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Nacher M, Lucarelli A, Van-Melle A, Basurko C, Rabier S, Chroum M, Santana T, Verin K, Bienvenu K, El Guedj M, Vaz T, Cisse H, Epelboin L, Le Turnier P, Abboud P, Djossou F, Pradinaud R, Adenis A, Couppié P. Forty Years of HIV Research in French Guiana: Comprehend to Combat. Pathogens 2024; 13:459. [PMID: 38921756 PMCID: PMC11206598 DOI: 10.3390/pathogens13060459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/10/2024] [Accepted: 05/17/2024] [Indexed: 06/27/2024] Open
Abstract
The drivers of the HIV epidemic, the viruses, the opportunistic infections, the attitudes and the resources allocated to the fight against HIV/AIDS, vary substantially across countries. French Guiana, at the crossroads between Amazonian South America and the Caribbean, constitutes a singular context with poor populations and rich country health funding, which has allowed researchers to gather lots of information on the particulars of our epidemic. We aimed to focus on the little known story of forty years of HIV research in French Guiana and emphasize how local research intertwined with public health action has yielded continuous progress, despite the difficult social conditions of the affected population. We searched Web of Science and associated local experts who worked through much of the epidemic in selecting the most meaningful products of local research for clinical and public health outcomes in French Guiana. Research tools and facilities included, from 1991 onwards, the HIV hospital cohort and the HIV-histoplasmosis cohort. Ad hoc studies funded by the ANRS or the European Regional Development fund shed light on vulnerable groups. The cumulative impact of prospective routine collection and focused efforts has yielded a breadth of knowledge, allowing for informed decisions and the adaptation of prevention, testing and care in French Guiana. After this overview, we emphasize that the close integration of research and public health was crucial in adapting interventions to the singular context of French Guiana.
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Affiliation(s)
- Mathieu Nacher
- Comité de Coordination Régionale de la Lutte contre le VIH et les IST, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana; (A.L.); (S.R.); (M.C.); (T.S.); (K.V.); (K.B.); (A.A.)
- Centre d’Investigation Clinique INSERM 1424, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana; (A.V.-M.); (C.B.)
- Département Formation Recherche en Santé, Université de Guyane, 97300 Cayenne, French Guiana;
- Institut Santé des Populations en Amazonie, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana
| | - Aude Lucarelli
- Comité de Coordination Régionale de la Lutte contre le VIH et les IST, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana; (A.L.); (S.R.); (M.C.); (T.S.); (K.V.); (K.B.); (A.A.)
| | - Astrid Van-Melle
- Centre d’Investigation Clinique INSERM 1424, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana; (A.V.-M.); (C.B.)
| | - Célia Basurko
- Centre d’Investigation Clinique INSERM 1424, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana; (A.V.-M.); (C.B.)
| | - Sébastien Rabier
- Comité de Coordination Régionale de la Lutte contre le VIH et les IST, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana; (A.L.); (S.R.); (M.C.); (T.S.); (K.V.); (K.B.); (A.A.)
| | - Malorie Chroum
- Comité de Coordination Régionale de la Lutte contre le VIH et les IST, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana; (A.L.); (S.R.); (M.C.); (T.S.); (K.V.); (K.B.); (A.A.)
| | - Thiago Santana
- Comité de Coordination Régionale de la Lutte contre le VIH et les IST, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana; (A.L.); (S.R.); (M.C.); (T.S.); (K.V.); (K.B.); (A.A.)
| | - Karine Verin
- Comité de Coordination Régionale de la Lutte contre le VIH et les IST, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana; (A.L.); (S.R.); (M.C.); (T.S.); (K.V.); (K.B.); (A.A.)
| | - Ketty Bienvenu
- Comité de Coordination Régionale de la Lutte contre le VIH et les IST, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana; (A.L.); (S.R.); (M.C.); (T.S.); (K.V.); (K.B.); (A.A.)
| | - Myriam El Guedj
- Hôpital de Jour Adultes, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana
| | - Tania Vaz
- Hôpital de Jour Adultes, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana
| | - Hawa Cisse
- Hôpital de Jour Adultes, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana
| | - Loïc Epelboin
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana; (L.E.); (P.L.T.); (P.A.); (F.D.)
| | - Paul Le Turnier
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana; (L.E.); (P.L.T.); (P.A.); (F.D.)
| | - Philippe Abboud
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana; (L.E.); (P.L.T.); (P.A.); (F.D.)
| | - Félix Djossou
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana; (L.E.); (P.L.T.); (P.A.); (F.D.)
| | - Roger Pradinaud
- Service de Dermatologie Vénéréologie, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana;
| | - Antoine Adenis
- Comité de Coordination Régionale de la Lutte contre le VIH et les IST, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana; (A.L.); (S.R.); (M.C.); (T.S.); (K.V.); (K.B.); (A.A.)
- Centre d’Investigation Clinique INSERM 1424, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana; (A.V.-M.); (C.B.)
- Département Formation Recherche en Santé, Université de Guyane, 97300 Cayenne, French Guiana;
- Institut Santé des Populations en Amazonie, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana
| | - Pierre Couppié
- Département Formation Recherche en Santé, Université de Guyane, 97300 Cayenne, French Guiana;
- Institut Santé des Populations en Amazonie, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana
- Service de Dermatologie Vénéréologie, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana;
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Nacher M, Basurko C, Douine M, Lambert Y, Rousseau C, Michaud C, Garlantezec R, Adenis A, Gomes MM, Alsibai KD, Sabbah N, Lambert V, Epelboin L, Sukul RG, Terlutter F, Janvier C, Hcini N. Contrasted life trajectories: reconstituting the main population exposomes in French Guiana. Front Public Health 2024; 11:1247310. [PMID: 38274531 PMCID: PMC10808558 DOI: 10.3389/fpubh.2023.1247310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 12/21/2023] [Indexed: 01/27/2024] Open
Abstract
In French Guiana, life expectancy is between 2 and 3 years below that of France, reflecting differences in mortality rates that are largely sensitive to primary healthcare and thus preventable. However, because poverty affects half of the population in French Guiana, global measurements of life expectancy presumably conflate at least two distinct situations: persons who have similar life expectancies as in mainland France and persons living in precariousness who have far greater mortality rates than their wealthier counterparts. We thus aimed to synthesize what is known about statistical regularities regarding exposures and sketch typical French Guiana exposomes in relation to health outcomes. We conducted a narrative review on common exposures in French Guiana and made comparisons between French Guiana and mainland France, between rich and poor in French Guiana, and between urban and rural areas within French Guiana. The most striking fact this panorama shows is that being a fetus or a young child in French Guiana is fraught with multiple threats. In French Guiana, poverty and poor pregnancy follow-up; renouncing healthcare; wide variety of infectious diseases; very high prevalence of food insecurity; psychosocial stress; micronutrient deficiencies; obesity and metabolic problems; and frequent exposure to lead and mercury in rural areas constitute a stunningly challenging exposome for a new human being to develop into. A substantial part of the population's health is hence affected by poverty and its sources of nutrition.
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Affiliation(s)
- Mathieu Nacher
- CIC INSERM, Centre Hospitalier de Cayenne, Cayenne, French Guiana
- Université de Guyane, Cayenne, French Guiana
- Amazonian Infrastructures for Population Health, Cayenne, French Guiana
| | - Célia Basurko
- CIC INSERM, Centre Hospitalier de Cayenne, Cayenne, French Guiana
- Amazonian Infrastructures for Population Health, Cayenne, French Guiana
| | - Maylis Douine
- CIC INSERM, Centre Hospitalier de Cayenne, Cayenne, French Guiana
- Université de Guyane, Cayenne, French Guiana
- Amazonian Infrastructures for Population Health, Cayenne, French Guiana
| | - Yann Lambert
- CIC INSERM, Centre Hospitalier de Cayenne, Cayenne, French Guiana
- Université de Guyane, Cayenne, French Guiana
- Amazonian Infrastructures for Population Health, Cayenne, French Guiana
| | - Cyril Rousseau
- Centres délocalisés de Prévention et de Soins, Centre hospitalier de Cayenne, Cayenne, French Guiana
| | - Celine Michaud
- Centres délocalisés de Prévention et de Soins, Centre hospitalier de Cayenne, Cayenne, French Guiana
| | - Ronan Garlantezec
- Épidémiologie et science de l’exposition en santé-environnement (Elixir), Institut de Recherche en Santé Environnement et Travail (IRSET), Rennes, France
- Santé publique et épidémiologie, CHU de Rennes, Rennes, France
| | - Antoine Adenis
- CIC INSERM, Centre Hospitalier de Cayenne, Cayenne, French Guiana
- Université de Guyane, Cayenne, French Guiana
- Amazonian Infrastructures for Population Health, Cayenne, French Guiana
| | | | - Kinan Drak Alsibai
- Amazonian Infrastructures for Population Health, Cayenne, French Guiana
- Centre de Ressources Biologiques Amazonie, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Nadia Sabbah
- Amazonian Infrastructures for Population Health, Cayenne, French Guiana
- Service d’endocrinologie diabétologie, Centre hospitalier de Cayenne, Cayenne, French Guiana
| | - Véronique Lambert
- Amazonian Infrastructures for Population Health, Cayenne, French Guiana
- Western French Guiana Hospital, Saint Laurent du Maroni, French Guiana
| | - Loïc Epelboin
- CIC INSERM, Centre Hospitalier de Cayenne, Cayenne, French Guiana
- Université de Guyane, Cayenne, French Guiana
- Amazonian Infrastructures for Population Health, Cayenne, French Guiana
- Service des Maladies Infectieuses et Tropicales, Centre hospitalier de Cayenne, Cayenne, French Guiana
| | | | - Fredrik Terlutter
- Western French Guiana Hospital, Saint Laurent du Maroni, French Guiana
| | - Caroline Janvier
- Service de Psychiatrie, Centre hospitalier de Cayenne, Cayenne, French Guiana
| | - Najeh Hcini
- Amazonian Infrastructures for Population Health, Cayenne, French Guiana
- Western French Guiana Hospital, Saint Laurent du Maroni, French Guiana
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Nacher M, Epelboin L, Bonifay T, Djossou F, Blaizot R, Couppié P, Adenis A, Lucarelli A, Lambert Y, Schaub R, Douine M. Migration in French Guiana: Implications in health and infectious diseases. Travel Med Infect Dis 2024; 57:102677. [PMID: 38049022 DOI: 10.1016/j.tmaid.2023.102677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 11/20/2023] [Accepted: 11/24/2023] [Indexed: 12/06/2023]
Abstract
In French Guiana, more than a third of the population, and nearly half of the adults, are of foreign origin. This immigration is explained by the French standard of living, which is attractive to nationals of surrounding countries. Infectious diseases remain in the top 10 causes of premature death, often in the most precarious populations. In this context we aimed to synthesize the state of the knowledge regarding immigration and infectious diseases in French Guiana and the general implications that follow this diagnosis. For HIV, although the majority of patients are of foreign origin, estimates of the presumed date of infection based on CD4 erosion modelling and from molecular analyses suggest that the majority of transmissions in foreign-born individuals occur in French Guiana and that the Guiana shield has been a crossroad between Latin America and the Caribbean. Among key populations bridging these regions illegal gold miners are very mobile and have the greatest proportion B Caribbean HIV viruses. Gold miners have been a key vulnerable population for falciparum malaria and other tropical diseases such as leishmaniasis, leprosy, or leptospirosis. The complex history of migrations in French Guiana and on the Guiana Shield is also reflected in the fingerprinting of mycobacterium tuberculosis and the high incidence of tuberculosis in French Guiana, notably in immigrants, reflects the incidences in the countries of origin of patients. The high burden of infectious diseases in immigrants in French Guiana is first and foremost a reflection of the precarious living conditions within French Guiana and suggests that community-based proactive interventions are crucial to reduce transmission, morbidity, and mortality from infectious diseases.
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Affiliation(s)
- Mathieu Nacher
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana; Université de Guyane, Cayenne, 97300, Cayenne, French Guiana; Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana.
| | - Loïc Epelboin
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana; Université de Guyane, Cayenne, 97300, Cayenne, French Guiana; Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana; Department of Infectious Diseases, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana
| | - Timothée Bonifay
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana; Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana
| | - Félix Djossou
- Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana; Department of Infectious Diseases, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana
| | - Romain Blaizot
- Department of Dermatology, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana
| | - Pierre Couppié
- Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana; Department of Dermatology, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana
| | - Antoine Adenis
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana; Université de Guyane, Cayenne, 97300, Cayenne, French Guiana; Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana
| | - Aude Lucarelli
- Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana; Coordination Regionale de lutte contre le VIH, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana
| | - Yann Lambert
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana; Université de Guyane, Cayenne, 97300, Cayenne, French Guiana; Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana
| | - Roxane Schaub
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana; Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana
| | - Maylis Douine
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana; Université de Guyane, Cayenne, 97300, Cayenne, French Guiana; Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana
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Mosnier E, Artigas F, Richard E, Hoyer M, Michels D, Vandentorren S, Girard G, Nagot N, Regnault H, Mosnier M, Inegbeze G, Roux P, Spire B, Eldin C. Effectiveness of a Community Empowerment Intervention to Improve Access to Pre-exposure Prophylaxis in Migrant Women Sex Workers: Protocol for a Mixed Methods Implementation Study. JMIR Res Protoc 2023; 12:e42844. [PMID: 37540547 PMCID: PMC10439469 DOI: 10.2196/42844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 03/24/2023] [Accepted: 04/03/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND The World Health Organization recommends pre-exposure prophylaxis (PrEP) for all populations at substantial risk of HIV infection. However, at-risk women very rarely use PrEP in France-this represents a critical issue among migrant women sex workers (MWSWs). Previous studies on PrEP use among women sex workers or migrants focused on individual or social determinants of motivation. However, operational studies in real-word settings using a holistic population approach to maximize PrEP adherence among MWSWs are lacking. OBJECTIVE FASSETS (ie, "Favoriser l'Accès à la Santé Sexuelle des Travailleuses du Sexe"; English: "facilitate the access to Sexual Health in women sex workers") is a participative, multilevel, mixed methods study aiming to improve global knowledge of and access to sexual health care and PrEP among MWSWs through targeted empowerment strategies. METHODS This study comprises several phases: (1) phase 1: an initial qualitative study combining semistructured interviews, informal interviews, and participative observations will be performed among MWSWs, local community nongovernmental organizations, and institutions providing sexual reproductive health services to identify the determinants of PrEP access among MWSWs and for respondent-driven sampling (RDS); (2) phase 2: the size of the hidden MWSW population is estimated in Marseille through capture-recapture (the RDS survey will serve as "recapture"); (3) phase 3: a longitudinal cohort will be formed through RDS to represent the MWSW population with a goal of 150 inclusions-this cohort will be followed up for 12 months, and sequential questionnaires exploring medical history; knowledge of sexual health, HIV, and sexually transmitted infections; migration route; and current living conditions will be administered at inclusion (month 0) and months 3, 6, and 12 to measure the following interventional phase's outcomes; and (4) phase 4: an interventional study with community empowerment actions about sexual health and PrEP will be conducted with community health workers; standardized questionnaires and semistructured interviews, observations, and focus groups will highlight MWSWs' experiences with empowerment resources, concerns about sexual health, and especially PrEP use or uptake, and we will evaluate whether and how community-adapted empowerment actions conducted by community health workers are effective in increasing access to sexual health, prevention and screening of sexually transmitted infections, and PrEP knowledge and access among MWSWs. RESULTS Recruitment commenced on March 1, 2022. We estimate the follow-up period to end on September 30, 2023. CONCLUSIONS This multiphase study will provide robust evidence about the magnitude of the MWSW population in Marseille (the second largest town in France) and their current conditions of living, access to and knowledge of sexual health, and PrEP access. Using a mixed methods analysis, we will investigate whether individual and collective community health empowerment approaches can facilitate access to PrEP and its initiation, use, and adherence in this vulnerable population. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/42844.
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Affiliation(s)
- Emilie Mosnier
- Aix Marseille University, Inserm, IRD, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Institute of Public Health ISSPAM, Marseille, France
- University of Health and Science, ANRS | MIE site, Phnom Penh, Cambodia
| | | | - Elodie Richard
- Université de Bordeaux; Laboratoire Bordeaux Population Health (BPH), Inserm U1219, Bordeaux, France
- Fnasat-GV, Paris, France
| | - Maxime Hoyer
- Aix Marseille University, Inserm, IRD, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Institute of Public Health ISSPAM, Marseille, France
| | - David Michels
- Laboratoire de recherche Communautaire, Coalition PLUS, AIDES NGO, Pantin, France
| | - Stephanie Vandentorren
- Université de Bordeaux; Laboratoire Bordeaux Population Health (BPH), Inserm U1219, Bordeaux, France
- Santé publique France, Saint Maurice, France
| | - Gabriel Girard
- Aix Marseille University, Inserm, IRD, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Institute of Public Health ISSPAM, Marseille, France
| | - Nicolas Nagot
- Pathogenesis and Control of Chronic & Emerging Infections, University of Montpellier, Inserm, Etablissement Français du Sang, University of Antilles-Guyane, Montpellier, France
| | - Hippolyte Regnault
- Aix Marseille University, Inserm, IRD, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Institute of Public Health ISSPAM, Marseille, France
| | | | | | - Perrine Roux
- Aix Marseille University, Inserm, IRD, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Institute of Public Health ISSPAM, Marseille, France
| | - Bruno Spire
- Aix Marseille University, Inserm, IRD, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Institute of Public Health ISSPAM, Marseille, France
| | - Carole Eldin
- Unité des Virus Émergents (UVE) Aix-Marseille Univ-IRD 190-Inserm 1207-IHU Méditerranée Infection), Marseille, France
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Nacher M, Le Turnier P, Abboud P, Françoise U, Lucarelli A, Demar M, Djossou F, Epelboin L, Couppié P, Adenis A. Primary or secondary prevention of HIV-associated histoplasmosis during the early antiretrovirals for all era. PLoS Negl Trop Dis 2023; 17:e0011066. [PMID: 36730157 PMCID: PMC9894381 DOI: 10.1371/journal.pntd.0011066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- Mathieu Nacher
- CIC INSERM 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
- Département Formation Recherche, Université de Guyane, Cayenne, French Guiana
- * E-mail:
| | - Paul Le Turnier
- Service des maladies infectieuses et tropicales, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Philippe Abboud
- Service des maladies infectieuses et tropicales, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Ugo Françoise
- CIC INSERM 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Aude Lucarelli
- Coordination Régionale de la lutte contre le VIH et les infections sexuellement transmissibles Guyane, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Magalie Demar
- Unité mixte de recherche Tropical Biome and Immunopathology, Université de Guyane, Cayenne, French Guiana
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Félix Djossou
- Service des maladies infectieuses et tropicales, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Loïc Epelboin
- Service des maladies infectieuses et tropicales, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Pierre Couppié
- Département Formation Recherche, Université de Guyane, Cayenne, French Guiana
- Service de Dermatologie, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Antoine Adenis
- CIC INSERM 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
- Département Formation Recherche, Université de Guyane, Cayenne, French Guiana
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Sexual and addictive risk behaviors and sexually transmitted infections in illegal gold miners in French Guiana: A multicenter observational study. PLoS One 2022; 17:e0272932. [PMID: 36174015 PMCID: PMC9522014 DOI: 10.1371/journal.pone.0272932] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 07/28/2022] [Indexed: 11/19/2022] Open
Abstract
Objectives Common representations of the world of gold mining–especially illegal–are usually negative: the activity conjures up images of drug trafficking, human exploitation, the sex trade, environmental destruction, and infectious diseases, in particular sexually transmitted infections (STIs). The aim of the present article is to describe the levels of risk behaviors such as transactional sex, multiple sexual partners, and the frequency of condom use, addictive substance consumption, and the prevalence of STIs among the population of illegal gold miners in French Guiana (FG), a French overseas entity in Amazonia, in order to guide potential interventions. Methods An observational multicenter cross-sectional study was carried out from October to December 2019 along the two borders of FG with Suriname and Brazil at rest sites used by the miners. Results Among the 499 participants, transactional sex was very prevalent, declared by 33.5% of men and 8.4% of women. Condoms were more frequently used for transactional sex than with a non-commercial partner (93.4% versus 42.1%). More women were tested for HIV than men (91.1% versus 55.2%). Excessive alcohol consumption (57.3%%) and tobacco use (41.2%) were very frequent, but cocaine or crack consumption was low (1.2%), which refuted our initial assumption. Consumers of alcohol had more sexual partners and reported condom use more frequently. Prevalence of HIV, HCV, HBV, and syphilis was respectively 0.5% (95% CI: 0.1–2.1), 2.1% (95% CI: 0.7–3.6), 1.6% (95% CI: 0.3–2.8), and 12.4% (95% CI: 9.0–15.7), which was higher than in the local population, especially for syphilis. Conclusion This study documents for the first time the risk behaviors of gold miners in FG. Although the level of condom use was high, the prevalence of STIs combined with the high rate of transactional sex should encourage an increase in prevention and screening, in particular through rapid tests, given the mobility of the population concerned.
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Floersheim C, Musso S, Eubanks A, Douine M, Spire B, Sagaon-Teyssier L, Parriault MC, Girard G, Mosnier E. What can lead to late diagnosis of HIV in an illegal gold mining environment? A qualitative study at the French Guiana's border with Brazil. BMJ Open 2022; 12:e061237. [PMID: 36691149 PMCID: PMC9445782 DOI: 10.1136/bmjopen-2022-061237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 08/05/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE The present study aimed to understand what factors can lead to late HIV diagnosis of illegal gold miners at French Guiana's border with Brazil. DESIGN An exploratory qualitative study with in-depth interviews and observations was conducted between November 2019 and February 2020. SETTING The study was conducted in the main medical healthcare service and two non-governmental organisation premises in the Oyapock border region, which is a supply area for illegal gold mining sites. PARTICIPANTS Fifteen people living with HIV diagnosed with CD4 count <350 cells 106/L were interviewed. Seven women and eight men participated; they were between 31 and 79 years old, and the median time since HIV diagnosis was 6 years. Eight had links to illegal gold mining. FINDINGS Three key themes for late HIV diagnosis emerged: (1) the presence of economic and political structural factors which constitute risks for this illegal activity, specifically the repression of gold mining sites by French Armed Forces and the distance from healthcare facilities; (2) representations of the body and health, related to the living conditions of this population; prioritisation of health emergencies and long-term self-medication; and (3) gender roles shaping masculinity and heterosexuality contributing to a perception of not being at risk of HIV and delaying testing. CONCLUSION This study highlights structural, group-based and individual factors that reduce access to HIV testing and healthcare in general for a population of migrant workers in an illegal gold mining area. Faced with harsh living conditions and state repression, these workers develop a vision of health which prioritises the functionality of the body. Associated with gender roles which are partly shaped both by the mining activity and its geographical location, this vision can lead to late HIV diagnosis.
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Affiliation(s)
- Charlotte Floersheim
- Centres Délocalisés de Prévention et de Soins, Centre Hospitalier de Cayenne, Cayenne, French Guiana
- Université Paris Cité, IRD, Ceped, Paris, F-75006, France
| | - Sandrine Musso
- Aix Marseille Univ, Centre Norbert Elias, UMR 8562, Marseille, France
| | - August Eubanks
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Maylis Douine
- Centre d'Investigation Clinique Antilles Guyane, INSERM 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Bruno Spire
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Luis Sagaon-Teyssier
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Marie Claire Parriault
- Centre d'Investigation Clinique Antilles Guyane, INSERM 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Gabriel Girard
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Emilie Mosnier
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, Cayenne, French Guiana
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Rochemont DR, Mimeau E, Misslin C, Papaix-Puech M, de Toffol B, Sabbah N, Delmas E, Bejot Y, Fournel I, Nacher M. A Prospective Comparative Study of Health Inequalities and the Epidemiology of Stroke in French Guiana and Dijon, France. Front Public Health 2022; 10:849036. [PMID: 35646768 PMCID: PMC9136220 DOI: 10.3389/fpubh.2022.849036] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 04/12/2022] [Indexed: 12/03/2022] Open
Abstract
Background In French Guiana poverty is widespread and specialized care is lacking. We aimed to compare strokes between precarious and non-precarious patients within French Guiana and to compare the epidemiology of ischemic strokes and their outcomes between French Guiana and mainland France. Methods A multicenter prospective cohort examined the influence of social inequalities on stroke characteristics. Consecutive patients aged > 18 years admitted for an acute ischemic stroke, confirmed by neuroimaging were eligible. Exclusion criteria were a history of symptomatic stroke, presence of other short-term life-threatening diseases and inability to contact patients by telephone during follow-up. Social deprivation was measured using the EPICES score, which is based on a multidimensional questionnaire. Results Overall, 652 patients with ischemic stroke were included. The patients in French Guiana were 7 years younger, were more frequently male, of sub-Saharan ancestry, they had a low level of education, and were more often precarious (67.7%) than the patients included in Dijon (39.2%). The origin of the ischemic stroke was predominantly lacunar for patients included in French Guiana and cardioembolic for patients included in Dijon, with greater severity for patients included in Dijon. The proportion of patients with known pre-stroke hypertension, diabetes, or a history of Transient Ischemic Accident was greater in French Guiana than in Dijon. In contrast, hypercholesterolemia, atrial fibrillation, and history of Myocardial Infarction were more frequently found in patients included in Dijon than in patients included in French Guiana. Fibrinolysis was less frequent in French Guiana than in Dijon, 24% of patients arriving early enough receiving thrombolysis in French Guiana vs. 45% in Dijon, P < 0.0001. However, after adjustment for patient characteristics, the effect of the center on the use of fibrinolysis disappeared. When comparing precarious and non-precarious patients within French Guiana, the main difference was the younger age and the lower mortality of precarious patients—notably immigrants. Conclusion Precariousness was widespread in French Guiana. Within French Guiana, despite a younger age among foreigners than French patients, the risk factors, mechanisms, and outcomes were homogenous across socioeconomic strata. The observed differences between the two contrasted French territories suggested that, beyond health inequalities, the epidemiology of cardiovascular risk factors may differ between French Guiana and mainland France.
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Affiliation(s)
- Devi Rita Rochemont
- CIC Inserm 1424, Centre d'investigation Clinique, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Emmanuelle Mimeau
- Service d'accueil des Urgences, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Caroline Misslin
- Service de Médecine, Centre Hospitalier de l'Ouest Guyanais, Saint-Laurent-du-Maroni, French Guiana
| | | | - Bertrand de Toffol
- Service de Neurologie, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Nadia Sabbah
- Service de Diabétologie, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Emmanuel Delmas
- Centre d'investigation Clinique - Épidémiologie Clinique, CIC Inserm 1432, Centre d'investigation Clinique, CHRU de Dijon, Dijon, France
| | - Yannick Bejot
- Registre des AVC de Dijon, EA7460, Service de Neurologie, Université de Bourgogne, CHRU Dijon, Dijon, France
| | - Isabelle Fournel
- Registre des AVC de Dijon, EA7460, Service de Neurologie, Université de Bourgogne, CHRU Dijon, Dijon, France
- UFR des Sciences de Santé, Université de Bourgogne, Dijon, France
| | - Mathieu Nacher
- CIC Inserm 1424, Centre d'investigation Clinique, Centre Hospitalier de Cayenne, Cayenne, French Guiana
- Département Formation Recherche (DFR) Santé, Université de Guyane, Cayenne, French Guiana
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Collectif. Oyapock coopération santé : une collaboration transfrontalière pour une meilleure prise en charge du VIH dans le bassin de l’Oyapock. CONFINS 2021. [DOI: 10.4000/confins.39613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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10
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Using phylogenetic surveillance and epidemiological data to understand the HIV-1 transmission dynamics in French Guiana. AIDS 2021; 35:979-984. [PMID: 33470610 DOI: 10.1097/qad.0000000000002817] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The aim of this study was to understand the transmission dynamics of the HIV-1 subtype B epidemic in French Guiana and the factors that shaped the expansion of major phylogenetic transmission clusters. DESIGN HIV-1 subtype B pol sequences with associated epidemiological data obtained from 703 treatment-naive patients living in French Guiana between 2006 and 2012, which correspond to 91% of all HIV cases diagnosed in that period, were employed in this study. METHODS Maximum likelihood and Bayesian methods were used to construct phylogenetic trees, identify transmission clusters and estimate intervals between successive infections. Statistical analysis was performed to evaluate epidemiological characteristics associated with cluster membership. RESULTS HIV-1 subtype B pol sequences from French Guiana were distributed in 10 large/medium transmission clades (LMTC, n > 10, 55%), 19 small transmission clades (STC, n = 3-8, 10%), 36 dyads (10%) or were nonclustered (25%). The rate of clustering did not differ by sex or clinical stage, but sex workers, crack-cocaine users, young individuals (15-20 years) and nationals or migrants from neighbouring South American countries were more likely to cluster within LMTC than individuals from other groups. We estimated that 53-63% of immigrants were infected after the arrival in French Guiana and that 50% of HIV transmissions within LMTC occurred during the first 2 years after infection. CONCLUSION These findings reinforce the notion that high-risk sexual behaviours among young individuals and migrants (postmigration) combined with late HIV diagnosis are key drivers of onward dissemination of major HIV transmission clusters in French Guiana.
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Lima VD, Wang L, Sereda P, McLinden T, Barrios R, Montaner JSG. Estimation of time of HIV seroconversion using a modified CD4 depletion model. PLoS One 2021; 16:e0246135. [PMID: 33577551 PMCID: PMC7880448 DOI: 10.1371/journal.pone.0246135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 01/13/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction Several methods have been proposed to estimate the time of HIV seroconversion, including those based on CD4 cell depletion models. However, previous models have failed to consider the heterogeneity that exists in CD4 trajectories among different sub-populations. Our objective was to estimate the time from HIV seroconversion relative to the HIV diagnosis date in a population-based cohort of people living with HIV (PLWH) in the province of British Columbia, Canada. Methods We used linked administrative and clinical data from the British Columbia Seek and Treat for Optimal Prevention of HIV/AIDS (STOP HIV/AIDS) cohort, which contains longitudinal individual-level data on all PLWH ever diagnosed in the province. Eligible participants were aged ≥18 years and diagnosed with HIV between 1989 and 2013. The outcome was pre-antiretroviral treatment CD4 cell count measurements assessed every six months. Models were stratified by age and stage of HIV infection at diagnosis. Several explanatory variables were considered including longitudinal viral load measurements. Longitudinal CD4, square root transformed, was modeled via a non-linear mixed effects model; time was modeled using an exponential decay function. We assumed a Gaussian distribution (identity link), an AR(1) correlation structure, and a random intercept and slope for the longitudinal viral load measurements. Due to the population variation in CD4 count among uninfected individuals, we assumed 500 to 1500 cells/mm3 as the normal range when estimating the time of HIV seroconversion. Results Longitudinal data on 1,253 individuals were analysed: 80% male, 33% White, and the median age at diagnosis was 38 years (25th-75th percentile [Q1-Q3], 31 to 45). CD4 decay differed by stage of infection at diagnosis and age, with those ≥50 years in Stages 1 and 2 experiencing a faster decline in CD4 over time. The median duration of infection from seroconversion until HIV diagnosis was 6.9 (Q1-Q3, 3.9 to 10.1) years. Conclusions Considering the heterogeneity that exists in individual CD4 cell trajectories in a population, we presented a methodology that only relies on routinely collected HIV-related data, which can be further extended to estimate other epidemic measures.
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Affiliation(s)
- Viviane D. Lima
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- * E-mail:
| | - Lu Wang
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Paul Sereda
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Taylor McLinden
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Rolando Barrios
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Vancouver Coastal Health, Vancouver, Canada
| | - Julio S. G. Montaner
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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12
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Mosnier E, Nacher M, Parriault MC, Dao C, Bidaud B, Brousse P, Gaillet M, Epelboin L, Mendes AM, Montenegro L, Daniel CN, Botreau R, Rouseliere A, Rhodes S, Carbunar A. Knowledge, attitudes, practices about HIV and implications in risk and stigma prevention among French Guianese and Brazilian border inhabitants : Beliefs about HIV among border inhabitants. BMC Public Health 2019; 19:1633. [PMID: 31801512 PMCID: PMC6894142 DOI: 10.1186/s12889-019-7997-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 11/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The border area between French Guiana and Brazil is an active HIV-transmission zone. The aim of the present study was to describe HIV knowledge, risk and the level of stigma among inhabitants of this border area. METHODS A cross-sectional study was conducted among 621 inhabitants over 18 years of age in the border cities of Saint-Georges-de-l'Oyapock in French Guiana and Oiapoque in Brazil. It was conducted between October 2017 and February 2018. An anonymous standardized questionnaire was filled out by culturally-trained mediators, then analyzed using STATA 12. RESULTS Almost half (45.9%) of the individuals had a low education level. Participants whose native language was Portuguese or French demonstrated better HIV knowledge than other populations, notably native Amerindian and creole-speaking people. HIV risk behavior was more frequent in men and in younger age groups. People with good HIV knowledge reported having performed more HIV tests in the last year than participants with poor knowledge. The stigma level was high and reported in 74.8% of respondents. CONCLUSIONS These results illustrate the need for initiatives to improve HIV prevention among autochthonous populations on both sides of this border area. Cross-border collaboration on health policies could produce common key messages adapted to the education level and multi-linguistic populations who live in this area.
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Affiliation(s)
- E Mosnier
- Pôle des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana. .,Aix Marseille University, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.
| | - M Nacher
- Centre d'Investigation Clinique Antilles Guyane, CIC INSERM 1424, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - M C Parriault
- Centre d'Investigation Clinique Antilles Guyane, CIC INSERM 1424, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana.,Ecosystèmes Amazoniens et Pathologie Tropicale, EA3593, Université de Guyane, Cayenne, French Guiana
| | - C Dao
- Dsanté NGO, Rémire Montjoly, Rémire Montjoly, French Guiana
| | - B Bidaud
- Pôle des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - P Brousse
- Pôle des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - M Gaillet
- Pôle des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana.,Ecosystèmes Amazoniens et Pathologie Tropicale, EA3593, Université de Guyane, Cayenne, French Guiana
| | - L Epelboin
- Ecosystèmes Amazoniens et Pathologie Tropicale, EA3593, Université de Guyane, Cayenne, French Guiana.,Unité de Maladies Infectieuses et Tropicales, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - A M Mendes
- Universidade Federal do Amapá (UNIFAP), Oiapoque, Brazil
| | - L Montenegro
- Dsanté NGO, Rémire Montjoly, Rémire Montjoly, French Guiana
| | | | - R Botreau
- Pôle des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - A Rouseliere
- Dsanté NGO, Rémire Montjoly, Rémire Montjoly, French Guiana
| | - S Rhodes
- Dsanté NGO, Rémire Montjoly, Rémire Montjoly, French Guiana
| | - A Carbunar
- Pôle des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana.,Dsanté NGO, Rémire Montjoly, Rémire Montjoly, French Guiana
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13
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Mosnier E, Epelboin L, Guiraud N, Huber F, Adriouch L, Guarmit B, Brousse P, Terraz A, Boser A, Gaillet M, Djossou F, Adenis A, Nacher M. Spatial dynamics and epidemiology for AIDS in remote areas in French Guiana. AIDS Care 2018; 31:498-504. [PMID: 30286608 DOI: 10.1080/09540121.2018.1524111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Although AIDS care is generally improving in French Guiana, disparities among regions and certain key populations remain significant. The purpose of this study was to describe the spatial and clinical characteristics of people living with HIV (PLHIV) in remote areas in comparison to those followed in hospitals on the urban coast of French Guiana. The data presented were obtained from outpatient on primary care centers located in rural regions away from the urban coast. Data were compared with that from medical records of PLHIV treated in French Guiana's urban care. The evolution of the annual rate of discovery of HIV seropositivity indicates a lag in remote areas as compared to urban and coastal areas. In recent years, the epidemic appeared as particularly active in rural areas among Brazilian patients. The median age of PLHIV in remote areas was 43.8 years, the sex ratio (M/F) was 0.93. Nearly 37% of PLHIV were discovered with advanced disease (<200 CD4/mm3). The percentage of virological success after six months of HAART was 80% and 88% in remote areas and urban area, respectively. Efforts must be made to control and halt the spread of the HIV epidemic, as these remote sites represent strategic points.
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Affiliation(s)
- Emilie Mosnier
- a Pôle des Centres Délocalisés de Prévention et de Soins , Centre hospitalier Andrée Rosemon , Cayenne , France.,b Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale , Université des Antilles et de la Guyane , Cayenne , France
| | - Loïc Epelboin
- b Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale , Université des Antilles et de la Guyane , Cayenne , France.,c Unité de Maladies Infectieuses et Tropicales , Centre hospitalier Andrée Rosemon , Cayenne , France
| | - Noé Guiraud
- d Institut des sciences humaines et sociales , UMR8504 Géographie-cités , Paris , France
| | - Florence Huber
- e Hôpital de jour , Centre hospitalier Andrée Rosemon , Cayenne , France
| | - Leila Adriouch
- f COREVIH , Centre Hospitalier Andrée Rosemon , Cayenne , France
| | - Basma Guarmit
- a Pôle des Centres Délocalisés de Prévention et de Soins , Centre hospitalier Andrée Rosemon , Cayenne , France
| | - Paul Brousse
- a Pôle des Centres Délocalisés de Prévention et de Soins , Centre hospitalier Andrée Rosemon , Cayenne , France
| | - Anne Terraz
- g Centre d'investigation Clinique , CIC INSERM 1424 , Cayenne , France
| | - Anna Boser
- h College of Letters and Sciences , University of California , Berkeley , CA , USA
| | - Mélanie Gaillet
- a Pôle des Centres Délocalisés de Prévention et de Soins , Centre hospitalier Andrée Rosemon , Cayenne , France
| | - Félix Djossou
- b Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale , Université des Antilles et de la Guyane , Cayenne , France.,c Unité de Maladies Infectieuses et Tropicales , Centre hospitalier Andrée Rosemon , Cayenne , France
| | - Antoine Adenis
- b Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale , Université des Antilles et de la Guyane , Cayenne , France.,g Centre d'investigation Clinique , CIC INSERM 1424 , Cayenne , France
| | - Mathieu Nacher
- b Equipe EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale , Université des Antilles et de la Guyane , Cayenne , France.,g Centre d'investigation Clinique , CIC INSERM 1424 , Cayenne , France
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