Gueit I, Etienne M, Fartoukh C, Feltgen K, Joly C, Robaday-Voisin S, Suel P, Khuong MA, Krausse J, Poupard M, Tran Van G, Cazorla C, Daoud F, Fascia P, Frésard A, Guglielminotti C, Lucht F, Bernard-Henry C, Cheneau C, Lang JM, de Mautort E, Partisani M, Priester M, Rey D, Majerholc C, Zucman D, Assi A, Lafeuillade A, de Jaureguiberry JP, Gisserot O, Aquilina C, du Clary FP, Alvarez M, Chauveau M, Delobel P, Garipuy D, Labau E, Marchou B, Massip P, Mularczyk M, Obadia M, Ajana F, Allienne C, Baclet V, de la Tribonnière X, Huleux T, Melliez H, Meybeck A, Riff B, Valette M, Viget N, Bastides F, Bernard L, Gras G, Guadagnin P, May T, Rabaud C, Dos Santos A, Poinsignon Y, Derradji O, Escaut L, Teicher E, Vittecoq D, Bantsima J, Caraux-Paz P, Patey O., Lissalde, Claire, and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, Social Psychology, Social stigma, Cross-sectional study, Social Stigma, Stigma (botany), HIV Infections, 03 medical and health sciences, Discrimination, Psychological, 0302 clinical medicine, Criminalization, 5. Gender equality, Criminal Law, Surveys and Questionnaires, medicine, Humans, 030212 general & internal medicine, 10. No inequality, Psychiatry, Prejudice (legal term), Transients and Migrants, Depressive Disorder, Major, Stereotyping, 030505 public health, Public health, Public Health, Environmental and Occupational Health, HIV, Awareness, Middle Aged, 16. Peace & justice, Health psychology, Cross-Sectional Studies, Sexual Partners, Infectious Diseases, Attitude, Socioeconomic Factors, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Criminal law, Female, Key population, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, 0305 other medical science, Psychology, Prejudice
Abstract: International audience; Some of the 12 criminal trials and sentences in France for HIV transmission in 1998-2011 attracted substantial public attention , with a possible negative impact on people living with HIV (PLWH) through reinforced stigma and discrimination. This analysis aimed to characterize PLWH enrolled in the representative ANRS-VESPA2 survey, aware of and concerned about convictions for HIV transmission. Being a migrant from Sub-Saharan Africa, having difficult socioeconomic conditions, having unprotected sex with one's main partner and concealing one's HIV status were all factors statistically associated with concern about the sentences. Participants tempted to press charges against someone for infecting them were more likely to be younger, women, not living in a couple, unemployed, and to report a major depressive disorder. Concern about HIV-related criminal proceedings among the most vulnerable PLWH do not reflect the actual risk of prosecution they are exposed to. Resumen En Francia, algunos de los 12 juicios y sentencias relacionados con la contaminación del VIH en 1998-2011 suscitaron con-siderablemente el interés público. Esto pudo impactar negativamente las personas viviendo con VIH (PVVIH) aumentando su estigmatización y discriminación. Este análisis busca caracterizar las PVVIH, de la encuesta ANRS-VESPA2, informadas acerca de esos juicios e inquietos por la posibilidad de implicación en uno de ellos. Ser inmigrante subsahariano, las con-diciones socio-económicas desfavorables, las relaciones sexuales no protegidas con la pareja principal, y ocultar el VIH, están asociados a la posibilidad de ser implicados en un juicio. Por otro lado, aquellos que han intentado presentar cargos por contaminación del VIH fueron mayoritariamente jóvenes, mujeres, personas viviendo solas, desempleados, y personas en depresión. Los juicios por contaminación del VIH entre las PVVIH más vulnerables no reflejan el riesgo de acusación al que están expuestos.
Published: 2018

25. De la recherche communautaire à la transformation sociale : l’exemple du projet ANRS-AERLI sur l’accompagnement et l’éducation aux risques liés à l’injection

Author: Marie Suzan-Monti, Daniela Rojas Castro, Fred Bladou, Patrizia Carrieri, Elisabeth Avril, Perrine Roux, and Marie Debrus
Subjects: 03 medical and health sciences, Psychiatry and Mental health, Clinical Psychology, 0302 clinical medicine, Political science, 030508 substance abuse, 030212 general & internal medicine, 0305 other medical science, Humanities, Cosmos
Abstract: La situation epidemiologique des usagers de drogue (UD), et tout particulierement des UD par voie intraveineuse (UDVI), vis-a-vis du virus de l’hepatite C et du VIH appelle aujourd’hui a de nouveaux moyens de prevention et de soins. L’intervention d’Accompagnement et d’Education aux Risques LIes a l’injection (AERLI) issue des pratiques des acteurs de terrain en direction des UDVI a fait l’objet d’une evaluation a travers le projet de recherche communautaire ANRS-AERLI mene en partenariat etroit avec l’Inserm, Medecins du Monde et AIDES. Cette intervention communautaire consiste en une session educative en face a face, basee sur une observation des pratiques d’injection permettant une reponse individualisee. Cette etude longitudinale ayant compare un groupe d’UDVI expose a AERLI et un groupe controle non expose a permis de mettre en evidence l’efficacite d’AERLI non seulement en termes de diminution des pratiques a risque de transmission du VHC et des complications cutanees, mais aussi a travers une amelioration de l’acces au depistage VHC. L’intervention AERLI apparait donc comme un outil supplementaire a la politique de reduction des risques et un moyen d’inciter les UDVI au depistage VHC a l’heure de l’acces universel aux traitements du VHC. C’est ainsi que deux changements majeurs ont ete possibles grâce aux resultats de cette recherche communautaire, l’inclusion de cet outil pedagogique dans la loi de sante et sa visibilite dans le dernier rapport Dhumeaux sur les hepatites comme moyen d’ameliorer l’acces au depistage VHC.
Published: 2017

26. Renunciation of Health Care by People Living with HIV in France is Still Associated with Discrimination in Health-Care Services and Social Insecurity – Results from the ANRS-VESPA2 Survey

Author: Rosemary Dray-Spira, F. Lert, Luis Sagaon-Teyssier, Antoine Vilotitch, Marie Suzan-Monti, Bruno Spire, Marion Fiorentino, 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 Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), and DUFOUR, Jean-Charles
Subjects: Adult, Male, Cross-sectional study, Health Personnel, [SDV]Life Sciences [q-bio], Population, HIV Infections, 030312 virology, Renunciation, 03 medical and health sciences, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Surveys and Questionnaires, Health care, medicine, Humans, Pharmacology (medical), Substance Abuse, Intravenous, 10. No inequality, education, Socioeconomic status, Pharmacology, Depressive Disorder, Major, 0303 health sciences, education.field_of_study, business.industry, Refusal to Treat, Social Discrimination, Odds ratio, Middle Aged, Patient Acceptance of Health Care, medicine.disease, 3. Good health, [SDV] Life Sciences [q-bio], Substance abuse, Cross-Sectional Studies, Infectious Diseases, Multivariate Analysis, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, France, business, Psychosocial, Demography
Abstract: Background This study aimed to estimate the frequency of renunciation of health care among people living with HIV (PLHIV) in France, including health care unrelated to HIV, and to characterize associated socioeconomic and psychosocial risk factors. Methods The cross-sectional ANRS-VESPA2 survey was conducted on adult PLHIV attending French hospitals in 2011. Correlates of health-care renunciation in the 12 months before the survey were assessed through logistic modelling. Results Among the 3,020 PLHIV included in the sample, 17% declared health-care renunciation during the preceding year and 42% had a high level of social insecurity. During the previous 2 years, 8% and 11%, respectively, were discriminated against by medical staff and family. In multivariate analysis, positive associations were found between health-care renunciation and a high level of social insecurity (adjusted odds ratio [95% CI] 3.44 [2.54, 4.65]; PConclusions In spite of universal health insurance in France, barrier- and refusal-renunciation of health care by PLHIV remain frequent. Poor psychosocial outcomes and discrimination by families and health-care providers compound the negative effect of social insecurity on health-care seeking in this population. To ensure optimal medical care, strategies are needed to prevent discrimination against PLHIV in health-care services. Special attention must be provided to patients experiencing social insecurity.
Published: 2017

27. What is the effect of self-identified HIV activism in willingness to participate in HIV cure-related clinical trials? Results from the ANRS-APSEC study

Author: Olivier Lambotte, Mohamed Mimi, Lisa Fressard, Luis Sagaon-Teyssier, Janine Barbot, Marion Fiorentino, Michael P Arnold, Cécile Goujard, Sylvie Fainzang, Laurence Meyer, Marie Préau, Bruno Spire, Marie Suzan-Monti, Christel Protière, 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), Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), service de Médecine Interne et d'Immunologie Clinique [AP-HP Hôpital Bicêtre], Université Paris-Sud - Paris 11 (UP11)-Hôpital Bicêtre, Assistance Publique - Hôpitaux de Paris (AP-HP), Centre d'étude des mouvements sociaux (CEMS), École des hautes études en sciences sociales (EHESS)-Centre National de la Recherche Scientifique (CNRS), CERMES3 - Centre de recherche Médecine, sciences, santé, santé mentale, société (CERMES3 - UMR 8211 / U988 / UM 7), École des hautes études en sciences sociales (EHESS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupe de Recherche en Psychologie Sociale (GRePS), Université Lumière - Lyon 2 (UL2), ORS PACA, Epidémiologie et Sciences Sociales Appliquées à l'Innovation Médicale, Université de la Méditerranée - Aix-Marseille 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Recherche Biomédicale des Armées (IRBA)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5)-École des hautes études en sciences sociales (EHESS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées (IRBA), CERMES3 - Centre de recherche Médecine, sciences, santé, santé mentale, société (CERMES3 - UM 7 (UMR 8211 / U988)), Centre de recherche Médecine, Science, Santé et Société (CERMES), Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), and COMBE, Isabelle
Subjects: 0301 basic medicine, cure research, Epidemiology, Immunology, Human immunodeficiency virus (HIV), medicine.disease_cause, Microbiology, activism, 03 medical and health sciences, 0302 clinical medicine, cure trial, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Virology, Medicine, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, 030212 general & internal medicine, Hiv services, 10. No inequality, Original Research, [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, business.industry, Public Health, Environmental and Occupational Health, virus diseases, HIV, Odds ratio, willingness to participate in clinical trials, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, QR1-502, Confidence interval, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, Clinical trial, 030104 developmental biology, Infectious Diseases, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, France, [SDV.MP.BAC] Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Public aspects of medicine, RA1-1270, business, Psychosocial, Viral load, [SDV.MP.PAR] Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Demography
Abstract: Objectives Enrolling people living with HIV with undetectable viral load into HIV cure-related clinical trials (HCRCT) is challenging. Few data are currently available about the individual factors that influence willingness to participate in HCRCT (WPHCRCT). We hypothesised that WPHCRCT would be more frequent among people living with HIV considering themselves HIV activists. The objective of this study was to investigate the individual characteristics associated with both WPHCRCT and self-identification as an HIV activist. Methods The study enrolled 195 long-term ART-treated and virologically suppressed people living with HIV, followed-up in 19 French HIV services, 2016–2017. A Bayesian model averaging approach was used to assess correlates of both outcomes i.e. WPHCRCT and self-identified HIV activism. Results WPHCRCT was reported by 43% of participants and was positively associated with self-identification as an HIV activist (adjusted odds ratio [aOR] 2.90 95% confidence interval [CI] 2.17–3.63], P0.75, indicating strong evidence. Conclusions WPHCRCT is strongly related to HIV activism, and also to positive psychosocial characteristics as a person living with HIV, especially regarding relationships with others. The desire to contribute to the fight against HIV for the sake of the HIV community and society should be taken into account to improve participation in upcoming HCRCT.
Published: 2019

28. Community-Based Care in the ANRS-IPERGAY Trial: The Challenges of Combination Prevention

Author: Eric Cua, Costanza Puppo, Marie Préau, Laurent Cotte, François Raffi, Xavier Mabire, Armelle Pasquet, Bruno Spire, Gilles Pialoux, Marie Suzan Monti, Jean-Michel Molina, Daniela Rojas Castro, Groupe de Recherche en Psychologie Sociale (GRePS), Université Lumière - Lyon 2 (UL2), Service de Maladies Infectieuses et Tropicales [Hôpital de la Croix-Rousse - HCL], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), 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], Hôpital l'Archet, Service des maladies infectieuses et tropicales [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service des Maladies Infectieuses et Tropicales [Hôpital Gustave Dron, Tourcoing], Centre Hospitalier Gustave Dron [Tourcoing], Centre hospitalier universitaire de Nantes (CHU Nantes), 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), HAL AMU, Administrateur, Service de Maladies infectieuses et tropicales [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Male, Gerontology, Health (social science), HIV Infections, law.invention, 0302 clinical medicine, Randomized controlled trial, law, negotiation, Transgender, 030212 general & internal medicine, Empowerment, Community-based care, Qualitative Research, Randomized Controlled Trials as Topic, media_common, Community Health Workers, education.field_of_study, Middle Aged, PrEP, 3. Good health, Negotiation, Infectious Diseases, France Read More: https://guilfordjournals.com/doi/10.1521/aeap.2019.31.3.259, Feeling, Pill, Female, 0305 other medical science, Psychology, Adult, Community-Based Participatory Research, Anti-HIV Agents, Sexual Behavior, media_common.quotation_subject, Population, Transgender Persons, Interviews as Topic, 03 medical and health sciences, ANRS-IPERGAY, Double-Blind Method, Humans, Homosexuality, Male, education, community-based care, 030505 public health, Public Health, Environmental and Occupational Health, HIV, empowerment, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Pre-Exposure Prophylaxis, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
Abstract: International audience; 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.
Published: 2019

29. Pleasure and PrEP: Pleasure-Seeking Plays a Role in Prevention Choices and Could Lead to PrEP Initiation

Author: Bruno Spire, Costanza Puppo, Marie Suzan-Monti, Marie Préau, Claire Pintado, Eric Cua, Xavier Mabire, Jean-Michel Molina, Daniela Rojas Castro, Marion Mora, Stéphane Morel, Julie Chas, Groupe de Recherche en Psychologie Sociale (GRePS), Université Lumière - Lyon 2 (UL2), AIDES, 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), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital l'Archet, Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Adult, Male, Pleasure, Health (social science), media_common.quotation_subject, Sexual Behavior, sexual health, lcsh:Medicine, Context (language use), Human sexuality, HIV Infections, physiological and endocrine disorders, Men who have sex with men, law.invention, Interviews as Topic, 03 medical and health sciences, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), Condom, law, medicine, Humans, 030212 general & internal medicine, Homosexuality, Male, media_common, Reproductive health, Aged, health-care issues, 030505 public health, business.industry, lcsh:R, Public Health, Environmental and Occupational Health, Middle Aged, medicine.disease, 3. Good health, sexuality, Sexual intercourse, Bisexuality, HIV/AIDS, Original Article, Pre-Exposure Prophylaxis, health promotion and disease prevention, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 0305 other medical science, business, Psychology, Social psychology
Abstract: International audience; 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.
Published: 2019

30. Intimate partner violence against HIV-positive Cameroonian women: Prevalence, associated factors and relationship with antiretroviral therapy discontinuity-results from the ANRS-12288 EVOLCam survey

Author: Khadim Ndiaye, Laura March, Christopher Kuaban, Luis Sagaon-Teyssier, Marie-Thérèse Mengue, Marie Suzan-Monti, Christian Laurent, Sylvie Boyer, Bruno Spire, Marion Fiorentino, Laurent Vidal, 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), Université Catholique d'Afrique Centrale - Institut Catholique de Yaoundé (UCAC), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Institut de Recherche pour le Développement (IRD), Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Montpellier (UM), This study was funded by the French National Agency for Research on AIDS and viral hepatitis (ANRS)., Aiello, Mélisande, Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), Université catholique d'Afrique centrale, Institut catholique de Yaoundé, Université de Yaoundé I [Yaoundé], Recherches Translationnelles sur le VIH et les maladies infectieuses (TransVIHMI), Université Montpellier 1 (UM1)-Institut de Recherche pour le Développement (IRD)-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Universtié Yaoundé 1 [Cameroun]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), and Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI)
Subjects: Sexual partner, Adult, intimate partner violence, [SDV]Life Sciences [q-bio], Human immunodeficiency virus (HIV), Stigma (botany), lcsh:Medicine, HIV Infections, 030312 virology, medicine.disease_cause, Medication Adherence, 03 medical and health sciences, 0302 clinical medicine, 5. Gender equality, Prevalence, Medicine, Humans, 030212 general & internal medicine, Cameroon, Hiv treatment, [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, 0303 health sciences, business.industry, lcsh:R, Central africa, HIV, General Medicine, Odds ratio, Middle Aged, Antiretroviral therapy, 3. Good health, [SDV] Life Sciences [q-bio], Cross-Sectional Studies, Anti-Retroviral Agents, Socioeconomic Factors, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Domestic violence, Women's Health, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, women, business, antiretroviral therapy interruption, Primary, Demography
Abstract: Background: Intimate partner violence in its various forms increases HIV exposure in female victims and potentially jeopardizes the HIV treatment cascade, for instance, by impeding engagement in and adherence to care. Elevated rates of HIV and intimate partner violence are reported in Central Africa. Evidence on the effect of intimate partner violence on antiviral therapy interruption is lacking in Cameroon, where only 330,000 women live with HIV and only 19% of HIV-positive people are virally suppressed. This study aimed to assess the prevalence and factors of intimate partner violence against HIV-positive women and its relationship with antiretroviral therapy interruption ⩾1 month. Methods: The EVOLCam cross-sectional survey was conducted in 19 hospitals in the Center and Littoral regions. The study sample comprised antiviral therapy–treated women declaring at least one sexual partner in the previous year. Scores of recent emotional, physical, extreme physical and sexual intimate partner violence were built using principal component analysis and categorized under no, occasional or frequent intimate partner violence. Multivariate logistic analyses were performed to investigate the relationship between intimate partner violence and recent antiretroviral therapy interruption ⩾1 month, and associated factors. Results: Among the 894 analyzed women, the prevalence of intimate partner violence was 29% (emotional), 22% (physical), 13% (extreme physical) and 18% (sexual). Frequent physical intimate partner violence was a significant risk factor of antiretroviral therapy interruption ⩾1 month (adjusted odds ratio = 2.42 (95% confidence interval = 1.00; 5.87)). It was also associated with HIV-related stigma (2.53 (1.58; 4.02)), living with a main partner (2.03 (1.20; 3.44) and non-defensive violence against this partner (5.75 (3.53; 9.36)). Conclusion: Intimate partner violence is a potential barrier to antiviral therapy continuity and aggravates vulnerability of Cameroonian HIV-positive women. The prevention and detection of intimate partner violence by HIV services might help to reach the last “90” of the 90-90-90 targets.
Published: 2019

31. Disclosure of HIV Status Beyond Sexual Partners by People Living with HIV in France: A Call for Help? Results from the National Cross-Sectional Survey ANRS-VESPA2

Author: Fabienne, Marcellin, Marie, Suzan-Monti, Antoine, Vilotitch, Luis, Sagaon-Teyssier, Marion, Mora, Rosemary, Dray-Spira, Marie, Préau, France, Lert, Bruno, Spire, and Martin, Duracinsky
Subjects: Male, medicine.medical_specialty, Self Disclosure, Social Psychology, Cross-sectional study, Population, Friends, HIV Infections, Truth Disclosure, 03 medical and health sciences, Social support, 0302 clinical medicine, Surveys and Questionnaires, medicine, Humans, Family, 030212 general & internal medicine, education, Multinomial logistic regression, education.field_of_study, 030505 public health, Social network, business.industry, Public health, Public Health, Environmental and Occupational Health, Social Support, Health psychology, Cross-Sectional Studies, Sexual Partners, Infectious Diseases, Multivariate Analysis, Female, France, Hiv status, 0305 other medical science, business, Psychology, Demography, Clinical psychology
Abstract: HIV status disclosure remains a complex issue for most people living with HIV (PLWH). We analyzed PLWH disclosure behaviors in France, where treatment is free and where the social image of HIV has improved in the general population. Analyses focused on disclosure to the social network excluding sexual partners (close family, other relatives, friends, colleagues). The study sample comprised 3016 participants from the nationally representative survey ANRS-VESPA2. Three PLWH clusters were identified using hierarchical classification ("high disclosure level": 28.2 %, "medium disclosure level": 27.5 %, and "low disclosure level": 44.3 %). In multivariable analyses, the variable "not living in a couple but psychological social support needed" was independently associated with medium (AOR [95 % CI] 1.8 [1.4; 2.3]) and high levels of disclosure (1.4 [1.1; 1.8]) (multinomial regression models). For PLWH living alone, HIV status disclosure may reveal a need for psychological social support, a key component to treatment adherence and positive prevention.
Published: 2016

32. HIV-1-RNA in seminal plasma correlates with detection of HIV-1-DNA in semen cells, but not with CMV shedding, among MSM on successful antiretroviral regimens: Table 1

Author: Ludivine David, Marianne Leruez-Ville, Dominique Costagliola, Jade Ghosn, Christine Rouzioux, Lambert Assoumou, Pierre Gantner, and Marie Suzan-Monti
Subjects: 0301 basic medicine, Pharmacology, Microbiology (medical), Cart, business.industry, Transmission (medicine), Case-control study, Congenital cytomegalovirus infection, virus diseases, Semen, medicine.disease, Hiv 1 rna, Andrology, 03 medical and health sciences, 030104 developmental biology, Infectious Diseases, Concomitant, Immunology, Medicine, Pharmacology (medical), Viral shedding, business
Abstract: Objectives Intermittent seminal HIV-RNA detection can occur in MSM despite concomitant plasma virological control on combined ART (cART). We undertook the present study to determine if seminal HIV detection was associated with seminal cytomegalovirus (CMV) detection or detection of HIV-infected cells in semen. Methods Longitudinal semen samples from HIV-1-infected MSM on successful cART enrolled in the EVARIST ANRS EP 49 study were analysed. We first conducted a case-control analysis (ratio 1 : 3) to assess HIV-DNA detection in semen cells in the 20 patients with detectable HIV-RNA in seminal plasma (cases) matched with 60 participants with undetectable HIV-RNA (controls) based on total HIV-DNA load in blood cells. Second, we measured CMV-DNA in all seminal plasma samples. Results HIV-1-DNA in semen cells was detected on at least one sample visit in 12/20 cases and 11/60 controls. Detection of HIV-RNA in seminal plasma was associated significantly with the detection of HIV-DNA in semen cells [OR, 7.6 (95% CI, 2.1-28.4); P = 0.002] when adjusted on total HIV-DNA in blood cells. CMV-DNA was detected in 107/273 seminal plasma samples with a median value of 3.62 log10 copies/mL (IQR, 2.83-4.38), yielding a prevalence of 39.2%. Seminal CMV-DNA shedding [OR, 1.5 (95% CI, 0.6-3.6); P = 0.343] was not associated with the risk of detection of HIV-RNA in seminal plasma. Conclusions The presence of HIV-DNA in semen cells was predictive of HIV-RNA detection, suggesting that viral particles arise through local HIV replication by infected semen cells. Despite virological control, compartmentalization of HIV in the genital tract might act in residual replication and transmission.
Published: 2016

33. Is on-demand HIV pre-exposure prophylaxis a suitable tool for men who have sex with men who practice chemsex ? Results from a substudy of the ANRS-IPERGAY trial

Author: Catherine Capitant, Luis Sagaon-Teyssier, Laurence Meyer, Cécile Tremblay, Daniela Rojas-Castro, Jean-Michel Molina, Lisa Fressard, Marie Suzan-Monti, Perrine Roux, Gilles Pialoux, Bruno Spire, Julie Chas, 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), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut de Recherche pour le Développement (IRD), Essais Thérapeutiques et Maladies Infectieuses, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Essais Therapeutiques et Infection Par Le Vih, Université de Montréal (UdeM), Groupe de Recherche en Psychologie Sociale (GRePS), Université Lumière - Lyon 2 (UL2), AIDES [Pantin] (Siège national), Institut Universitaire d'Hématologie (IUH), Université Paris Diderot - Paris 7 (UPD7), ANRS, Canadian HIV Trials Network, Fonds de Dotation Pierre Bergé pour la Prévention, Gilead Sciences donated the TDF-FTC and placebo used in the study, and partly funded for the pharmacokinetics analysis., Bill and Melinda Gates Foundation, Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Sud - Paris 11 (UP11), and Lissalde, Claire
Subjects: Adult, Male, medicine.medical_specialty, chemsex, HIV Infections, Logistic regression, Medication Adherence, law.invention, Men who have sex with men, 03 medical and health sciences, Pre-exposure prophylaxis, 0302 clinical medicine, Double-Blind Method, Randomized controlled trial, gay, prevention, law, Humans, Medicine, Pharmacology (medical), 030212 general & internal medicine, Homosexuality, Male, harm reduction, Generalized estimating equation, [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Harm reduction, 030505 public health, business.industry, HIV, Odds ratio, Middle Aged, PrEP, Risk perception, Infectious Diseases, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Family medicine, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Pre-Exposure Prophylaxis, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 0305 other medical science, business
Abstract: International audience; Background: Chemsex-the use of psychoactive substances during sexual encounters-among men who have sex with men is a growing concern. On-demand HIV pre-exposure prophylaxis (PrEP) may be a suitable tool to prevent HIV transmission among "chemsexers." We used the open-label extension study of the ANRS-IPERGAY trial to describe chemsexers and their PrEP use. Methods: Among the 361 men who have sex with men enrolled in ANRS-IPERGAY's open-label extension study, we selected the 331 with available data on drug use. A 2-monthly web questionnaire on sociobehavioral data was used to compare sexual behaviors between questionnaires where chemsex was reported and those where it was not. Using a generalized estimating equation logistic regression, we studied whether practicing chemsex was associated with correct PrEP use. Results: Among the 331 participants, 30% reported chemsex practice at least once during follow-up and were considered chemsexers. Chemsex was reported in 16% of all questionnaires. Chemsexers were not significantly different from nonchemsexers regarding sociodemographic characteristics, although they reported greater use of anxiolytics and more sensation-seeking. Reporting chemsex was associated with more high-risk sexual practices and a higher perception of risk. After adjustment for other potential correlates, chemsex remained associated with correct PrEP use [odds ratio (95% confidence interval) = 2.24 (1.37 to 3.66)]. Conclusions: Our findings show that chemsexers were more likely to report high-risk sexual practices but also had a higher perception of risk. They were also more likely to use PrEP correctly when practicing chemsex. Consequently, PrEP may be a suitable tool to reduce HIV-risk transmission among chemsexers.
Published: 2018

34. Posttraumatic Stress Disorder as a Significant Correlate of Voluntary Antiretroviral Treatment Interruption in Adult HIV-Infected Patients Followed up in French Hospitals

Author: Perrine, Roux, Fabienne, Marcellin, Khadim, Ndiaye, Marie, Suzan-Monti, Aurélie, Mayet, Martin, Duracinsky, Laélia, Briand-Madrid, Gwenaëlle, Maradan, Marion, Mora, Marie, Préau, Pierre, Verger, Patrizia, Carrieri, Rosemary, Dray-Spira, and Bruno, Spire
Subjects: Adult, Male, medicine.medical_specialty, Cross-sectional study, Population, MEDLINE, Emigrants and Immigrants, HIV Infections, Comorbidity, Logistic regression, Stress Disorders, Post-Traumatic, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, mental disorders, Antiretroviral treatment, Humans, Medicine, 030212 general & internal medicine, education, Psychiatry, Africa South of the Sahara, education.field_of_study, 030505 public health, business.industry, Odds ratio, Middle Aged, medicine.disease, Health Surveys, 3. Good health, Psychiatry and Mental health, Cross-Sectional Studies, Anti-Retroviral Agents, Turnover, Patient Compliance, Female, France, 0305 other medical science, business
Abstract: OBJECTIVE: Although antiretroviral treatment (ART) no longer requires 100% adherence, voluntary treatment interruption (VTI) still may have a negative impact on virologic success. Previous studies have shown that posttraumatic stress disorder (PTSD) is more prevalent in HIV-infected patients than in the general population. However, no study has yet investigated the relationship between PTSD and VTI. We analyzed this relationship using data from a French national survey representative of HIV-infected adults followed up in hospitals. METHODS: A total of 3,022 HIV-infected adults participated in the ANRS-VESPA2 survey (April 2011-January 2012) and answered a face-to-face questionnaire that included the Composite International Diagnostic Interview Short-Form to diagnose PTSD and assess sociobehavioral variables such as VTI. Multivariable logistic regression models were used to study the relationship between PTSD and VTI. RESULTS: Among the 2,768 ART-treated participants with available data for both PTSD screening and ART interruption (study sample), prevalence of PTSD was 13.3%, and 7.2% of individuals reported VTI during the previous month. After adjustment for being a female Sub-Saharan African immigrant and reporting harmful alcohol consumption (Alcohol Use Disorders Identification Test score ≥ 8), lifetime PTSD was found to be independently associated with VTI (adjusted odds ratio [95% CI] = 1.64 [1.07-2.53], P = .025). CONCLUSIONS: PTSD is highly prevalent in HIV-infected patients followed up in French hospitals and is a significant predictor of VTI. PTSD is a psychiatric disorder that is still underdiagnosed and undertreated in many countries despite its negative consequences on health behaviors. As there is evidence of effective treatment for PTSD, HIV care providers need to be trained in screening for this disorder.
Published: 2018

35. Treatment interruption in HIV-positive patients followed up in Cameroon's antiretroviral treatment programme : individual and health care supply-related factors (ANRS-12288 EVOLCam survey)

Author: Christelle, Tong, Marie, Suzan-Monti, Luis, Sagaon-Teyssier, Mohamed, Mimi, Christian, Laurent, Gwenaëlle, Maradan, Marie-Thérèse, Mengue, Bruno, Spire, Christopher, Kuaban, Laurent, Vidal, Sylvie, Boyer, I, Seyep, 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), Institut de Recherche pour le Développement (IRD), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Université Catholique d'Afrique Centrale - Institut Catholique de Yaoundé (UCAC), Department of Internal Medicine and Subspecialties [Yaoundé, Cameroon], University of Yaoundé [Cameroun], This study was approved by the Cameroonian Ministry of Public Health and was financially supported by the French National Agency for Research on AIDS and viral hepatitis (ANRS)., EVOL Cam group, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), and Lissalde, Claire
Subjects: 0301 basic medicine, Program evaluation, medicine.medical_specialty, Health Knowledge, Attitudes, Practice, Tuberculosis, Cross-sectional study, Anti-HIV Agents, [SDV]Life Sciences [q-bio], Developing country, HIV Infections, interruption du traitement antirétroviral, antiretroviral treatment interruption, health care supply-related factors, Logistic regression, Lower risk, Health Services Accessibility, 03 medical and health sciences, 0302 clinical medicine, Antiretroviral Therapy, Highly Active, Health care, Medicine, Humans, 030212 general & internal medicine, Cameroon, [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, 1. No poverty, Public Health, Environmental and Occupational Health, VIH, HIV, facteurs liés à l'offre des soins de santé, Patient Acceptance of Health Care, individual factors, medicine.disease, facteurs individuels, 030112 virology, 3. Good health, [SDV] Life Sciences [q-bio], Infectious Diseases, Cross-Sectional Studies, Family medicine, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Population study, Patient Compliance, Parasitology, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; introduction Decreasing international financial resources for HIV and increasing numbers of antiretroviral treatment (ART)-treated patients may jeopardise treatment continuity in low-income settings. Using data from the EVOLCam ANRS-12288 survey, this study aimed to document the prevalence of unplanned treatment interruption for more than 2 consecutive days (TI>2d) and investigate the associated individual and health care supply-related factors within the Cameroonian ART programme. methods A cross-sectional mixed methods survey was carried out between April and December 2014 in 19 HIV services of the Centre and Littoral regions. A multilevel logistic model was estimated on 1885 ART-treated patients in these services to investigate factors of TI>2d in the past 4 weeks. results Among the study population, 403 (21%) patients reported TI>2d. Patients followed up in hospitals reporting ART stock-outs were more likely to report TI>2d while those followed up in the Littoral region, in medium-or small-sized hospitals and in HIV services proposing financial support were at lower risk of TI>2d. The following individual factors were also associated with a lower risk of TI>2d: living in a couple, having children, satisfaction with attention provided by doctor, tuberculosis co-infection and not having consulted a traditional healer. conclusions Besides identifying individual factors of TI>2d, our study highlighted the role of health care supply-related factors in shaping TI in Cameroon's ART programme, especially the deleterious effect of ART stock-outs. Our results also suggest that the high proportion of patients reporting TI could jeopardise progress in the fight against HIV in the country, unless effective measures are quickly implemented like ensuring the continuity of ART supply. keywords HIV, Cameroon, antiretroviral treatment interruption, individual factors, health care supply-related factors
Published: 2018

36. Acceptability of HIV cure-related trials: the challenges for physicians and people living with HIV (ANRS-APSEC)

Author: Christel Protière, Marion Mora, Marie Préau, Jean-Daniel Lelièvre, François Raffi, Cécile Goujard, Marjolaine Doumergue, Bruno Spire, Marie Suzan-Monti, Laurence Meyer, Olivier Lambotte, 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), Hôpital Bicêtre, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Biopathologie de la Myéline, Neuroprotection et Stratégies Thérapeutiques (BMNST), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Strasbourg (UNISTRA), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, Maladies infectieuses et tropicales, Service de Médecine Interne et Immunologie clinique [AP-HP Hôpital Bicêtre], Immunologie des Maladies Virales et Autoimmunes (IMVA - U1184), Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM), The ANRS APSEC survey was supported by ANRS (France Recherche Nord & sud Sida-hiv Hépatites)., Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de médecine interne et maladies infectieuses, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Bicêtre, Biopathologie de la Myéline, Neuroprotection et Stratégies Thérapeutiques, Service d'immunologie clinique [Créteil], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), INSERM U1012, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), and Greps, Laboratoire
Subjects: 0301 basic medicine, Male, medicine.medical_specialty, Health (social science), Social Psychology, Anti-HIV Agents, Attitude of Health Personnel, 030106 microbiology, Human immunodeficiency virus (HIV), [SHS.PSY]Humanities and Social Sciences/Psychology, HIV Infections, medicine.disease_cause, HIV culture, [SHS.PSY] Humanities and Social Sciences/Psychology, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), cure trial, Willingness to participate in clinical trials, Physicians, Epidemiology, Medicine, Humans, 030212 general & internal medicine, Infectious disease (athletes), HIV history, ComputingMilieux_MISCELLANEOUS, business.industry, Public Health, Environmental and Occupational Health, Middle Aged, Focus group, 3. Good health, Clinical trial, Family medicine, Quality of Life, Female, France, business, Psychosocial
Abstract: International audience; Essential HIV cure-related clinical trials (HCRCT) have a potentially high-risk profile in terms of participants' health, which could hinder enrollment by people living with HIV (PLWH) and healthcare professionals (HP). The ANRS-APSEC survey is part of the IAS "Towards an HIV cure" initiative, which promotes multidisciplinary research for a safe, affordable and scalable cure. The study objectives were to understand the psychosocial mechanisms underlying PLWH and HP viewpoints about future HCRCT. Six focus group discussions (three with PLWH (n = 21) and three with HP (n = 30)) were held in three French infectious disease units. From these, three perspectives on HCRCT were identified. The first involved beliefs and knowledge associating HCRCT with poorer health and quality of life for PLWH. The second concerned perceptions of HCRCT as a biological and epidemiological flashback to a situation when HIV infection was left uncontrolled. The third was characterized by aspects of historical HIV culture that embrace innovation.
Published: 2018

37. The ANRS-Ipergay trial, an opportunity to use qualitative research to understand the perception of the 'participant'-physician relationship

Author: Marion Di Ciaccio, Marie Suzan-Monti, Martin Siguier, Eric Cua, Laurent Cotte, Bruno Spire, Marie Préau, Jean-Michel Molina, Daniela Rojas Castro, Christel Protière, Julie Chas, Di Ciaccio, Marion, 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), Groupe de Recherche en Psychologie Sociale (GRePS), Université Lumière - Lyon 2 (UL2), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), AIDES [Pantin, France] (Mission Innovation Recherche Expérimentation), Coalition Internationale Sida [Pantin, France] (Programme Recherche Communautaire), Service de Maladies infectieuses et tropicales [CHU Tenon], CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service des maladies infectieuses et tropicales [CH Lyon Sud - HCL] (Hôpital de la Croix-Rousse), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL)-Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Génétique et Ecologie des Virus, Génétique des Virus et Pathogénèse des Maladies Virales, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département des Maladies Infectieuses [CHU Nice] (Hôpital de l'Archet), Hôpital l'Archet - CHU de Nice, Service des Maladies Infectieuses et Tropicales, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), ANRS IPERGAY Study Group, Epidémiologie et Sciences Sociales Appliquées à l'Innovation Médicale, Université de la Méditerranée - Aix-Marseille 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Service des Maladies Infectieuses et Tropicales [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Tenon [APHP], Equipe 16, Centre de Recherche en Cancérologie de Lyon (CRCL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre Léon Bérard [Lyon]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre Léon Bérard [Lyon]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Centre Hospitalier Universitaire de Nice (CHU Nice), Service de maladies infectieuses et tropicales [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Service des maladies infectieuses et tropicales [CHU Tenon], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL)-Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), 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)-Université Paris Diderot - Paris 7 (UPD7), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Adult, Counseling, Male, medicine.medical_specialty, Health (social science), Social Psychology, Anti-HIV Agents, ANRS-IPERGAY trial, media_common.quotation_subject, Identity (social science), [SHS.PSY]Humanities and Social Sciences/Psychology, HIV Infections, Context (language use), Men who have sex with men, Paternalism, Condoms, [SHS.PSY] Humanities and Social Sciences/Psychology, 03 medical and health sciences, 0302 clinical medicine, Physicians, Perception, Humans, Medicine, 030212 general & internal medicine, Homosexuality, Male, Medical prescription, patient-as-partner, Qualitative Research, ComputingMilieux_MISCELLANEOUS, media_common, Physician-Patient Relations, 030505 public health, Patient-physician relationship, business.industry, Public Health, Environmental and Occupational Health, Middle Aged, PrEP, 3. Good health, Sexual Partners, Family medicine, Female, Pre-Exposure Prophylaxis, 0305 other medical science, business, Construct (philosophy), Qualitative research
Abstract: International audience; The ANRS-IPERGAY trial consisted in providing sexual activity-based antiretroviral prophylaxis for HIV prevention (PrEP) with a package of prevention tools (counselling, condoms, HIV and sexually transmitted infections' screening) to highly exposed HIV-negative men who have sex with men (MSM). Few data exist concerning the patient-physician relationship in the particular context of PrEP, where physicians discuss sexual behaviours with MSM who are not classic patients, in that consultation is for prevention purposes, not for illness. This study took place during the open-label extension of ANRS-IPERGAY trial when all participants received PrEP. In this qualitative study, we examined how physicians perceived their relationship with participants in the ANRS-IPERGAY trial. Of all 30 physicians involved in the trial who were contacted by email to participate in an interview about their opinions and perceptions of ANRS-IPERGAY 18 volunteered to participate in the current sub-study. We performed a vertical analysis for each interview to identify the extract in each physician's discourse concerning their relationship with MSM participants, and conducted a horizontal analysis to construct the thematic tree and subsequently investigate differences and similitudes between themes. An analysis of all physicians' discourses showed that the participant-physician relationship during the trial could be described through 4 themes: (i) personal experience of the relationship, (ii) trust and non-judgement, (iii) positive relational climate and (iv) influence of physician's characteristics (age, gender, etc.) on relationship. We found that the particular context of PrEP led some physicians to adopt a patient-as-partner approach during consultations rather than a paternalist or hierarchical approach. Indeed, the close follow-up provided by the trial and the active role of patients in their own prevention care trajectory, are more compatible with the patient-as-partner approach. The prescription of PrEP may lead to an evolution in patient-physician relationships and may even modify the professional identity of physicians.
Published: 2018

38. Innovative community‐based educational face‐to‐face intervention to reduce HIV, hepatitis C virus and other blood‐borne infectious risks in difficult‐to‐reach people who inject drugs: results from the ANRS–AERLI intervention study

Author: Jean-Marie Le Gall, Marie Suzan-Monti, Marion Mora, Caroline Lions, Camelia Protopopescu, Perrine Roux, Marie Debrus, Maria Patrizia Carrieri, Bruno Spire, Khadim Ndiaye, Baptiste Demoulin, Aurelie Haas, 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)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), AIDES [Marseille, France] (Association loi de 1901), Médecins du Monde [Paris, France] (Association médicale militante de solidarité internationale), French National Agency for Research for AIDS and Viral Hepatitis (ANRS)., and Lissalde, Claire
Subjects: Adult, Male, Program evaluation, medicine.medical_specialty, local complications, 030508 substance abuse, Medicine (miscellaneous), HIV Infections, Communicable Diseases, Education, 03 medical and health sciences, Risk-Taking, 0302 clinical medicine, Harm Reduction, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Intervention (counseling), Cluster Analysis, Humans, Medicine, Community Health Services, injecting drug user, 030212 general & internal medicine, Substance Abuse, Intravenous, Health Education, intervention, Drug injection, Harm reduction, business.industry, HIV, Hepatitis C, medicine.disease, Checklist, 3. Good health, Psychiatry and Mental health, Telephone interview, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Family medicine, HCV, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Health education, France, 0305 other medical science, business, Social psychology, Program Evaluation
Abstract: Aims To study the effectiveness of an educational intervention on risks associated with drug injection, comparing primary [unsafe HIV–hepatitis C virus (HCV) practices] and secondary (local complications at injecting site) end-points in harm reduction (HR) programmes offering this intervention versus HR programmes not offering it. Design This non-random clustered intervention study was conducted in nine intervention groups (programmes offering the intervention) and eight control groups (programmes not offering it). Each participant was followed-up through a telephone interview at enrolment and at 6 and 12 months. Setting The study took place in 17 cities throughout France. Participants Of the 271 participants, 144 were enrolled into the intervention group and 127 in the control group. Of the latter, 113 received at least one educational session. Intervention A series of participant-centred face-to-face educational sessions. Each session included direct observation by trained non-governmental organization (NGO) staff or volunteers of participants’ self-injecting the psychoactive product they used habitually; analysis by the trained NGO staff or volunteers of the participant's injecting practices, identification of injection-related risks and explanation of safer injecting practices; and an educational exchange on the individual participant's injection practices and the questions he or she asked. Measurements Primary and secondary outcomes were ‘at least one unsafe HIV–HCV practice’ and at least one injection-related complication (derived from a checklist). Findings The proportion of participants with at least one unsafe HIV–HCV practice in the intervention group decreased significantly, from 44% at M0 to 25% at M6, as well as complications at the injection site (from 66 to 39% at M12), while in the control group it remained mainly stable. Multivariate probit analyses showed that the intervention group experienced a significant reduction in unsafe HIV–HCV practices at M6 [coefficient, 95% confidence interval (CI) = −0.73 (−1.47 to 0.01)] and in injection-related complications at M12 [coefficient, 95% CI = −1.01 (−1.77 to −0.24)], compared with the control group. Conclusions An inexpensive and easily implemented educational intervention on risks associated with drug injection reduces significantly unsafe HIV–HCV transmission practices and injection-related complications.
Published: 2015

39. Benefits of task-shifting HIV care to nurses in terms of health-related quality of life in patients initiating antiretroviral therapy in rural district hospitals in Cameroon [Stratall Agence Nationale de Recherche sur le SIDA (ANRS) 12110/Ensemble pour un

Author: Marie Suzan-Monti, Jérôme Blanche, Patrizia Carrieri, Renée-Cécile Bonono, Eric Delaporte, Bruno Spire, Charles Kouanfack, Christian Laurent, Sylvie Boyer, Camelia Protopopescu, 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)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), and Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)
Subjects: Adult, Male, Rural Population, Program evaluation, Gerontology, Anti-HIV Agents, Cost-Benefit Analysis, Health Status, antiretroviral therapy, Population, Nurses, Developing country, HIV Infections, World Health Organization, Quality of life (healthcare), [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Physicians, Humans, Medicine, Pharmacology (medical), Cameroon, Longitudinal Studies, education, Sida, Monitoring, Physiologic, education.field_of_study, biology, business.industry, Health Policy, Viral Load, Hospitals, District, biology.organism_classification, task-shifting, Confidence interval, CD4 Lymphocyte Count, 3. Good health, health-related quality of life, Infectious Diseases, Patient Satisfaction, comprehensive care, Scale (social sciences), Practice Guidelines as Topic, Disease Progression, Quality of Life, HIV-1, Female, Rural area, business, Follow-Up Studies
Abstract: International audience; OBJECTIVES:The World Health Organization (WHO) recommends task-shifting HIV care to nurses in low-resource settings with limited numbers of physicians. However, the effect of such task-shifting on the health-related quality of life (HRQL) of people living with HIV (PLHIV) has seldom been evaluated. We aimed to investigate the effect of task-shifting HIV care to nurses on HRQL outcomes in PLHIV initiating antiretroviral therapy (ART) in rural district hospitals in Cameroon.METHODS:Outcomes in PLHIV were longitudinally collected in the 2006-2010 Stratall trial. PLHIV were followed up for 24 months by nurses and/or physicians. Six HRQL dimensions were assessed during face-to-face interviews using the WHO Quality of Life (WHOQOL)-HIV BREF scale: physical health; psychological health; independence level; social relationships; environment; and spirituality/religion/personal beliefs. The degree of task-shifting was estimated using a consultant ratio (i.e. the ratio of nurse-led to physician-led visits). The effect of task-shifting and other potential correlates on HRQL dimensions was explored using a Heckman two-stage approach based on linear mixed models to adjust for the potential bias caused by missing data in the outcomes.RESULTS:Of 1424 visits in 440 PLHIV (70.5% female; median age 36 years; median CD4 count 188 cells/μL at enrolment), 423 (29.7%) were task-shifted to nurses. After multiple adjustment, task-shifting was associated with higher HRQL level for four dimensions: physical health [coefficient 0.7; 95% confidence interval (CI) 0.1-1.2; P = 0.01], psychological health (coefficient 0.5; 95% CI 0.0-1.0; P = 0.05), independence level (coefficient 0.6; 95% CI 0.1-1.1; P = 0.01) and environment (coefficient 0.6; 95% CI 0.1-1.0; P = 0.02).CONCLUSIONS:Task-shifting HIV care to nurses benefits the HRQL of PLHIV. Together with the previously demonstrated comparable clinical effectiveness of physician-based and nurse-based models of HIV care, our results support the WHO recommendation for task-shifting.
Published: 2015

40. Will CURE trials introduce an uncomfortable revolution in the field of HIV research?

Author: Olivier Lambotte, Marion Mora, Marjolaine Doumergue, Christel Protière, Marie Suzan-Monti, Bruno Spire, Marie Préau, Epidémiologie et Sciences Sociales Appliquées à l'Innovation Médicale, Université de la Méditerranée - Aix-Marseille 2-Institut National de la Santé et de la Recherche Médicale (INSERM), 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 - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Immunologie des Maladies Virales et Autoimmunes (IMVA - U1184), Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), This work was financially supported from ANRS [France Recherche Nord & Sud Sida-hiv Hépatites – N° 14697], and Protière, Christel
Subjects: 0301 basic medicine, medicine.medical_specialty, Biomedical Research, Anti-HIV Agents, 030106 microbiology, Human immunodeficiency virus (HIV), Alternative medicine, [SHS.PSY]Humanities and Social Sciences/Psychology, HIV Infections, medicine.disease_cause, Cure trials, [SHS.PSY] Humanities and Social Sciences/Psychology, 03 medical and health sciences, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Innovation, [SHS.ECO] Humanities and Social Sciences/Economics and Finance, ComputingMilieux_MISCELLANEOUS, Clinical Trials as Topic, Medical education, business.industry, Field (Bourdieu), HIV, medicine.disease, [SHS.ECO]Humanities and Social Sciences/Economics and Finance, 3. Good health, HIV identity, Infectious Diseases, Epistemological break, business
Abstract: Since the start of the HIV/Aids epidemic, in the early eighties, innovations to cope with emergency have come one after another. They have always followed the same logic, that of improving upon cur...
Published: 2017

41. Prevalence of HIV at the Kokoyo informal gold mining site: What lies behind the glitter of gold with regard to HIV epidemics in Mali ? A community-based approach (The ANRS-12339 Sanu Gundo cross-sectional survey)

Author: B. Dembélé Keita, Marion Mora, Nikos Kalampalikis, Michel Bourrelly, Luis Sagaon-Teyssier, Bruno Spire, Fodié Diallo, H. Balique, Marie Suzan-Monti, 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), INSERM U 379 / ORS PACA, Institut National de la Santé et de la Recherche Médicale (INSERM), ARCAD-SIDA (ARCAD-SIDA), Groupe de Recherche en Psychologie Sociale (GRePS), Université Lumière - Lyon 2 (UL2), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), and Kalampalikis, Nikos
Subjects: Male, Gerontology, Cross-sectional study, [SHS.PSY]Humanities and Social Sciences/Psychology, HIV Infections, Mali, Health Services Accessibility, Condoms, 0302 clinical medicine, 5. Gender equality, Residence Characteristics, Risk Factors, Surveys and Questionnaires, HIV Seropositivity, Epidemiology, Prevalence, 030212 general & internal medicine, education.field_of_study, Health Policy, public health, Commerce, General Medicine, epidemiology, Female, 0305 other medical science, Adult, medicine.medical_specialty, Sexual Behavior, Population, Context (language use), Mining, [SHS.PSY] Humanities and Social Sciences/Psychology, Young Adult, 03 medical and health sciences, Acquired immunodeficiency syndrome (AIDS), Environmental health, medicine, Humans, Occupations, Epidemics, education, Health policy, Sex Workers, 030505 public health, business.industry, Research, Public health, HIV, medicine.disease, Sex Work, Focus group, Cross-Sectional Studies, Gold, business
Abstract: ObjectivesThe aim of this article was to estimate HIV prevalence and the factors associated with HIV seropositivity in the population living and working at the informal artisanal small-scale gold mining (IASGM) site of Kokoyo in Mali, using data from the Sanu Gundo survey. Our main hypothesis was that HIV prevalence is higher in the context of IASGM than in the country as a whole.DesignThe ANRS-12339 Sanu Gundo was a cross-sectional survey conducted in December 2015. The quantitative survey consisted of face-to-face administration of questionnaires. Five focus groups were conducted for the qualitative survey. HIV prevalence was calculated for the sample, and according to the type of activity performed in IASGM.SettingsThe IASGM site of Kokoyo, one of the largest sites in Mali (between 6000 and 1000 people).Participants224 respondents: 37.5% were gold-diggers, 33% retail traders, 6.7%tombolomas(ie, traditional guards) and 9% female sex workers. The remaining 13.8% reported another activity (mainly street vending).Primary and secondary outcome measuresHIV prevalence and HIV prevalence according to subgroup, as defined by their activity at the Kokoyo IASGM. A probit logistic regression was implemented to estimate the characteristics associated with HIV seropositivity.ResultsHIV prevalence for the total sample was 8% (95% CI 7.7% to 8.3%), which is much higher than the 2015 national prevalence of 1.3%Joint United Nations Programme on HIV/AIDS (UNAIDS). The probability of HIV seropositivity was 7.8% (p=0.037) higher for female non-sex workers than for any other category, and this probability increased significantly with age. Qualitative data revealed the non-systematic use of condoms with sex workers; and long distance from health services was the main barrier to accessing care.ConclusionsIntegrated policymaking should pay special attention to infectious diseases among populations in IASGM zones. Bringing information/prevention activities closer to people working in gold mining zones is an urgent public health action.
Published: 2017

42. Self-Reported Bothersome Symptoms Across Different Socioepidemiological Groups of People Living With HIV Attending French Hospitals: Results From the ANRS-VESPA2 Survey

Author: Véronique Boyer, Antoine Vilotitch, Fabienne Marcellin, Baptiste Demoulin, Rosemary Dray-Spira, Bruno Spire, France Lert, Maria Patrizia Carrieri, Christine Hamelin, Nicolas Lorente, Marie Préau, Marie Suzan-Monti, Martin Duracinsky, Marion Mora, 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), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), French National Agency for Research on Aids and Viral Hepatitis (ANRS) (ANRS-EN12), Lissalde, Claire, Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)
Subjects: 0301 basic medicine, Adult, Male, medicine.medical_specialty, Multivariate analysis, Adolescent, Anti-HIV Agents, Population, Human immunodeficiency virus (HIV), Context (language use), HIV Infections, Comorbidity, medicine.disease_cause, Social group, 03 medical and health sciences, Young Adult, 0302 clinical medicine, medicine, Humans, 030212 general & internal medicine, Moderate number, education, Psychiatry, Self report, General Nursing, education.field_of_study, General symptoms, business.industry, 1. No poverty, Middle Aged, self-report, 030112 virology, 3. Good health, Anesthesiology and Pain Medicine, Logistic Models, Socioeconomic Factors, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Multivariate Analysis, socioepidemiological group, symptoms, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neurology (clinical), France, Self Report, business, ART
Abstract: Context Twenty years after the advent of combined antiretroviral therapies (ARTs), there is a growing need for up-to-date information about the daily experience of people living with HIV (PLWH). Objectives This study aimed to investigate the relationship between socioepidemiological groups and the types of bothersome symptoms reported by PLWH participating in a national survey in France. Methods We analyzed self-reported bothersome symptoms in a representative sample of PLWH (ANRS-VESPA2 survey), most of whom were receiving ART treatment. PLWH ( N = 2505) were grouped into three clusters according to the number of bothersome symptoms reported: Cluster A (low number, n = 1848), Cluster B (moderate number, n = 271), and Cluster C (high number, n = 386). Results Individuals in Cluster A (low number of bothersome symptoms) were less likely to report all the symptom types investigated. Psychological, sexual, and general symptoms were more likely to be reported in Cluster B (moderate number), whereas gastric-, pain-, and appearance-related symptoms were more likely in Cluster C (high number). In multivariate analyses, women not natives of Sub-Saharan Africa and former/active female injecting drug users were more likely to report a medium or high number of symptoms, and lower adherence to ART. Conclusion Combining new biomedical strategies with coping mechanisms and providing better support to socially vulnerable PLWH may improve this population's quality of health and daily life.
Published: 2017

43. Importance of the patient-physician interaction in assessing acceptability of HIV cure trials

Author: Marie Préau, Patrizia Carrieri, Olivier Lambotte, Marie Suzan-Monti, Christel Protière, Bruno Spire, 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), Groupe de Recherche en Psychologie Sociale (GRePS), Université Lumière - Lyon 2 (UL2), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Service de Médecine Interne - Immunologie Clinique [AP-HP Bicêtre], Immunologie des Maladies Virales et Autoimmunes (IMVA - U1184), Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Lissalde, Claire, Aix-Marseille Sciences Economiques (AMSE), École des hautes études en sciences sociales (EHESS)-Aix Marseille Université (AMU)-Ecole Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), service de Médecine Interne et d'Immunologie Clinique [AP-HP Hôpital Bicêtre], Université Paris-Sud - Paris 11 (UP11)-Hôpital Bicêtre, Assistance Publique - Hôpitaux de Paris (AP-HP), and Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)
Subjects: 0301 basic medicine, medicine.medical_specialty, [SHS.ECO]Humanities and Social Sciences/Economies and finances, Human immunodeficiency virus (HIV), [SHS.PSY]Humanities and Social Sciences/Psychology, HIV Infections, medicine.disease_cause, Health Services Accessibility, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Intensive care medicine, ComputingMilieux_MISCELLANEOUS, Clinical Trials as Topic, Physician-Patient Relations, business.industry, Health Policy, 030112 virology, 3. Good health, Infectious Diseases, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, business
Abstract: International audience
Published: 2017

44. Factors associated with partner notification of STIs in men who have sex with men on PrEP in France: a cross-sectional substudy of the ANRS-IPERGAY trial

Author: Lisa Fressard, Laurence Meyer, Jean-Michel Molina, Laurent Cotte, Marie Suzan-Monti, Catherine Capitant, Eric Cua, Gilles Pialoux, Bruno Spire, Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), 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), Service de Maladies Infectieuses et Tropicales [Hôpital de la Croix-Rousse - HCL], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Maladies Infectieuses [CHU Nice], Hôpital l'Archet - CHU de Nice, Essais Thérapeutiques et Maladies Infectieuses, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Sud - Paris 11 (UP11), Essais Therapeutiques et Infection Par Le Vih, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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), The ANRS IPERGAY trial was sponsored by the ANRS (France Recherche Nord & Sud Sida-HIV Hepatites), and funded by ANRS, the Canadian HIV Trials Network, the Fonds de dotation Pierre Bergé pour la Prévention - SIDACTION, and the Bill & Melinda Gates Foundation., ANRS IPERGAY Study Group, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], and Lissalde, Claire
Subjects: Adult, Male, medicine.medical_specialty, Casual, Sexual Behavior, Street drugs, Sexually Transmitted Diseases, Behavioural sciences, partner notification, Dermatology, 030501 epidemiology, infectious diseases, behavioural science, Men who have sex with men, Condoms, Drug Users, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Surveys and Questionnaires, Medicine, Humans, 030212 general & internal medicine, Longitudinal Studies, Homosexuality, Male, gay men, Unsafe Sex, business.industry, Public health, Extension study, Partner notification, 3. Good health, Cross-Sectional Studies, Sexual Partners, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Family medicine, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Contact Tracing, 0305 other medical science, business, Anal sex, Follow-Up Studies
Abstract: ObjectivesPartner notification (PN) is a useful public health approach to enhance targeted testing of people at high risk of HIV and other STIs, and subsequent linkage to care for those diagnosed. In France, no specific PN guidelines exist and information about current practices is scarce. We used the ANRS-IPERGAY PrEP trial to investigate PN in HIV-negative men who have sex with men (MSM) reporting a bacterial STI.MethodsThis substudy included 275 participants who completed a specific online PN questionnaire during the open-label extension study of the ANRS-Intervention Préventive de l’Exposition aux Risques avec et pour les Gays (IPERGAY) trial. Variables used as proxies of at-risk practices were defined using data collected at the previous follow-up visit about participants’ most recent sexual encounter and preventive behaviours. χ2 or Fisher’s exact test helped select variables eligible for multiple logistic models.ResultsOf the 275 participants, 250 reported at least one previous STI. Among the latter, 172 (68.8%) had informed their partner(s) of their most recent STI. Of these, 138 (80.2%) and 83 (48.3%) had notified their casual and main partners, respectively. Participants were less likely to notify their main partner when their most recent sexual encounter involved unsafe anal sex with a casual partner (adjusted OR (aOR) (95% CI) 0.18 (0.06 to 0.54), P=0.02). Older participants were less likely to inform casual partners (aOR (95% CI) 0.44 (0.21 to 0.94), P=0.03), while those practising chemsex during their most recent sexual encounter were more likely to inform their casual partners (aOR (95% CI) 2.56 (1.07 to 6.09), P=0.03).ConclusionUnsafe sexual encounters with people other than main partners and street drugs use were two sociobehavioural factors identified, respectively, as a barrier to main PN and a motivator for casual PN, in a sample of high-risk MSM. These results provide an insight into current PN practices regarding STI in France and might inform future decisions about how to define feasible and acceptable PN programmes.
Published: 2017

45. Informal pre-exposure prophylaxis use in France : results from the Flash PrEP survey (2014)

Author: Bruno Spire, Marie Suzan-Monti, J-M Le Gall, D. Rojas Castro, Luis Sagaon-Teyssier, G. Quatremère, Marie Préau, Groupe de Recherche en Psychologie Sociale (GRePS), Université Lumière - Lyon 2 (UL2), AIDES [Pantin] (Siège national), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), 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), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), and Lissalde, Claire
Subjects: Adult, Male, 0301 basic medicine, Health Knowledge, Attitudes, Practice, Pediatrics, medicine.medical_specialty, Anti-HIV Agents, HIV Infections, Chemoprevention, Health Services Accessibility, Young Adult, 03 medical and health sciences, Pre-exposure prophylaxis, Flash (photography), 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Surveys and Questionnaires, Humans, Medicine, Pharmacology (medical), 030212 general & internal medicine, Homosexuality, Male, Young adult, ComputingMilieux_MISCELLANEOUS, Aged, business.industry, Health Policy, Awareness, Middle Aged, Patient Acceptance of Health Care, 030112 virology, 3. Good health, Infectious Diseases, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, Pre-Exposure Prophylaxis, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, business, Male Homosexuality
Abstract: International audience
Published: 2017

46. Population Pharmacokinetic Modeling of Tenofovir in the Genital Tract of Male HIV-Infected Patients

Author: Saïk Urien, Déborah Hirt, Marie Suzan-Monti, Jade Ghosn, Christine Rouzioux, Elodie Valade, Lambert Assoumou, Sílvia M. Illamola, Frantz Foissac, Jean-Marc Tréluyer, Maïlys De Sousa Mendes, Sihem Benaboud, Gabrielle Lui, Naïm Bouazza, Jean-Paul Viard, Aurélie Cobat, Camille Chenevier-Gobeaux, Evaluation thérapeutique et pharmacologie périnatale et pédiatrique (EA_7323), Université Paris Descartes - Paris 5 (UPD5), CIC - Mère Enfant Necker Cochin Paris Centre (CIC 1419), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Département de Pharmacologie Clinique [CHU Cochin], Hôpital Cochin [AP-HP], CTG repeat instability and myotonic dystrophy (Equipe Inserm U1163), Imagine - Institut des maladies génétiques (IMAGINE - U1163), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Infection à VIH, réservoirs, diversité génétique et résistance aux antirétroviraux (ARV) (EA 7327), Laboratoire de Virologie [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Epidémiologie, stratégies thérapeutiques et virologie cliniques dans l'infection à VIH [Paris], Institut National de la Santé et de la Recherche Médicale (INSERM), UF de Thérapeutique en Immuno‑Infectiologie [AP-HP Hôtel Dieu], Hôpital Hôtel-Dieu [Paris], Service de médecine interne et maladies infectieuses, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Infections à Vih, Réservoirs, Pharmacologie des Antirétroviraux et Prévention de la Transmission Mère Enfant, The French National Agency for Research on AIDS and Viral Hepatitis (ANRS) sponsored the Evarist study. This study also received financial support from SIDACTION., Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], and Lissalde, Claire
Subjects: 0301 basic medicine, Male, Physiology, Gene Expression, HIV Infections, population pharmacokinetics, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Blood plasma, Medicine, Pharmacology (medical), Drug Dosage Calculations, education.field_of_study, Liter, Middle Aged, HIV Reverse Transcriptase, Markov Chains, Infectious Diseases, Area Under Curve, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Monte Carlo Method, medicine.drug, Adult, Tenofovir, Anti-HIV Agents, Population, Biological Availability, Single-nucleotide polymorphism, Semen, Microbial Sensitivity Tests, Genitalia, Male, Polymorphism, Single Nucleotide, Drug Administration Schedule, 03 medical and health sciences, Pharmacokinetics, Humans, education, Pharmacology, Models, Statistical, business.industry, Body Weight, Bayes Theorem, genital tract, 030112 virology, tenofovir, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, HIV-1, seminal plasma, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Pharmacogenetics
Abstract: The aims of this study were to describe the blood plasma (BP) and seminal plasma (SP) pharmacokinetics of tenofovir (TFV) in HIV-1-infected men, to assess the role of genetic polymorphism in the variability of TFV transfer into the male genital tract, and to evaluate the impact of TFV SP exposure on seminal plasma HIV load (spVL). Men from the Evarist-ANRS EP 49 study treated with TFV as part of their antiretroviral therapy were included in the study. A total of 248 and 217 TFV BP and SP concentrations from 129 men were available for the analysis. For pharmacogenetic assessment, a total of 121 single nucleotide polymorphisms (SNP) were genotyped. Data were analyzed using a nonlinear mixed-effects modeling approach. TFV pharmacokinetics were best described by a two-compartment model for BP and by an effect compartment with different input and output constants for SP. TFV exposures (area under the concentration-time curve from 0 to 24 h [AUC 0–24 ]) were higher in SP than in BP (median AUC 0–24 , 7.01 versus 2.97 mg · liter −1 · h, respectively). The median (range) SP-to-BP AUC 0–24 ratio was 2.24 (0.53 to 34.13). After correction for multiple testing, none of the SNPs were significantly associated with the TFV transfer rate constant. The impact of the TFV SP AUC 0–24 or TFV SP-to-BP AUC 0–24 ratio on spVL was not significant ( P = 0.808 and 0.768, respectively). This is the first population model describing TFV pharmacokinetics in the male genital tract. TFV SP concentrations were higher than BP concentrations. Despite TFV SP exposures being higher than BP exposures, an spVL was detectable for 12.2% of the men.
Published: 2017

47. HIV-1 DNA Levels in Peripheral Blood Mononuclear Cells and Cannabis Use are Associated With Intermittent HIV Shedding in Semen of Men Who Have Sex With Men on Successful Antiretroviral Regimens

Author: Ana Canestri, Jérôme Blanche, Aurore Delobelle, Marie Suzan-Monti, Jade Ghosn, Christine Rouzioux, Laurence Mascard, Marianne Leruez-Ville, Hervé Lécuyer, Diane Ponscarme, Bruno Spire, Jean-Paul Viard, Céline Beaudoux, Roland Landman, Agathe Rami, Dominique Costagliola, and David Zucman
Subjects: Adult, Male, Sexually Transmitted Diseases, Bacterial, Microbiology (medical), Cart, medicine.medical_specialty, Sexual transmission, Anti-HIV Agents, HIV Infections, Marijuana Smoking, Semen, Men who have sex with men, Acquired immunodeficiency syndrome (AIDS), Internal medicine, Blood plasma, medicine, Humans, Homosexuality, Male, Sida, biology, business.industry, virus diseases, Middle Aged, Viral Load, biology.organism_classification, medicine.disease, Virus Shedding, Infectious Diseases, DNA, Viral, Immunology, HIV-1, Leukocytes, Mononuclear, RNA, Viral, Drug Therapy, Combination, Viral disease, business
Abstract: Few data exist on the efficacy of combined antiretroviral therapy (cART) in semen of human immunodeficiency virus type 1 (HIV-1) infected men who have sex with men (MSM) with sustained control of HIV replication in blood.HIV-1 infected MSM on successful cART for6 months were enrolled. HIV-RNA was quantified in seminal plasma (spVL) and in blood plasma (bpVL) from 2 paired samples collected 4 weeks apart. Relationship between spVL and bpVL (measured by an ultrasensitive assay, LOQ 10 copies/mL), total peripheral blood mononuclear cells (PBMC)-associated HIV-DNA, sexually transmitted infections (STIs), and self-reported socio-behavioral characteristics was assessed using GEE logistic regression.In total, 157 patients were included. Median time with bpVL50 copies/mL was 3.3 years. spVL was detectable in 23/304 samples (prevalence 7.6%). Median spVL was 145 cp/mL (100-1475). spVL was detectable on the first, on the second, and on both samples in 5, 14, and 2 men, respectively. In sum, 33 individuals (21%) had STIs (asymptomatic in 24/33). Residual bpVL was undetectable by ultrasensitive assay in 225/300 samples (75%). After multivariable adjustments, PBMC-associated HIV-DNA (OR 2.6[1.2; 6.0], for HIV-DNA2.5 log10 cp/10(6) PBMC, P = .02), and cannabis use during sexual intercourse (OR 2.8[1.2; 6.7], P = .02) were the only factors associated significantly with spVL.We show that HIV-RNA can be detected intermittently in semen of HIV-1 infected MSM despite successful cART. The size of blood HIV-1 reservoir predicted spVL detection. Our results indicated also that the possible effect of cannabis should be taken into account when developing prevention interventions targeted toward HIV-infected MSM on successful cART.
Published: 2014

48. Patterns of adherence to antiretroviral therapy and HIV drug resistance over time in the Stratall ANRS 12110/ESTHER trial in Cameroon

Author: Marie Suzan-Monti, Avelin F. Aghokeng, Maria Patrizia Carrieri, Meresse M, Bruno Spire, Christian Laurent, Stratall Anrs, Sylvie Boyer, Renée-Cécile Bonono, Gabrièle Laborde-Balen, Laura March, Charles Kouanfack, and Eric Delaporte
Subjects: medicine.medical_specialty, Reverse-transcriptase inhibitor, business.industry, Proportional hazards model, Health Policy, Hazard ratio, Odds ratio, Confidence interval, Surgery, Infectious Diseases, Internal medicine, medicine, Pharmacology (medical), business, Viral load, HIV drug resistance, Cohort study, medicine.drug
Abstract: Objectives The emergence of HIV drug resistance is a crucial issue in Africa, where second-line antiretroviral therapy (ART) is limited, expensive and complex. We assessed the association between adherence patterns and resistance emergence over time, using an adherence measure that distinguishes low adherence from treatment interruptions, in rural Cameroon. Methods We performed a cohort study among patients receiving nonnucleoside reverse transcriptase inhibitor (NNRTI)-based ART in nine district hospitals, using data from the Stratall trial (2006−2010). Genotypic mutations associated with antiretroviral drug resistance were assessed when 6-monthly HIV viral loads were > 5000 HIV-1 RNA copies/mL. ART adherence data were collected using face-to-face questionnaires. Combined indicators of early (1−3 months) and late (6 months to t − 1; t is the time point when the resistance had been detected) adherence were constructed. Multivariate logistic regression and Cox models were used to assess the association between adherence patterns and early (at 6 months) and late (after 6 months) resistance emergence, respectively. Results Among 456 participants (71% women; median age 37 years), 45 developed HIV drug resistance (18 early and 27 late). Early low adherence ( 2 days) were associated with early resistance [adjusted odds ratio (95% confidence interval) 8.51 (1.30–55.61) and 5.25 (1.45–18.95), respectively]. Early treatment interruptions were also associated with late resistance [adjusted hazard ratio (95% confidence interval) 3.72 (1.27–10.92)]. Conclusions The emergence of HIV drug resistance on first-line NNRTI-based regimens was associated with different patterns of adherence over time. Ensuring optimal early adherence through specific interventions, adequate management of drug stocks, and viral load monitoring is a clinical and public health priority in Africa.
Published: 2014

49. Patterns of patient and healthcare provider viewpoints regarding participation in HIV cure-related clinical trials. Findings from a multicentre French survey using Q methodology (ANRS-APSEC)

Author: François Raffi, Cécile Goujard, Olivier Lambotte, Marie Suzan-Monti, Christel Protière, David Zucman, Marie Préau, Philippe Morlat, Marjolaine Doumergue, Isabelle Poizot-Martin, Bruno Spire, Marion Mora, 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)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Centre d'information et de soins de l'immuno-déficience humaine (CISIH), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Groupe de Recherche en Psychologie Sociale (GRePS), Université Lumière - Lyon 2 (UL2), Service de médecine interne et maladies infectieuses [Bordeaux], CHU Bordeaux [Bordeaux]-Groupe hospitalier Saint-André, Service de Médecine Interne [Suresnes], Hôpital Foch [Suresnes], Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de Médecine Interne et Immunologie clinique [AP-HP Hôpital Bicêtre], Hôpital Bicêtre, Département des Maladies Infectieuses [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Immunologie des Maladies Virales et Autoimmunes (IMVA - U1184), Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), ANRS, Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Greps, Laboratoire
Subjects: 0301 basic medicine, RNA viruses, Medical Doctors, Health Care Providers, Human immunodeficiency virus (HIV), Alternative medicine, lcsh:Medicine, [SHS.PSY]Humanities and Social Sciences/Psychology, HIV Infections, medicine.disease_cause, Pathology and Laboratory Medicine, 0302 clinical medicine, Immunodeficiency Viruses, Informed consent, Medicine and Health Sciences, Medicine, Public and Occupational Health, 030212 general & internal medicine, Medical Personnel, lcsh:Science, Multidisciplinary, HIV diagnosis and management, Viewpoints, Vaccination and Immunization, 3. Good health, Professions, Medical Microbiology, Research Design, Viral Pathogens, Viruses, France, Pathogens, Research Article, medicine.medical_specialty, Drug Research and Development, Patients, Anti-HIV Agents, Attitude of Health Personnel, Clinical Research Design, Health Personnel, Immunology, Antiretroviral Therapy, Context (language use), Research and Analysis Methods, Microbiology, [SHS.PSY] Humanities and Social Sciences/Psychology, 03 medical and health sciences, Quality of life (healthcare), Antiviral Therapy, Physicians, Retroviruses, Humans, Clinical Trials, Microbial Pathogens, Pharmacology, business.industry, lcsh:R, Lentivirus, Organisms, Biology and Life Sciences, HIV, Diagnostic medicine, Clinical trial, Health Care, 030104 developmental biology, Family medicine, People and Places, Quality of Life, lcsh:Q, Population Groupings, Adverse Events, Preventive Medicine, Clinical Medicine, business, Healthcare providers
Abstract: Context Despite huge advances in the fight against HIV concerning diagnosis, clinical efficacy of antiretroviral treatments (ART), patient survival and quality of life, there is still no cure. Recent developments in HIV cure research have opened the way for clinical trials which could lead to a temporary or definitive end to ART. However, ethical questions exist about related trial-participation risks. The main goal of the ANRS-APSEC survey was, using Q-methodology, to investigate the viewpoints of people living with HIV (PLWH) and HIV healthcare providers (HHP) regarding motivations for and barriers to participation in HIV Cure-related clinical trials (HCRCT). Materials and methods Thirty-three statements were defined encompassing seven dimensions: treatment and follow-up; risks; benefits; patient-physician relationship; beliefs and attitudes; information; target population. Forty-one PLWH and 41 HHP from five French HIV services were asked to rank-order the statements. Results Five main viewpoints were elicited from “the most motivated” to “the most reluctant” vis-a-vis HCRCT participation. All placed importance on the wish to participate in HIV research. This result is in line with the HIV-specific culture of joint mobilization. For some viewpoints, the motivation to participate in/propose HCRCT was primarily conditioned by side-effects and/or by constraints, which overall were more accepted by PLWH than HHP. Some viewpoints placed particular importance on HCRCT recruitment strategies. Finally, some expressed a high acceptance of risks and constraints but emphasized the need for information. Conclusion HIV cure research clinical trials (HCRCT) constitute a risky yet unavoidable step towards the goal of finding a cure. To improve future HCRCT and informed consent designs, based on PLWH and HHP preferences and expectations, we need greater knowledge about how these populations perceive the risks and the benefits of HCRCT. Our results confirmed the importance of careful, studied HCRCT design, management and communication, to ensure PLWH and HHP acceptability and convergence of their expectations.
Published: 2016

50. Larger is not necessarily better! Impact of HIV care unit characteristics on virological success: results from the French national representative ANRS-VESPA2 study

Author: Rosemary Dray-Spira, Gwenaëlle Maradan, Valérie Guagliardo, Luis Sagaon-Teyssier, Marion Mora, Lisa Fressard, Marie Suzan-Monti, Bruno Spire, 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)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), and Lissalde, Claire
Subjects: Adult, Male, medicine.medical_specialty, multi-level modeling, Adolescent, Anti-HIV Agents, Human immunodeficiency virus (HIV), Patient characteristics, Sample (statistics), Context (language use), HIV Infections, medicine.disease_cause, Health outcomes, Unit (housing), 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Surveys and Questionnaires, medicine, Health Status Indicators, Humans, 030212 general & internal medicine, Hiv treatment, Intensive care medicine, HIV clinical outcomes, business.industry, 030503 health policy & services, Health Policy, Hospital merger, Multilevel model, caseload size, Middle Aged, 3. Good health, Treatment Outcome, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Patient Compliance, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, 0305 other medical science, business, Case Management, Demography
Abstract: International audience; OBJECTIVES:To determine the impact of hospital caseload size on HIV virological success when taking into account individual patient characteristics.METHODS:Data from the ANRS-VESPA2 survey representative of people living with HIV in France was used. Analyses were carried out on the 2612 (86.4% out of 3022) individuals receiving antiretroviral (ARV) treatment for at least one year. Outcomes correspond to two definitions of virological success (VS1 and VS2 respectively) and were analyzed under a multi-level modeling framework with a special focus on the effect of the caseload size on VS.RESULTS:Structures with caseloads
Published: 2016

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