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Mosnier E, Hoyer M, Artigas F, Regnault H, Richard E, Michels D, Mosnier M, Inegbeze G, Robledo MS, Spire B, Vandentorren S, Lescaudron M, Eldin C, Roux P. Enhancing sexual health and empowerment among migrant women sex workers: a community health worker-led intervention in Marseille, France. Front Public Health 2024; 12:1359363. [PMID: 38601503 PMCID: PMC11005911 DOI: 10.3389/fpubh.2024.1359363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/21/2024] [Indexed: 04/12/2024] Open
Abstract
Introduction Given the high infection rate of sexually transmitted infections (STI) among migrant women sex workers (WSWs), it is necessary to understand how to improve prevention, information and care for this vulnerable population. Community health workers (CHWs), by linking community to health services, are positioned to improve health outcomes in migrant communities. This article aims to describe a pilot innovative intervention performed by CHWs to improve sexual health in migrant WSWs. Methods This one-year intervention study used a respondent-driven sampling (RDS) to recruit a representative cohort of migrant WSWs in Marseille, France. Four CHWs were recruited from different communities and participated in all stages of the research. They performed individual and group interventions of prevention, support in care and empowerment. Data on participant characteristics, type of intervention and adherence to the intervention were reported via questionnaires given to participants. Simultaneously, semi-structured interviews and informal interviews of migrant WSW, CHWs and care providers were carried out. Results A total of 132 migrant WSWs were included in the cohort. Very few of them knew about PrEP (12%) or already used HIV post-exposure treatment (9%). Migrant WSWs were often victims of rape or racism, 15 and 21%, respectively. In two-thirds of cases the level of health literacy was low. Participants suffered from a combination of vulnerability factors: difficulties with access to social rights, food or housing. Only 13% reported having benefited from medical follow-up or assistance by an NGO in the 3 months prior to the program. By 3 months, more than one third of the participants had been tested for HIV (35%) and 63% knew about PrEP. A total retention rate of 70% was reported in the cohort after 6 months. Conclusion CHWs enabled to improve care access for migrant WSWs by improving the collaboration between care and social actors at a local level. Through these "bring-back-to" interventions for this hard-to-reach population, CHWs enabled an optimization of the care pathway. Our results also highlight the importance of a population-based approach for individual and group support of empowerment interventions in order to strengthen their capacity for action.
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Affiliation(s)
- Emilie Mosnier
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l’Information Médicale, Aix Marseille Institute of Public Health ISSPAM, Marseille, France
- ANRS-MIE, University of Health Sciences, Phnom Penh, Cambodia
| | - Maxime Hoyer
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l’Information Médicale, Aix Marseille Institute of Public Health ISSPAM, Marseille, France
| | | | - Hippolyte Regnault
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l’Information Médicale, Aix Marseille Institute of Public Health ISSPAM, Marseille, France
| | - Elodie Richard
- PHAReS, Centre INSERM U1218, Bordeaux Population Health, Université de Bordeaux, Bordeaux, France
| | - David Michels
- Association AIDES, Pantin, France
- Laboratoire de Recherche Communautaire, Coalition PLUS, Pantin, France
| | | | | | | | - Bruno Spire
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l’Information Médicale, Aix Marseille Institute of Public Health ISSPAM, Marseille, France
- Association AIDES, Pantin, France
| | - Stéphanie Vandentorren
- PHAReS, Centre INSERM U1218, Bordeaux Population Health, Université de Bordeaux, Bordeaux, France
| | | | - Carole Eldin
- Unité des Virus Emergents (UVE), Aix-Marseille Université, IRD 190 INSERM 1207 EFS-IRBA, Marseille, France
| | - Perrine Roux
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l’Information Médicale, Aix Marseille Institute of Public Health ISSPAM, Marseille, France
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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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Abdella S, Demissie M, Worku A, Dheresa M, Berhane Y. HIV treatment cascade among female sex workers in Ethiopia: Assessment against the UNAIDS 90-90-90 targets. PLoS One 2023; 18:e0294991. [PMID: 38091300 PMCID: PMC10718439 DOI: 10.1371/journal.pone.0294991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 11/14/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND HIV treatment cascades for HIV-positive female sex workers (FSWs) have been challenged by the overlapping stigma and discrimination associated with both their sex work and HIV status. This study aims to assess the proportion of HIV-positive FSWs who access care and treatment in Ethiopia. METHOD A cross-sectional study with a respondent-driven sampling technique was used to enroll 6,085 female sex workers from January to June 2020. Interviews were conducted to assess the FSWs' HIV status awareness and access to ART. A blood sample was drawn to determine the current HIV status and viral load level. Logistic regression was run to identify factors associated with FSWs' HIV status awareness. RESULTS Of the total 1140 HIV-positive FSWs, 50.38% knew they were HIV positive; 92.88% of those who knew their status were on ART, and 91.68% of those on ART had attained viral suppression of less than 1000 copies per milliliter. The adjusted odds of knowing HIV status was 3.20 (95% CI; 2.00, 5.13) among those aged 35 years and older, 1.81 (95% CI; 1.05, 3.12) among widowed, and 1.73 (95% CI; 1.28, 2.32) in those who did not perceive the risk of HIV acquisition. CONCLUSION Only about half of HIV-positive FSWs knew they were HIV positive. More than 90% of those who knew their status were put on ART and achieved viral suppression. The weakest point in achieving HIV control among FSWs is the identification of those living with HIV.
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Affiliation(s)
- Saro Abdella
- HIV and TB Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Meaza Demissie
- Department of Global Health and Health Policy, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Alemayehu Worku
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Merga Dheresa
- School of Nursing and Midwifery, College of Health Sciences, Haramaya University, Harar, Ethiopia
| | - Yemane Berhane
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
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Mutricy-Hureau L, Pisoni A, Suarez-Mutis M, Figueira da Silva A, Lambert Y, Mespoulhe P, Godin A, Parriault MC, Van Melle A, Mosnier E, Gaillet M, Michaud C, Schaub R, Galindo M, Adenis A, Nacher M, Vreden S, Tuaillon E, Douine M. 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] [MESH Headings] [Grants] [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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Affiliation(s)
- Louise Mutricy-Hureau
- Center for Clinical Investigation Antilles-Guyane, Inserm 1424, Cayenne Hospital, Cayenne, French Guiana, France
| | - Amandine Pisoni
- UMR 1058 INSERM/EFS/University of Montpellier, Pathogenesis and Control of Chronic Infection, Montpellier University Hospital, Department of Bacteriology-Virology, Montpellier, France
| | - Martha Suarez-Mutis
- Oswaldo Cruz Foundation (Fiocruz), Laboratory of Parasitic Diseases, Rio de Janeiro, Brazil
| | | | - Yann Lambert
- Center for Clinical Investigation Antilles-Guyane, Inserm 1424, Cayenne Hospital, Cayenne, French Guiana, France
| | - Pauline Mespoulhe
- CRB Amazonie (Biological Resource Center), Cayenne Hospital, Cayenne, French Guiana, France
| | - Audrey Godin
- Center for Clinical Investigation Antilles-Guyane, Inserm 1424, Cayenne Hospital, Cayenne, French Guiana, France
| | - Marie-Claire Parriault
- Center for Clinical Investigation Antilles-Guyane, Inserm 1424, Cayenne Hospital, Cayenne, French Guiana, France
| | - Astrid Van Melle
- Center for Clinical Investigation Antilles-Guyane, Inserm 1424, Cayenne Hospital, Cayenne, French Guiana, France
| | - Emilie Mosnier
- Department of Infectious and Tropical Diseases, Cayenne Hospital, Cayenne, French Guiana, France
- Aix-Marseille University, INSERM, IRD, SESSTIM—Economic and Social Sciences, Health Systems, and Medical Informatics, F-13005, Marseille, France
| | - Mélanie Gaillet
- Centres Délocalisés de Prévention et de Soins (CDPS), Cayenne Hospital, Cayenne, French Guiana, France
| | - Céline Michaud
- Centres Délocalisés de Prévention et de Soins (CDPS), Cayenne Hospital, Cayenne, French Guiana, France
| | - Roxane Schaub
- Center for Clinical Investigation Antilles-Guyane, Inserm 1424, Cayenne Hospital, Cayenne, French Guiana, France
| | - Muriel Galindo
- Center for Clinical Investigation Antilles-Guyane, Inserm 1424, Cayenne Hospital, Cayenne, French Guiana, France
| | - Antoine Adenis
- Center for Clinical Investigation Antilles-Guyane, Inserm 1424, Cayenne Hospital, Cayenne, French Guiana, France
- TBIP, University of French Guiana, University of Lille, CNRS, Inserm, Institut Pasteur de Lille, U1019-UMR9017-CIIL Center for Infection and Immunity of Lille, Lille, France
| | - Mathieu Nacher
- Center for Clinical Investigation Antilles-Guyane, Inserm 1424, Cayenne Hospital, Cayenne, French Guiana, France
- TBIP, University of French Guiana, University of Lille, CNRS, Inserm, Institut Pasteur de Lille, U1019-UMR9017-CIIL Center for Infection and Immunity of Lille, Lille, France
| | - Stephen Vreden
- Foundation for the Advancement of Scientific Research in Suriname (SWOS), Paramaribo, Suriname
| | - Edouard Tuaillon
- UMR 1058 INSERM/EFS/University of Montpellier, Pathogenesis and Control of Chronic Infection, Montpellier University Hospital, Department of Bacteriology-Virology, Montpellier, France
| | - Maylis Douine
- Center for Clinical Investigation Antilles-Guyane, Inserm 1424, Cayenne Hospital, Cayenne, French Guiana, France
- TBIP, University of French Guiana, University of Lille, CNRS, Inserm, Institut Pasteur de Lille, U1019-UMR9017-CIIL Center for Infection and Immunity of Lille, Lille, France
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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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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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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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E6/E7 Sequence Diversity of High-Risk Human Papillomaviruses in Two Geographically Isolated Populations of French Guiana. Microorganisms 2020; 8:microorganisms8111842. [PMID: 33238632 PMCID: PMC7700404 DOI: 10.3390/microorganisms8111842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 11/21/2022] Open
Abstract
Amerindian and Maroon populations of French Guiana have been living in isolation for generations and sexual networks remained mostly endogamous. The present study aimed to describe the phylogeny of E6 and E7 sequences of the most common high-risk HPV genotypes in these regions, to ascertain the diversity of intra-type variants and describe evolutionary relationships. There were 106 women with at least one of HPV16, 18, 31, 52, 58, and 68 genotypes. The most clear-cut phylogenetic pattern was obtained for HPV18 and HPV58 for which the major branches were crisply divided between Amerindian villages on the Oyapock and Maroon villages on the Maroni. Such clustering was less clear for HPV31 and 52. For HPV16, there was also some evidence of clustering on the Oyapock with type A European viruses and on the Maroni with type B and C African viruses among Maroon women. HPV68 showed the largest sequence heterogeneity of the six genotypes at both nucleotide and amino acid levels and was restricted to Maroon women. The present results show that there were significant geographically based differences of E6 and E7 oncogenes. These differences were compatible with different ancestral virus populations and local virus evolution in a context of prolonged population isolation.
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Edi Putra IGN, Januraga PP. Social Capital and HIV Testing Uptake among Indirect Female Sex Workers in Bali, Indonesia. Trop Med Infect Dis 2020; 5:tropicalmed5020073. [PMID: 32392824 PMCID: PMC7345714 DOI: 10.3390/tropicalmed5020073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 04/23/2020] [Accepted: 05/06/2020] [Indexed: 01/20/2023] Open
Abstract
Indirect female sex workers (FSWs), a type of FSW working under the cover of entertainment enterprises (e.g., karaoke lounge, bar, etc.), remain as an important key population for HIV transmission, signaling the need of appropriate interventions targeting HIV-related behaviors. This study aimed to investigate the association between social capital and HIV testing uptake. A cross-sectional study was conducted among 200 indirect FSWs in Denpasar, Bali. The dependent variable was HIV testing uptake in the last six months preceding the survey. The main independent variables were social capital constructs: social cohesion (perceived peer support and trust) and social participation. Variables of socio-demographic characteristics were controlled in this study to adjust the influence of social capital. Binary logistic regression was performed. The prevalence of HIV testing in the last six months was 72.50%. The multivariate analysis showed that only peer support from the social capital constructs was associated with HIV testing uptake. Indirect FSWs who perceived a high level of support within FSWs networks were 2.98-times (95% CI = 1.43–6.24) more likely to report for HIV testing. Meanwhile, perceived trust and social participation did not show significant associations in relation to HIV testing uptake. As social cohesion (support) within FSWs’ relationships can play an important role in HIV testing uptake, existing HIV prevention programs should consider support enhancement to develop a sense of belonging and solidarity.
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Affiliation(s)
- I Gusti Ngurah Edi Putra
- School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW 2522, Australia;
| | - Pande Putu Januraga
- Center for Public Health Innovation, Faculty of Medicine, Udayana University, Denpasar, Bali 80361, Indonesia
- Correspondence: ; Tel.: +6281246180389
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ELLWANGER JOELHENRIQUE, KULMANN-LEAL BRUNA, KAMINSKI VALÉRIAL, VALVERDE-VILLEGAS JACQUELINEMARÍA, VEIGA ANABEATRIZGDA, SPILKI FERNANDOR, FEARNSIDE PHILIPM, CAESAR LÍLIAN, GIATTI LEANDROLUIZ, WALLAU GABRIELL, ALMEIDA SABRINAE, BORBA MAUROR, HORA VANUSAPDA, CHIES JOSÉARTURB. Beyond diversity loss and climate change: Impacts of Amazon deforestation on infectious diseases and public health. ACTA ACUST UNITED AC 2020; 92:e20191375. [DOI: 10.1590/0001-3765202020191375] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 02/17/2020] [Indexed: 12/15/2022]
Affiliation(s)
| | | | | | | | | | | | | | - LÍLIAN CAESAR
- Universidade Federal do Rio Grande do Sul/UFRGS, Brazil
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11
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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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12
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Brito AMD, Szwarcwald CL, Damacena GN, Dourado IC. HIV testing coverage among female sex workers, Brazil, 2016. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2019; 22Suppl 1:e190006. [PMID: 31576982 DOI: 10.1590/1980-549720190006.supl.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 04/12/2019] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Knowing the factors associated with periodic HIV testing among female sex workers (FSW) is essential to expand testing coverage and to broaden programs of treatment as prevention. METHODS We used data from 4,328 FSWs recruited by the respondent-driven sampling (RDS) method in 12 Brazilian cities in 2016. Data analysis considered the complex sampling design. The prevalence of HIV testing in the last year and periodic HIV test were estimated. Factors associated with regular HIV testing were identified through logistic regression models. RESULTS The testing coverage in the last year was 39.3%. Only 13.5% of FSW reported having performed a periodic HIV test in the last year. Among the factors associated with the higher probability of HIV testing in the last year were a better level of education, living with a partner, working indoors, consistent use of condoms, and regular use of public and private health services stood out. DISCUSSION Periodic HIV testing allows early diagnosis and immediate treatment of cases, reducing the chances of spreading the infection to the population. However, factors such as stigma and discrimination hinder the use of regular health services. CONCLUSION It is necessary to expand awareness campaigns, especially among FSWs with low educational level and greater vulnerability, in order to broaden the perception of risk and the importance of periodic testing, in addition to encouraging regular health care.
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Affiliation(s)
- Ana Maria de Brito
- Department of Collective Health, Aggeu Magalhães Institute, Oswaldo Cruz Foundation - Recife (PE), Brazil
| | - Célia Landmann Szwarcwald
- Institute of Scientific and Technological Communication and Information in Health, Oswaldo Cruz Foundation - Rio de Janeiro (RJ), Brazil
| | - Giseli Nogueira Damacena
- Institute of Scientific and Technological Communication and Information in Health, Oswaldo Cruz Foundation - Rio de Janeiro (RJ), Brazil
| | - Inês Costa Dourado
- Department of Collective Health, Federal University of Bahia - Salvador (BA), Brazil
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13
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Castro RR, Oliveira SSD, Pereira IRBDO, Santos WND, Fernandes SF, Silva RARD. Construct validation: coping with HIV/AIDS in Primary Health Care. Rev Bras Enferm 2019; 72:1173-1181. [PMID: 31531638 DOI: 10.1590/0034-7167-2018-0734] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 01/31/2019] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To validate the construct and measure the trustworthiness of a questionnaire aimed at assessing HIV/AIDS coping actions developed by health professionals in Primary Health Care. METHOD A methodological study carried out with 397 primary health care professionals in two municipalities in the Northeast region of Brazil. The construct validity was developed by the exploratory and confirmatory factor analysis, and the reliability analyzed by the reliability and reproducibility. RESULTS The validation determined six factors retention that composed the six domains of the questionnaire. Internal consistency was 0.91 and quality of the confirmatory analysis adjustment was 0.998 for Goodness of Fit Index. The domains presented Kappa values between 0.833 and 0.997. CONCLUSIONS The final questionnaire was composed of 18 items and presented feasibility of application, and potential to evaluate actions for HIV/AIDS control in Primary Health Care.
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Affiliation(s)
- Révia Ribeiro Castro
- Universidade do Estado do Rio Grande do Norte. Mossoró, Rio Grande do Norte, Brazil
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14
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da Costa LM, Raiol NC, Lisboa BLA, Frade PCR, Blandtt LDS, Silva-Oliveira GC, Machado LFA, Martins LC, Oliveira-Filho AB. Prevalence and Risk Factors for Human Immunodeficiency Virus Infection Among Female Sex Workers: Distinct Offers of Sexual Services in a Municipality of the Brazilian Amazon. AIDS Res Hum Retroviruses 2019; 35:826-832. [PMID: 31204860 DOI: 10.1089/aid.2019.0032] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This study determined the prevalence of human immunodeficiency virus (HIV) infection and its associated factors in female sex workers (FSWs) from the municipality of Bragança in the state of Pará, Brazil. A cross-sectional study using a respondent-driven sampling method was used to investigate 137 FSWs. They were interviewed using a questionnaire for the collection of data on their characteristics and risk behavior. Blood samples were collected for serological and molecular testing for HIV. Poisson regression models were used to estimate the reasons of prevalence (RP). The majority was single, young, poorly educated, had a low monthly income, and had worked in the sex trade for more than 7 years. Sexual services were offered either directly (easy identification of FSWs in street markets, town squares, street corners, bars, and gas stations) or indirectly/discretely (more complex identification of FSWs, offering services through a cryptic approach or an intermediary). Overall, 22 (16.06%) FSWs had anti-HIV-1/2 antibodies, and 21 (15.33%) also had complementary DNA-HIV. The use of illicit drugs [adjusted RP (aRP) = 3.13; 95% confidence interval (CI) = 1.27-8.41], unprotected sex (aRP = 4.09; 95% CI = 1.34-11.62), anal sex (aRP = 4.01; 95% CI = 1.37-10.15), the exemption of condoms for clients paying extra (aRP = 4.71; 95% CI = 1.52-10.89), more than 7 years working as a sex worker (aRP = 6.04; 95% CI = 1.20-16.33), low levels of education (aRP = 3.55; 95% CI = 1.15-11.02), and a lack of regular medical or gynecological examinations were all associated with HIV infection (aRP = 5.87; 95% CI = 1.26-15.71). The FSWs who offered their services indirectly suffered significantly less physical and sexual aggression, charged more for encounters, had a significantly higher monthly income, and were more likely to have undergone a medical or gynecological examination within the preceding 12 months. This study identified information relevant to the control and prevention of HIV in FSWs.
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Affiliation(s)
- Luana Mota da Costa
- Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança, Brazil
- Residência Multiprofissional em Saúde da Mulher e da Criança, Hospital Santo Antonio Maria Zaccaria, Bragança, Brazil
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brazil
| | - Nairis Costa Raiol
- Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança, Brazil
| | | | - Paula Cristina R. Frade
- Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança, Brazil
- Residência Multiprofissional em Saúde da Mulher e da Criança, Hospital Santo Antonio Maria Zaccaria, Bragança, Brazil
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brazil
| | - Lucinaldo da Silva Blandtt
- Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança, Brazil
- Residência Multiprofissional em Saúde da Mulher e da Criança, Hospital Santo Antonio Maria Zaccaria, Bragança, Brazil
| | | | | | - Luísa Caricio Martins
- Residência Multiprofissional em Saúde da Mulher e da Criança, Hospital Santo Antonio Maria Zaccaria, Bragança, Brazil
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brazil
| | - Aldemir B. Oliveira-Filho
- Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança, Brazil
- Residência Multiprofissional em Saúde da Mulher e da Criança, Hospital Santo Antonio Maria Zaccaria, Bragança, Brazil
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Santa Catarina, Florianópolis, Brazil
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Hoang CD, Tran BX, Pham MD, Nguyen LH, Do HN, Vuong QH, Ho MT, Dam VN, Vuong TT, Nguyen HH, Nguyen V, Pham HQ, Ha GH, Latkin CA, Ho CSH, Ho RCM. HIV- and AIDS-related knowledge and attitude of residents in border regions of Vietnam. Harm Reduct J 2019; 16:11. [PMID: 30732621 PMCID: PMC6367780 DOI: 10.1186/s12954-019-0282-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 01/29/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Residents in border areas are vulnerable to HIV/AIDS due to high rates of risk behaviors such as unprotected sexual practices or illicit drug use. Improving knowledge and attitude toward HIV/AIDS prevention and treatment are vital to diminish the burden of the HIV epidemic in this setting. However, evidence about this issue in Vietnam has been limited. This study aims to explore the knowledge and attitude toward HIV/AIDS among people in Vietnam border zones. METHODS We conducted a cross-sectional study in three border communes in Thanh Hoa province with 600 HIV(-) residents. Data about socio-demographic characteristics, general HIV knowledge, knowledge about prevention of mother-to-child transmission, treatment and care, HIV testing services, and attitude toward HIV/AIDS were collected. Multivariate Tobit regression was used to determine related factors with the knowledge and attitude. RESULTS The highest percentage of people having correct statements was for "HIV could be transmitted from mother to child" (98.2%), while the lowest percentage was for item "Know health facilities where HIV-positive people could register for care and check-up" (28.2%). People had the highest score in "Knowledge about HIV transmission routes" and the lowest score in "Knowledge about HIV/AIDS prevention measures". Most of the people were not afraid of being exposed to HIV-positive individuals (66.0%), willing to buy goods from HIV-positive sellers (78.9%), and willing to take care of people living with HIV in their family (90.1%). Education, ethnic, marital status, occupations, and HIV/AIDS information sources were found to be associated with knowledge and attitude toward HIV/AIDS. CONCLUSIONS The general knowledge and attitude on HIV/AIDS of residents were relatively good. Educational campaigns to improve knowledge and attitude toward PLWH, involving peer educators and local associations, are potential strategies for sustaining HIV intervention in this remote setting.
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Affiliation(s)
- Canh Dinh Hoang
- Vietnam Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam. .,Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Manh Duc Pham
- Vietnam Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam
| | - Long Hoang Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Ha Ngoc Do
- Youth Research Institute, Ho Chi Minh Communist Youth Union, Hanoi, Vietnam
| | - Quan Hoang Vuong
- Center for Interdisciplinary Social Research, Phenikaa University, Hanoi, Vietnam
| | - Manh Tung Ho
- Center for Interdisciplinary Social Research, Phenikaa University, Hanoi, Vietnam
| | | | | | - Hai Hong Nguyen
- Vietnam Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam
| | - Vu Nguyen
- Department of Neurosurgery Spine-Surgery, Hanoi Medical University Hospital, Hanoi, Vietnam
| | - Hai Quang Pham
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Giang Hai Ha
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Cyrus S H Ho
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
| | - Roger C M Ho
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam.,Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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16
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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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Tokar A, Broerse JEW, Blanchard J, Roura M. HIV Testing and Counseling Among Female Sex Workers: A Systematic Literature Review. AIDS Behav 2018; 22:2435-2457. [PMID: 29464430 PMCID: PMC6097720 DOI: 10.1007/s10461-018-2043-3] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
HIV testing uptake continues to be low among Female Sex Workers (FSWs). We synthesizes evidence on barriers and facilitators to HIV testing among FSW as well as frequencies of testing, willingness to test, and return rates to collect results. We systematically searched the MEDLINE/PubMed, EMBASE, SCOPUS databases for articles published in English between January 2000 and November 2017. Out of 5036 references screened, we retained 36 papers. The two barriers to HIV testing most commonly reported were financial and time costs—including low income, transportation costs, time constraints, and formal/informal payments—as well as the stigma and discrimination ascribed to HIV positive people and sex workers. Social support facilitated testing with consistently higher uptake amongst married FSWs and women who were encouraged to test by peers and managers. The consistent finding that social support facilitated HIV testing calls for its inclusion into current HIV testing strategies addressed at FSW.
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Affiliation(s)
- Anna Tokar
- ISGlobal, Barcelona Institute for Global Health, University of Barcelona, Hospital Clínic - Universitat de Barcelona, Rosselló, 132, 08036 Barcelona, Spain
| | | | - James Blanchard
- Department of Community Health Sciences, Manitoba University, Manitoba, Canada
| | - Maria Roura
- ISGlobal, Barcelona Institute for Global Health, University of Barcelona, Hospital Clínic - Universitat de Barcelona, Rosselló, 132, 08036 Barcelona, Spain
- Public and Patient Involvement Research Unit, Graduate Entry Medical School, University of Limerick, Limerick, Ireland
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18
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Bello G, Nacher M, Divino F, Darcissac E, Mir D, Lacoste V. The HIV-1 Subtype B Epidemic in French Guiana and Suriname Is Driven by Ongoing Transmissions of Pandemic and Non-pandemic Lineages. Front Microbiol 2018; 9:1738. [PMID: 30108576 PMCID: PMC6079251 DOI: 10.3389/fmicb.2018.01738] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 07/11/2018] [Indexed: 12/29/2022] Open
Abstract
The HIV-1 subtype B epidemic in French Guiana and Suriname is characterized by the co-circulation of the globally disseminated “BPANDEMIC” lineage and of non-pandemic subtype B lineages of Caribbean origin (BCAR). To reconstruct the spatiotemporal pattern of spread of those viral lineages circulating in these two countries, a total of 361 HIV-1 subtype B pol sequences recovered from treatment-naive adult patients from French Guiana and Suriname between 2006 and 2012 were combined with BPANDEMIC and BCAR reference sequences. Major Guianese/Surinamese BPANDEMIC and BCAR lineages were identified by Maximum Likelihood phylogenetic analysis and the spatiotemporal and demographic parameters estimated using a Bayesian coalescent-based method. We detected four BCAR and three BPANDEMIC transmission chains of large size that together comprise most pandemic and non-pandemic subtype B sequences from French Guiana (≥52%) and Suriname (≥70%) here analyzed. These major lineages were probably introduced into French Guiana and Suriname from the Caribbean (BCAR) and North/South America (BPANDEMIC) between the middle 1970s and the late 1980s and spread among populations from both countries with roughly comparable demographic growth rates. We detected a significant trend for higher viral loads and higher proportion of homosexual/bisexual men among subjects infected with BPANDEMIC relative to BCAR strains in French Guiana. These results show that the HIV subtype B epidemic in French Guiana and Suriname has been driven by multiple active BCAR and BPANDEMIC transmission chains that arose since the middle 1970s onward and operate in both countries simultaneously. Although no significant differences in the epidemic potential of major BCAR and BPANDEMIC lineages were observed, relevant associations between the infecting subtype B lineage and epidemiological and clinical characteristics were detected in French Guiana.
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Affiliation(s)
- Gonzalo Bello
- Laboratório de AIDS e Imunologia Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Mathieu Nacher
- Coordination Régionale de la Lutte Contre le VIH (COREVIH) and Centre d'Investigation Clinique - CIC INSERM 1424, Centre Hospitalier de Cayenne "Andrée Rosemon", Cayenne, French Guiana
| | - Flavia Divino
- Laboratório de AIDS e Imunologia Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Edith Darcissac
- Laboratoire des Interactions Virus-Hôtes, Institut Pasteur de la Guyane, Cayenne, French Guiana
| | - Daiana Mir
- Laboratório de AIDS e Imunologia Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Vincent Lacoste
- Laboratoire des Interactions Virus-Hôtes, Institut Pasteur de la Guyane, Cayenne, French Guiana
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20
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Dinh L, Chowell G, Rothenberg R. Growth scaling for the early dynamics of HIV/AIDS epidemics in Brazil and the influence of socio-demographic factors. J Theor Biol 2018; 442:79-86. [PMID: 29330056 DOI: 10.1016/j.jtbi.2017.12.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 12/25/2017] [Accepted: 12/29/2017] [Indexed: 12/13/2022]
Abstract
The early dynamics of an infectious disease outbreak can be affected by various factors including the transmission mode of the disease and host-specific factors. While recent works have highlighted the presence of sub-exponential growth patterns during the early phase of epidemics, empirical studies examining the contribution of different factors to early epidemic growth dynamics are lacking. Here we aim to characterize and explain the early incidence growth patterns of local HIV/AIDS epidemics in Brazil as a function of socio-demographic factors. For this purpose, we accessed annual AIDS incidence series and state-level socio-demographic variables from publicly available databases. To characterize the early growth dynamics of the HIV/AIDS epidemic, we employed the generalized-growth model to estimate with quantified uncertainty the scaling of growth parameter (p) which captures growth patterns ranging from constant incidence (p=0) to sub-exponential (0 < p < 1) and exponential growth dynamics (p=1) at three spatial scales: national, regional, and state levels. We evaluated the relationship between socio-demographic variables and epidemic growth patterns across 27 Brazilian states using mixed-effect regression analyses. We found wide variation in the early dynamics of the AIDS epidemic in Brazil, displaying sub-exponential growth patterns with the p parameter estimated substantially below 1.0. The mean p was estimated to be 0.81 at the national level, with a range of 0.72-0.85 at the regional level, and a range of 0.28-0.96 at the state level. Our findings support the notion that socio-demographic factors contribute to shaping the early growth dynamics of the epidemic at the local level. Gini index and socio-demographic index were negatively associated with the parameter p, whereas urbanicity was positively associated with p. The results could have theoretical significance in understanding differences in growth scaling across different sexually transmitted disease systems, and have public health implications to guide control.
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Affiliation(s)
- L Dinh
- Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, GA, USA.
| | - G Chowell
- Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, GA, USA; Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - R Rothenberg
- Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, GA, USA
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21
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Douine M, Mosnier E, Le Hingrat Q, Charpentier C, Corlin F, Hureau L, Adenis A, Lazrek Y, Niemetsky F, Aucouturier AL, Demar M, Musset L, Nacher M. Illegal gold miners in French Guiana: a neglected population with poor health. BMC Public Health 2017; 18:23. [PMID: 28716015 PMCID: PMC5513330 DOI: 10.1186/s12889-017-4557-4] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 06/30/2017] [Indexed: 11/17/2022] Open
Abstract
Background In French Guiana, a French overseas territory in South America, 6 to 10 thousands undocumented persons work illegally in gold mining sites in the Amazonian forest. Precarious life conditions lead to poor health but few data exist on the health status of illegal gold miners in French Guiana. The objective of this article was to describe the sociodemographic and health status of this vulnerable population. Method A prospective cross-sectional survey was conducted in 2015 on gold mine supply sites at the border between French Guiana and Suriname. Health status was assessed through medical examination, past medical history, haemoglobin concentration, and HIV and malaria testing. A questionnaire was used to collect data about the migration itinerary and life conditions on mining sites. Results Among the 421 adults included in the study, 93.8% (395/421) were Brazilian, mainly from Maranhão (55.7%, 220/395), the poorest Brazilian state. The sex ratio was 2.4. Overall, 48% of persons never went to school or beyond the primary level. The median time spent in gold mining was quite long (10 years), with a high turn-over. One third of the surveyed population (37.1%, 156/421) had high blood pressure, and only two had a medical follow-up. Most persons had experienced malaria (89.3%, 376/421). They declared frequent arboviroses and digestive disorders. Active leishmaniasis was observed in 8.3% of gold miners. Among women, 28.5% were anemic. Concerning HIV, 36.6% (154/421) of persons, mainly men, never got tested before and 6 were tested positive, which represented an HIV prevalence of 1.43% (95%CI =0.29–2.5). Conclusion These findings support the hypothesis that mining in remote areas is linked to several specific illnesses. Theoretically, gold miners would be presumed to start their economical migration to French Guiana as a healthy group. However, their strenuous working and living conditions there lead to poor health caused by infectious and non infectious diseases. This description of their health status is precious for health policy planners in French Guiana given the importance of controlling communicable disease, and the severity and range of specific illnesses acquired by this neglected population. Trial registration Clinical trial registration PRS N° NCT02903706. Retrospectively registered 09/13/2016.
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Affiliation(s)
- Maylis Douine
- Centre d'Investigation Clinique Antilles-Guyane (Inserm 1424), Cayenne Hospital, Av des Flamboyant, BP 6006, 97306 cedex, Cayenne, French Guiana, France. .,Epidemiology of Tropical Parasitoses, EA 3593, Université de Guyane, Cayenne, French Guiana, France.
| | - Emilie Mosnier
- Epidemiology of Tropical Parasitoses, EA 3593, Université de Guyane, Cayenne, French Guiana, France.,Centres Délocalisés de Prévention et de Soins, Cayenne Hospital, Cayenne, French Guiana, France
| | - Quentin Le Hingrat
- INSERM UMR1137, IAME Université Paris Diderot Sorbonne Paris Cité, AP-HP, Laboratoire de Virologie, Hôpital Bichat-Claude Bernard, Paris, France
| | - Charlotte Charpentier
- INSERM UMR1137, IAME Université Paris Diderot Sorbonne Paris Cité, AP-HP, Laboratoire de Virologie, Hôpital Bichat-Claude Bernard, Paris, France
| | - Florine Corlin
- Centre d'Investigation Clinique Antilles-Guyane (Inserm 1424), Cayenne Hospital, Av des Flamboyant, BP 6006, 97306 cedex, Cayenne, French Guiana, France
| | - Louise Hureau
- Centre d'Investigation Clinique Antilles-Guyane (Inserm 1424), Cayenne Hospital, Av des Flamboyant, BP 6006, 97306 cedex, Cayenne, French Guiana, France
| | - Antoine Adenis
- Centre d'Investigation Clinique Antilles-Guyane (Inserm 1424), Cayenne Hospital, Av des Flamboyant, BP 6006, 97306 cedex, Cayenne, French Guiana, France.,Epidemiology of Tropical Parasitoses, EA 3593, Université de Guyane, Cayenne, French Guiana, France
| | - Yassamine Lazrek
- Laboratoire de parasitologie, WHO Collaborating Center for Surveillance of Anti-Malarial Drug Resistance, Centre National de Référence du paludisme, Institut Pasteur de la Guyane, Cayenne, French Guiana, France
| | - Florence Niemetsky
- Centres Délocalisés de Prévention et de Soins, Cayenne Hospital, Cayenne, French Guiana, France
| | - Anne-Laure Aucouturier
- Centre d'Investigation Clinique Antilles-Guyane (Inserm 1424), Cayenne Hospital, Av des Flamboyant, BP 6006, 97306 cedex, Cayenne, French Guiana, France.,Centres Délocalisés de Prévention et de Soins, Cayenne Hospital, Cayenne, French Guiana, France
| | - Magalie Demar
- Academic Laboratory of Parasitology - Mycology, Cayenne Hospital, Cayenne, French Guiana, France
| | - Lise Musset
- Laboratoire de parasitologie, WHO Collaborating Center for Surveillance of Anti-Malarial Drug Resistance, Centre National de Référence du paludisme, Institut Pasteur de la Guyane, Cayenne, French Guiana, France
| | - Mathieu Nacher
- Centre d'Investigation Clinique Antilles-Guyane (Inserm 1424), Cayenne Hospital, Av des Flamboyant, BP 6006, 97306 cedex, Cayenne, French Guiana, France.,Epidemiology of Tropical Parasitoses, EA 3593, Université de Guyane, Cayenne, French Guiana, France
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22
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Parriault MC, Van Melle A, Basurko C, Adriouch L, Rogier S, Couppié P, Nacher M. The use of structural equation modelling and behavioural theory to target priority interventions to increase condom use among the intimate partners of sex workers in French Guiana. AIDS Care 2016; 28:1600-1606. [PMID: 27248182 DOI: 10.1080/09540121.2016.1191607] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
French Guiana is the French overseas territory that is most affected by HIV. Sex work seems to be an important driver of the epidemic. Although female sex workers are informed by local NGOs, they still have risky behaviours, including not using condoms with their intimate partner despite knowing HIV is highly prevalent. The objective of this study was to find intervention targets on this specific behaviour. For this, a structural equation model (SEM) was built using assumptions from behavioural theories. Behaviour theories attempt to connect research and practice. Within the health belief model framework, perceived threats, perceived benefits, and self-perceived efficacy were tested. Vulnerability was added because of the particular context of French Guiana. The results highlight that female sex workers' perceived self-efficacy was central in condom use with the intimate partner (with a significant correlation coefficient of 0.52 in the SEM). The perceived self-efficacy was strongly influenced by sociodemographic factors, particularly by nationality. Female sex workers from Brazil seemed to be more comfortable about asking their intimate partner to use condoms (OR: 7.81; CI: 1.87-32.63) than sex workers of other nationalities. These results emphasize that prevention interventions for female sex workers should emphasize their empowerment.
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Affiliation(s)
| | - Astrid Van Melle
- a INSERM CIC 1424, Cayenne General Hospital , Cayenne , French Guiana
| | - Célia Basurko
- a INSERM CIC 1424, Cayenne General Hospital , Cayenne , French Guiana
| | - Leila Adriouch
- b COREVIH Guyane, Cayenne General Hospital , Cayenne , French Guiana
| | - Stéphanie Rogier
- a INSERM CIC 1424, Cayenne General Hospital , Cayenne , French Guiana
| | - Pierre Couppié
- c Department of Dermatology , Cayenne General Hospital , Cayenne , French Guiana
| | - Mathieu Nacher
- a INSERM CIC 1424, Cayenne General Hospital , Cayenne , French Guiana.,b COREVIH Guyane, Cayenne General Hospital , Cayenne , French Guiana
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