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Boering P, Seeley J, Buule J, Kamacooko O, King R. A Comparison of Self-reported Condomless Sex and Yc-DNA Biomarker Data from Young Women Engaged in High Risk Sexual Activity in Kampala, Uganda. AIDS Behav 2024; 28:320-331. [PMID: 37751111 PMCID: PMC10803388 DOI: 10.1007/s10461-023-04177-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 09/27/2023]
Abstract
Reporting of condom-use can limit researchers' understanding of high-risk sexual behaviours. We compared self-reported condom-use with the Yc-DNA biomarker data and investigated potential factors influencing participation in, and reporting of, sexual behaviours. Self-reported data were collected using Audio Computer Assisted Self Interviews (ACASI) and samples for Yc-DNA biomarker were collected using self-administered and health worker-collected vaginal swabs from 644 women (aged 15-24 years) who were not living with HIV. Yc-DNA results and interview data were compared using McNemar-Bowker Analysis and Cohen's Kappa. Test statistics for Yc-DNA biomarker were calculated. Log Binomial models for Yc-DNA and self-reported results were conducted to assess for association. We found strong evidence (p < 0.001) for a difference between Yc-DNA and self-reported results. 13.7% of participants reported consistent condom-use with all partners, regardless of HIV status. Self-reported condom-use was discordant in 50.0% (n = 206) of cases, when compared to Yc-DNA results. Positive Yc-DNA results were found to be associated with older age (RR 1.36; 95%CI 1.04, 1.76 p = 0.023). Self-reported condom-use with partners with unknown HIV status was associated with higher education (RR 0.76; 95%CI 0.58,0.99 p = 0.043). Sensitivity analysis did not determine difference between methods for controlling for missing data. We found significant under-reporting of condomless sex in the self-reported data when compared to Yc-DNA results.
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Affiliation(s)
- Pippa Boering
- London School of Hygiene and Tropical Medicine, London, UK
| | - Janet Seeley
- London School of Hygiene and Tropical Medicine, London, UK.
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.
| | - Joshua Buule
- Uganda Virus Research Institute, Entebbe, Uganda
| | | | - Rachel King
- University of California, San Francisco, CA, USA
- INSERM, 60 Rue de Navacelles, 34090, Montpellier, France
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Gomes HS, Farrington DP, Krohn MD, Cunha A, Jurdi J, Sousa B, Morgado D, Hoft J, Hartsell E, Kassem L, Maia Â. The impact of modes of administration on self-reports of offending: evidence from a methodological experiment with university students. JOURNAL OF EXPERIMENTAL CRIMINOLOGY 2022:1-21. [PMID: 36164649 PMCID: PMC9491655 DOI: 10.1007/s11292-022-09531-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/31/2022] [Indexed: 06/16/2023]
Abstract
Objectives Current knowledge about the causes of offending behavior is heavily reliant on self-reports of offending (SRO). However, methodological research on the impact of modes of administration on SRO is very scarce. Further, the existing evidence conflicts with the general knowledge about responding to sensitive questions. In this study, we aimed to test whether SRO are affected by modes of administration. Methods We carried out a methodological experiment, with a 2 (interviewer-administered vs. self-administered surveys) × 2 (paper-and-pencil vs. computer- assisted surveys) factorial design. A total of 181 undergraduate students were randomly assigned to one of these conditions and completed the International Self-Report Delinquency 3 (ISRD3) questionnaire. Results Findings showed an increased odds of reporting offending behavior in self-administered surveys, compared to face-to-face interviews. Paper-and-pencil and computer-assisted modes resulted in comparable estimates of offending. Conclusions This experiment provides evidence that SRO provide more accurate estimates of offending behavior using self-administered surveys.
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Affiliation(s)
- Hugo S. Gomes
- Psychology Research Centre (CIPsi/UM), University of Minho, Braga, Portugal
| | | | - Marvin D. Krohn
- Sociology and Criminology & Law, University of Florida, Gainesville, FL USA
| | - Ana Cunha
- Psychology Research Centre (CIPsi/UM), University of Minho, Braga, Portugal
| | - Julia Jurdi
- Psychology Research Centre (CIPsi/UM), University of Minho, Braga, Portugal
| | - Bárbara Sousa
- Psychology Research Centre (CIPsi/UM), University of Minho, Braga, Portugal
| | - Diogo Morgado
- Psychology Research Centre (CIPsi/UM), University of Minho, Braga, Portugal
| | | | | | - Leigh Kassem
- Sociology and Criminology & Law, University of Florida, Gainesville, FL USA
| | - Ângela Maia
- Psychology Research Centre (CIPsi/UM), University of Minho, Braga, Portugal
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Bitty-Anderson AM, Gbeasor-Komlanvi FA, Tchankoni MK, Sadio A, Salou M, Coffie PA, Dagnra CA, Ekouevi DK. HIV prevalence and risk behaviors among female sex workers in Togo in 2017: a cross-sectional national study. Arch Public Health 2022; 80:92. [PMID: 35331303 PMCID: PMC8943989 DOI: 10.1186/s13690-022-00851-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 03/14/2022] [Indexed: 11/24/2022] Open
Abstract
Background The HIV epidemic remains an important public health challenge for the sub-Saharan region. Female Sex Workers (FSW) in this region are among the most vulnerable of the key population groups with HIV prevalence as high as twice that of the general population. The aim of this study was to estimate HIV prevalence and explore sexual risk behaviors among FSW in Togo. Methods A cross-sectional study using a Respondent Driven Sampling method was conducted across the six regions of country among FSW in 2017. A comprehensive questionnaire was used to explore socio-demographic characteristics, sexual history, HIV knowledge, and sexual behaviors. HIV rapid tests were used to assess HIV infection. Results A total of 1,036 FSW, with a median age of 26 years old [interquartile range (IQR): 22–33], participated in the study, with 49.2% (n = 510) of them having reached secondary school. Median age at first sexual intercourse was 20 years old [IQR: 17–25] and estimated number of clients per week was of 5 [IQR: 3–10]. A total of 936 (95.6%) reported the use of a condom during last sexual intercourse with a client and 493 (47.6%) reported the use of a condom during their last sexual intercourse with a partner or husband. HIV prevalence was 13.2% [95% CI: 11.2 – 15.4], and was associated with age (being between 26 and 32 years old; aOR = 4.5; 95% CI: [2.4 – 9.1], p < 0.0001) and ≥ 33 years old; aOR = 6.4; 95% CI [3.5 – 12.7], p < 0.0001), education level (being in primary school or less; aOR = 1.7; 95% CI: [1.1–2.6]; p = 0.012) and the number of partners per week (more than 2 and 3 partners; aOR = 2.5; 95% CI [1.2—5.2]; p = 0.014). Conclusions HIV prevalence and sexual risk behaviors remain high among FSW in Togo, despite prevention efforts aimed at curbing this trend. Other factors, such as access and availability of condoms, the social and legal environment in which FSW operate, should be considered for HIV prevention strategies in this population. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-022-00851-0.
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Affiliation(s)
- Alexandra M Bitty-Anderson
- Centre Africain de Recherches en Epidémiologie et en Santé Publique (CARESP), Lomé, Togo.,INSERM U1219, Bordeaux Population Health Research, ISPED, Université de Bordeaux, Bordeaux, France.,Programme PACCI - Site ANRS Côte d'Ivoire, CHU de Treichville, Abidjan, Côte d'Ivoire
| | - Fifonsi A Gbeasor-Komlanvi
- Centre Africain de Recherches en Epidémiologie et en Santé Publique (CARESP), Lomé, Togo.,Département de santé Publique, Faculté des Sciences de la Santé, Université de Lomé, Lomé, Togo
| | - Martin Kouame Tchankoni
- Centre Africain de Recherches en Epidémiologie et en Santé Publique (CARESP), Lomé, Togo.,Département de santé Publique, Faculté des Sciences de la Santé, Université de Lomé, Lomé, Togo
| | - Arnold Sadio
- Centre Africain de Recherches en Epidémiologie et en Santé Publique (CARESP), Lomé, Togo.,Département de santé Publique, Faculté des Sciences de la Santé, Université de Lomé, Lomé, Togo
| | - Mounerou Salou
- Département des Sciences Fondamentales, Laboratoire de Biologie Moléculaire, Université de Lomé, Lomé, Togo
| | - Patrick A Coffie
- Programme PACCI - Site ANRS Côte d'Ivoire, CHU de Treichville, Abidjan, Côte d'Ivoire.,Département de Dermatologie et d'Infectiologie, Université Félix Houphouët Boigny, UFR des Sciences Médicales, Abidjan, Côte d'Ivoire.,CHU de Treichville, Service de Maladies Infectieuses et Tropicales, Abidjan, Côte d'Ivoire
| | - Claver A Dagnra
- Département des Sciences Fondamentales, Laboratoire de Biologie Moléculaire, Université de Lomé, Lomé, Togo.,Programme National de Lutte contre le VIH/Sida, les Hépatites virales et les Infections Sexuellement Transmissibles (PNLS/HV/IST), Lomé, Togo
| | - Didier K Ekouevi
- Centre Africain de Recherches en Epidémiologie et en Santé Publique (CARESP), Lomé, Togo. .,INSERM U1219, Bordeaux Population Health Research, ISPED, Université de Bordeaux, Bordeaux, France. .,Département de santé Publique, Faculté des Sciences de la Santé, Université de Lomé, Lomé, Togo.
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Zimmerman RS, Mehrotra P, Madden T, Paul R. The Value of Assessing Self-Reported and Biological Indicators of Outcomes in Evaluating HIV Programs. Curr HIV/AIDS Rep 2021; 18:365-376. [PMID: 33993397 DOI: 10.1007/s11904-021-00560-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE OF REVIEW In this manuscript, we present recent findings concerning concordance and discrepancy between biological measures and self-reports of these three outcomes of HIV programs: HIV status, adherence to antiretroviral medications (ARVs) and use of and adherence to pre-exposure prophylaxis medication (PrEP), and condom use/unprotected sex. RECENT FINDINGS Recent studies suggest that three successive rapid HIV tests (for those whose first test in positive) might be reasonably inexpensive and valid biological data to collect to combine with self-reports of HIV status, dried blood spots sufficiently affordable to combine with self-reports of adherence to ARVs and use of or adherence to PrEP, and that the discrepancy between self-reports of condom use and biomarkers of unprotected sex may be relatively small in high-income countries. Additional work on assessment of incorrect condom usage and breakage, standardized self-report measures of condom use, and more private data collection methodologies in low-income settings might reduce the recent observed discrepancies even further. Concordance between self-reports of HIV and biomarkers indicating HIV positive status has varied considerably, with much lower rates in low-income countries, where the stigma of HIV is still very high. Recommendation is for combining self-report data with the results of three successive rapid tests for those testing positive. For adherence, again agreement between self-reports and a variety of more objective and/or biological measures is only moderate. Dried blood spots (DBS) may be sufficiently inexpensive in low-resource settings that this may be the best biological method to combine with self-reports. In publications over the last 8 years, the discrepancy between self-reports of condom use and biomarkers for unprotected sex may be even lower than 20% after controlling for other features of the study, particularly in high-income countries. Our results suggest that more careful assessment of incorrect condom use and breakage as reasons other than intentional misreporting should be investigated more carefully and that more private data collection methods such as audio, computer-assisted self-interviewing (ACASI) might be employed more often in low-resource settings to reduce this discrepancy in those settings further. In addition, further analysis of the discrepancy between self-reports of condom use and biomarkers should be conducted of published studies using the correct calculation methods to be more certain of these findings.
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Affiliation(s)
- Rick S Zimmerman
- College of Nursing, Wayne State University, 5557 Cass Ave., 319 Cohn Bldg, Detroit, MI, 48202, USA.
| | - Purnima Mehrotra
- Centre for Social and Behaviour Change, Ashoka University, Rajiv Gandhi Education City, Sonipat, Haryana, India
| | - Tessa Madden
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA
| | - Rachel Paul
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA
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Trends in Reported Sexual Behavior and Y-Chromosomal DNA Detection Among Female Sex Workers in the Senegal Preexposure Prophylaxis Demonstration Project. Sex Transm Dis 2021; 47:314-320. [PMID: 32187172 PMCID: PMC7213512 DOI: 10.1097/olq.0000000000001175] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A study among female sex workers in Senegal found no evidence of increased sexual risk behavior after preexposure prophylaxis initiation as measured by self-report or Y-chromosomal DNA detection. Supplemental digital content is available in the text. Background Preexposure prophylaxis (PrEP) can reduce HIV acquisition among female sex workers (FSWs). However, changes in condomless sex frequency after PrEP initiation could reduce PrEP effectiveness when PrEP adherence is suboptimal as well as increase the risk of acquiring other sexually transmitted infections. Objective measures of condomless sex may be more accurate for determining changes in sexual behavior than self-reported measures. Methods We longitudinally measured self-reported condom use, number of clients, and presence of Y-chromosomal DNA (Yc-DNA) in vaginal swabs among 267 FSWs accessing PrEP at 4 clinics in Senegal between 2015 and 2016. We assessed trends in sexual behavior over time since PrEP initiation using generalized estimating equations and evaluated predictors of Yc-DNA detection. Results We found no increase in self-reported condomless sex with clients (odds ratio [OR], 0.94; 95% confidence interval [CI], 0.89–1.00), main partners (OR, 0.99; 95% CI, 0.96–1.02), or Yc-DNA detection (OR, 0.99; 95% CI, 0.90–1.08) over time since initiation. Y-chromosomal DNA was detected in 34 (22%) of 154 swabs tested and in 15 (26%) of 58 swabs from FSW reporting consistent condom use among both clients and main partners. Self-reported condom use with clients or main partners did not predict Yc-DNA detection. Conclusions In a FSW PrEP demonstration project in Senegal, we found no evidence of risk compensation among FSWs on PrEP as measured by self-reported behavior or through Yc-DNA detection. Y-chromosomal DNA detection was frequently detected among FSWs reporting consistent condom use, highlighting limitations of self-reported sexual behavioral measures.
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Prevalence and Factors Associated With HIV and Sexually Transmitted Infections Among Female Sex Workers in Bamako, Mali. Sex Transm Dis 2021; 47:679-685. [PMID: 32932403 DOI: 10.1097/olq.0000000000001231] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND We aimed to (1) estimate the prevalence of HIV and other sexually transmitted infections (STIs) among female sex workers (FSWs) in Bamako, Mali, and (2) identify factors associated with STIs including HIV infection in this population. METHODS We analyzed baseline data from a prospective observational cohort study on cervical cancer screening, human papillomavirus, and HIV infections among FSWs 18 years or older recruited in Bamako. Multivariable log-binomial regression was used to estimate the adjusted prevalence ratios (APRs) with 95% confidence interval (95% CI) for HIV infection and STIs versus associated factors. RESULTS Among 353 women participating in the study, mean age was 26.8 (±7.6) years. HIV prevalence was 20.4%, whereas 35.1% of the FSWs had at least one STI. Factors significantly associated with HIV were older age (P < 0.0001, test for trend), duration of sex work ≥6 years (APR, 1.92; 95% CI, 1.22-3.02), uneducated status (APR, 2.24; 95% CI, 1.16-4.34), less than 10 clients in the last 7 days (APR, 1.55; 95% CI, 1.02-2.34), and gonococcal (APR, 1.85; 95% CI, 1.21-2.82) and chlamydial (APR, 2.58; 95% CI, 1.44-4.62) infections. Younger age (P = 0.018, test for trend), having ≥10 clients in the last week (APR, 1.47; 95% CI, 1.11-1.94), and HIV infection (APR, 2.00; 95% CI, 1.49-2.69) were significantly associated with STIs. CONCLUSIONS HIV and curable STI prevalence are high among FSWs in Bamako. There is thus a need to enhance the efficiency of interventions toward FSWs in Mali to reduce the burden of HIV and STIs among them and prevent HIV spread to the general population.
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Abstract
Supplemental Digital Content is Available in the Text. Little is known about risk compensation among female sex workers (FSW) on HIV pre-exposure prophylaxis (PrEP), and self-report of sexual behaviors is subject to bias.
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Eluwa GIE, Adebajo SB, Eluwa T, Ogbanufe O, Ilesanmi O, Nzelu C. Rising HIV prevalence among men who have sex with men in Nigeria: a trend analysis. BMC Public Health 2019; 19:1201. [PMID: 31477073 PMCID: PMC6721282 DOI: 10.1186/s12889-019-7540-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 08/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Men who have sex with men (MSM) are conservatively estimated to be less than 1% of the Nigerian population yet nationally account for about 20% of new HIV infection. We estimated the trend in HIV prevalence and determined correlates of HIV infection among MSM. METHODS This study used data from respondent-driven sampling in three rounds of integrated biological and behavioral surveillance survey (2007, 2010 and 2014) and covered three states in 2007, six states in 2010 and eight states in 2014. Each round used similar methodology and thus allows for comparison. Behavioral data were obtained using a structured pre-coded questionnaire. Differences in categorical variables were assessed with Chi Square. Logistic regression was used to identify factors associated with HIV. RESULTS A total of 879, 1545 and 3611 MSM were recruited in 2007, 2010 and 2014 respectively. Median age was 22 years for 2007 and 2014 while it was 24 years in 2010. About one-third of MSM in 2007 and 2014 and about two-fifths in 2010 had engaged in transactional sex. HIV prevalence increased from 14% in 2007 to 17% in 2010 to 23% in 2014 (p < 0.0001). Factors associated with HIV include older age ≥ 25 years (adjusted odds ratio {AOR}:2.41; 95% CI:1.84-3.16); receptive anal sex (AOR:1.92; 95% CI:1.54-2.40) and history of sexually transmitted infections (AOR:1.26; 95% CI:1.02-1.55). CONCLUSION There's been a consistent and significant increase in HIV prevalence among MSM with about 10-percentage points relative increase per year over 7 years. Older MSM were more likely to be HIV positive and this may reflect their prolonged exposure to high risk sexual activities. Evidence based interventions are urgently needed to mitigate intra-group HIV transmission and propagation of HIV epidemic between MSM and the general population.
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Affiliation(s)
- George I E Eluwa
- Population Council, No. 16, Mafemi Crescent, Utako, Abuja, Nigeria.
| | - Sylvia B Adebajo
- Population Council, No. 16, Mafemi Crescent, Utako, Abuja, Nigeria
| | | | - Obinna Ogbanufe
- Centers for Disease Prevention and Control, United States Embassy, Abuja, Plot 1038 Diplomatic Drive, Abuja, Nigeria
| | - Oluwafunke Ilesanmi
- HIV and Viral Hepatitis Communicable Diseases Cluster, World Health Organization Country Office, Abuja, Nigeria
| | - Charles Nzelu
- National AIDS and STI Control Program, Federal Ministry of Health, Abuja, Nigeria
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Giguère K, Leblond FA, Goma-Matsétsé E, Dave V, Béhanzin L, Guédou FA, Alary M. A novel nested polymerase chain reaction targeting the testis-specific protein Y-encoded family of genes for high sensitivity of recent semen exposure detection: Comparison with four other assays of semen detection. PLoS One 2019; 14:e0220326. [PMID: 31344101 PMCID: PMC6657882 DOI: 10.1371/journal.pone.0220326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 07/12/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Because self-report of sexual behaviours is prone to biases, biomarkers of recent semen exposure are increasingly used to assess unprotected sex. We aimed to present a novel nested polymerase chain reaction (PCR) assay targeting testis-specific protein Y-encoded (TSPY) genes and to compare its performance in detecting recent semen exposure with that of four other assays. METHODS Forty-five vaginal samples were selected at baseline of a prospective observational demonstration study of early antiretroviral treatment and pre-exposure prophylaxis among female sex workers in Benin. Semen exposure was assessed with: a rapid prostate-specific antigen (PSA) detection assay, a quantitative PCR targeting the sex-determining region (SRY) gene, a standard PCR targeting SRY, a standard PCR targeting TSPY, and a nested PCR targeting TSPY (n-TSPY). Because we had hypothesized that n-TSPY would be the most sensitive of the five assays while remaining specific, and as our results suggested that it was the case, sensitivity and specificity were calculated for each assay in comparison with n-TSPY. RESULTS The n-TSPY could detect male DNA at concentration 16 and 64 times lower compared to s-TSPY and s-SRY, respectively. Among the 45 vaginal samples, prevalences of semen exposure according to the different assays varied from 22.2% (95%CI: 11.2%-37.1%) to 70.5% (95%CI: 54.8%-83.2%), with the highest prevalence measured with n-TSPY. The n-TSPY products were of expected size and we observed no false-positive in female DNA controls. The assay that offered the second best performance in detecting semen exposure was the PSA rapid test, with a sensitivity of 61.3% and a specificity of 100% compared to n-TSPY. CONCLUSIONS Compared to n-TSPY, all other PCR assays had poor performance to detect semen exposure. The n-TSPY is an accessible assay that may have great utility in assessing semen exposure in studies where many factors are expected to accelerate biomarkers' clearance.
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Affiliation(s)
- Katia Giguère
- Centre de recherche du CHU de Québec, Université Laval, Québec, Québec, Canada
- Département de médecine sociale et préventive, Université Laval, Québec, Québec, Canada
| | - François A. Leblond
- Centre de Recherche de l’Hôpital Maisonneuve Rosemont, Montréal, Québec, Canada
| | | | - Vibhuti Dave
- Centre de Recherche de l’Hôpital Maisonneuve Rosemont, Montréal, Québec, Canada
| | - Luc Béhanzin
- Centre de recherche du CHU de Québec, Université Laval, Québec, Québec, Canada
- Dispensaire IST, Centre de santé communal de Cotonou 1, Cotonou, Bénin
- École Nationale de Formation des Techniciens Supérieurs en Santé Publique et en Surveillance Épidémiologique, Université de Parakou, Parakou, Bénin
| | - Fernand A. Guédou
- Centre de recherche du CHU de Québec, Université Laval, Québec, Québec, Canada
- Dispensaire IST, Centre de santé communal de Cotonou 1, Cotonou, Bénin
| | - Michel Alary
- Centre de recherche du CHU de Québec, Université Laval, Québec, Québec, Canada
- Département de médecine sociale et préventive, Université Laval, Québec, Québec, Canada
- Institut national de santé publique du Québec, Québec, Québec, Canada
- * E-mail:
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