1
|
Fiorentino M, Coulibaly B, Couderc C, Keita BD, Anoma C, Dah E, Mensah E, Aka TN, Touré JR, Camara D, Kokouba AR, Maradan G, Mora M, Bourrelly M, Riegel L, Rojas-Castro D, Spire B, Laurent C, Sagaon-Teyssier L. Men Who Have Sex with Both Men and Women in West Africa: Factors Associated with a High Behavioral Risk of Acquiring HIV from Male Partners and Transmission to Women (CohMSM ANRS 12324-Expertise France). Arch Sex Behav 2024; 53:757-769. [PMID: 37973698 PMCID: PMC10844348 DOI: 10.1007/s10508-023-02715-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 09/13/2023] [Accepted: 09/21/2023] [Indexed: 11/19/2023]
Abstract
HIV is highly prevalent in men who have sex with men (MSM) in West Africa. Many MSM in the region also have sex with women (MSMW). Accordingly, they are a potential bridge subpopulation for HIV transmission to women. We aimed to evaluate the proportions and characteristics of West African MSMW at high behavioral risk of acquiring HIV from male partners and transmitting it to female partners (HBRMF). The cohort ANRS-12324 CohMSM Study included 630 HIV-negative MSM in Burkina Faso, Cote d'Ivoire, Mali, and Togo. Among MSMW (i.e., with ≥ 1 female partner) in the cohort, HBRMF was identified using trajectory models based on seven at-risk sexual practices with male and female partners, including inconsistent condom use, multiple partnerships, and receptive same-sex anal intercourse. To assess the relevance of using trajectory models, we compared the proportions of participants who seroconverted during the cohort follow-up among those at HBRMF and those not at HBRMF. Factors associated with HBRMF were identified using a generalized estimation equation logistic regression model accounting for longitudinal data. Approximately half (47%) of the 304 MSMW (22% of all CohMSM study participants) were at HBRMF. This group accounted for 75% of the 28 HIV seroconversions observed during follow-up (p = 0.001). HBRMF was positively associated with being aged < 25 years (aOR 95% CI 1.67 [1.23-2.27]), being sexually attracted only to men (1.97 [1.38-2.78]), feelings of loneliness (1.92 [1.38-2.65]), and homonegative violence score (1.22 [1.05-1.41]). HBRMF was negatively associated with having had both stable and casual female partners in the previous 6 months (0.34 [0.20-0.60] vs. only a stable female partner). HBRMF tended to be negatively associated with having ≥ 4 sexual intercourses with female partners in the previous four weeks (0.54 [0.27-1.06] vs. no intercourse). Establishing official relationships with women might be a strategy for young and/or stigmatized MSMW to comply with social pressure to display a heterosexual lifestyle. However, this seems to increase the risk of HIV transmission to female partners. In the present study, almost half of MSMW were at HBRMF. This result stresses the need to adapt HIV research and prevention to MSMW and their female partners.
Collapse
Affiliation(s)
- Marion Fiorentino
- IRD, Inserm, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, ISSPAM, Aix Marseille University, Marseille, 13385, France.
| | - Bakary Coulibaly
- ARCAD Santé PLUS, Centre Intégré de Recherche, de Soins et d'Action Communautaire, Bamako, Mali
| | | | - Bintou Dembélé Keita
- ARCAD Santé PLUS, Centre Intégré de Recherche, de Soins et d'Action Communautaire, Bamako, Mali
| | | | - Elias Dah
- Association African Solidarité, Ouagadougou, Burkina Faso
| | | | | | | | - Drissa Camara
- ARCAD Santé PLUS, Centre Intégré de Recherche, de Soins et d'Action Communautaire, Bamako, Mali
| | | | - Gwenaëlle Maradan
- IRD, Inserm, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, ISSPAM, Aix Marseille University, Marseille, 13385, France
- Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Marion Mora
- IRD, Inserm, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, ISSPAM, Aix Marseille University, Marseille, 13385, France
| | - Michel Bourrelly
- IRD, Inserm, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, ISSPAM, Aix Marseille University, Marseille, 13385, France
| | - Lucas Riegel
- Coalition PLUS, Laboratoire de recherche communautaire, Pantin, France
| | - Daniela Rojas-Castro
- IRD, Inserm, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, ISSPAM, Aix Marseille University, Marseille, 13385, France
- Coalition PLUS, Laboratoire de recherche communautaire, Pantin, France
| | - Bruno Spire
- IRD, Inserm, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, ISSPAM, Aix Marseille University, Marseille, 13385, France
| | | | - Luis Sagaon-Teyssier
- IRD, Inserm, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, ISSPAM, Aix Marseille University, Marseille, 13385, France
- ARCAD Santé PLUS, Centre Intégré de Recherche, de Soins et d'Action Communautaire, Bamako, Mali
| |
Collapse
|
2
|
Molina JM, Ghosn J, Assoumou L, Delaugerre C, Algarte-Genin M, Pialoux G, Katlama C, Slama L, Liegeon G, Beniguel L, Ohayon M, Mouhim H, Goldwirt L, Spire B, Loze B, Surgers L, Pavie J, Lourenco J, Ben-Mechlia M, Le Mestre S, Rojas-Castro D, Costagliola D. Daily and on-demand HIV pre-exposure prophylaxis with emtricitabine and tenofovir disoproxil (ANRS PREVENIR): a prospective observational cohort study. The Lancet HIV 2022; 9:e554-e562. [DOI: 10.1016/s2352-3018(22)00133-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 04/25/2022] [Accepted: 04/29/2022] [Indexed: 12/24/2022]
|
3
|
Yaya I, Boyer V, Ehlan PA, Coulibaly A, Agboyibor MK, Traoré I, Kouamé MJB, Maiga AK, Kotchi OR, Nyasenu YT, Maradan G, Rojas-Castro D, Diallo F, Anoma C, Dah TTE, Mensah E, Dembélé Keita B, Spire B, Dagnra CA, Laurent C. Heterogeneity in the Prevalence of High-Risk Human Papillomavirus Infection in Human Immunodeficiency Virus-Negative and Human Immunodeficiency Virus-Positive Men Who Have Sex With Men in West Africa. Clin Infect Dis 2021; 73:2184-2192. [PMID: 33606001 DOI: 10.1093/cid/ciab157] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Men who have sex with men (MSM) are at high risk of human papillomavirus (HPV) infection. We assessed (i) the prevalence of high-risk HPV (HR-HPV) infection and associated factors, and (ii) the prevalence of vaccine-preventable HPV infections in MSM in Burkina Faso, Côte d'Ivoire, Mali, and Togo. METHODS A cross-sectional study was conducted in 2017-2018 among MSM ≥18 years old followed in community-based clinics. HPV infection was investigated in oral and anal samples using the e-BRID system. Factors associated with HR-HPV infection were identified using multivariate logistic regressions. RESULTS Among 631 participants, 425 were HIV-negative and 206 HIV-positive. HR-HPV prevalence ranged from 9.2% to 34.8% in the former, and 33.3% to 71.0% in the latter, according to the study country. In multivariate analysis, HIV infection (adjusted odds ratio (aOR) 3.61, 95% confidence interval (CI) 2.48-5.27) and study country (4.73, 2.66-8.43 for Mali; 3.12, 1.68-5.80 for Burkina Faso; 3.51, 1.92-6.42 for Togo) were associated with HR-HPV infection. Other associated factors were low educational level, self-defined homosexual identity, and condomless anal sex. The prevalence of infections which can be prevented with bivalent, quadrivalent, and nonavalent vaccines was 5.9, 27.1, and 34.6% in HIV-negative participants, and 18.9, 43.7, and 54.9% in HIV-positive participants, respectively. CONCLUSIONS HR-HPV prevalence was very heterogeneous between the study countries in both HIV-negative and HIV-positive MSM. Vaccine-preventable HPV infections predominated. Vaccination should be proposed to young MSM to reduce the burden of HPV infection in this vulnerable population and their female partners in West Africa.
Collapse
Affiliation(s)
- Issifou Yaya
- IRD, Inserm, University Montpellier, TransVIHMI, Montpellier, France
| | - Véronique Boyer
- IRD, Inserm, University Montpellier, TransVIHMI, Montpellier, France
| | - Phyllis Amivi Ehlan
- Laboratoire de Biologie Moléculaire et d'Immunologie, Faculté des Sciences de la Santé, University Lomé, Lomé, Togo
| | | | | | - Issa Traoré
- Association African Solidarité, Ouagadougou, Burkina Faso
| | | | | | | | - Yawo Tufa Nyasenu
- Laboratoire de Biologie Moléculaire et d'Immunologie, Faculté des Sciences de la Santé, University Lomé, Lomé, Togo
| | | | | | | | | | - Ter Tiero Elias Dah
- IRD, Inserm, University Montpellier, TransVIHMI, Montpellier, France.,Association African Solidarité, Ouagadougou, Burkina Faso.,Institut National de Santé Publique, Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | | | | | - Bruno Spire
- University Aix Marseille, Inserm, IRD, SESSTIM, Marseille, France
| | - Claver Anoumou Dagnra
- Laboratoire de Biologie Moléculaire et d'Immunologie, Faculté des Sciences de la Santé, University Lomé, Lomé, Togo
| | - Christian Laurent
- IRD, Inserm, University Montpellier, TransVIHMI, Montpellier, France
| | | |
Collapse
|
4
|
Dah TTE, Yaya I, Sagaon-Teyssier L, Coulibaly A, Kouamé MJB, Agboyibor MK, Maiga K, Traoré I, Mora M, Palvadeau P, Rojas-Castro D, Diallo F, Mensah E, Anoma C, Keita BD, Spire B, Laurent C. Adherence to quarterly HIV prevention services and its impact on HIV incidence in men who have sex with men in West Africa (CohMSM ANRS 12324 - Expertise France). BMC Public Health 2021; 21:972. [PMID: 34022820 PMCID: PMC8141121 DOI: 10.1186/s12889-021-10994-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 05/06/2021] [Indexed: 11/22/2022] Open
Abstract
Background Access to tailored HIV prevention services remains limited for West African MSM. We assessed adherence to quarterly HIV prevention services and its impact on HIV incidence in MSM followed up in four cities in Burkina Faso, Côte d’Ivoire, Mali, and Togo. Methods We performed a prospective cohort study between 2015 and 2018. HIV-negative MSM aged over 18 benefited from quarterly medical visits which included a clinical examination, HIV testing, screening and treatment for other sexually transmitted infections, peer-led counselling and support, and the provision of condoms and lubricants. Determinants of adherence to quarterly follow-up visits and incident HIV infections were identified using generalized estimating equation models and Cox proportional hazard models, respectively. Results 618 MSM were followed up for a median time of 20.0 months (interquartile range 15.2–26.3). Overall adherence to quarterly follow-up visits was 76.5% (95% confidence interval [CI] 75.1–77.8), ranging from 66.8% in Abidjan to 87.3% in Lomé (p < 0.001). 78 incident HIV infections occurred during a total follow-up time of 780.8 person-years, giving an overall incidence of 10.0 per 100 person-years (95% CI 8.0–12.5). Adherence to quarterly follow-up visits was not associated with the risk of incident HIV infection (adjusted hazard ratio 0.80, 95% CI 0.44–1.44, p = 0.545). Conclusions Strengthening HIV prevention services among MSM in West Africa, including the use of PrEP, will be critical for controlling the epidemic, not only in this key population but also in the general population. Quarterly follow-up of MSM, which is essential for PrEP delivery, appears feasible. Trial registration ClinicalTrials.gov, number NCT02626286 (December 10, 2015).
Collapse
Affiliation(s)
- Ter Tiero Elias Dah
- Association African Solidarité, Ouagadougou, Burkina Faso. .,TransVIHMI, Univ Montpellier, Inserm, IRD, Montpellier, France. .,Institut National de Santé Publique, Centre Muraz, Bobo-Dioulasso, Burkina Faso.
| | - Issifou Yaya
- TransVIHMI, Univ Montpellier, Inserm, IRD, Montpellier, France
| | | | | | | | | | | | - Issa Traoré
- Association African Solidarité, Ouagadougou, Burkina Faso
| | - Marion Mora
- SESSTIM, Aix Marseille Univ, Inserm, IRD, Marseille, France
| | | | | | | | | | | | | | - Bruno Spire
- SESSTIM, Aix Marseille Univ, Inserm, IRD, Marseille, France
| | | | | |
Collapse
|
5
|
Fiorentino M, Eubanks A, Coulaud PJ, Couderc C, Keita BD, Anoma C, Dah E, Mensah E, Maradan G, Bourrelly M, Riegel L, Rojas-Castro D, Yaya I, Spire B, Laurent C, Sagaon-Teyssier L. Homonegativity, sexual violence and condom use with women in men who have sex with men and women in West Africa. AIDS 2021; 35:681-687. [PMID: 33306548 DOI: 10.1097/qad.0000000000002782] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The study aimed to explore longitudinal interactions between homonegativity and sexual behaviors with female partners among HIV-negative West African men who have sex with men and women (MSMW). DESIGN AND METHOD The community-based cohort CohMSM ANRS 12324 - Expertise France enrolled MSM in Togo, Burkina Faso, Côte d'Ivoire and Mali. Sociobehavioral data were collected every 6 months. Using 30-month follow-up data, a multiprobit analysis was performed to investigate the relationship between psychosocial and behavioral variables ex-ante (t - 1) and ex-post (t). RESULTS MSMW (n = 326) accounted for half of all participants in CohMSM. They reported inconsistent condom use with women in 39% of visits. Perceived and internalized homonegativity at t - 1 tended to lead to sexual violence toward women at t (P < 0.1), which was associated with inconsistent condom use with them at t (P < 0.05). CONCLUSION Given the high HIV prevalence in West African MSM, widespread condom-less sex with women in MSMW, and the aggravating effect of social and internalized homonegativity, more research in the MSMW subpopulation is needed to assess the risk of HIV bridging to women and to design support activities.
Collapse
Affiliation(s)
- Marion Fiorentino
- INSERM, IRD, Aix Marseille Univ, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale
- ORS PACA, Observatoire régional de la santé, Provence-Alpes-Côte d'Azur, Marseille
| | - August Eubanks
- INSERM, IRD, Aix Marseille Univ, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale
- ORS PACA, Observatoire régional de la santé, Provence-Alpes-Côte d'Azur, Marseille
| | - Pierre-Julien Coulaud
- INSERM, IRD, Aix Marseille Univ, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale
- ORS PACA, Observatoire régional de la santé, Provence-Alpes-Côte d'Azur, Marseille
| | | | | | | | - Elias Dah
- Association African Solidarité, Ouagadougou
- Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | | | - Gwenaëlle Maradan
- INSERM, IRD, Aix Marseille Univ, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale
- ORS PACA, Observatoire régional de la santé, Provence-Alpes-Côte d'Azur, Marseille
| | - Michel Bourrelly
- INSERM, IRD, Aix Marseille Univ, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale
- ORS PACA, Observatoire régional de la santé, Provence-Alpes-Côte d'Azur, Marseille
| | | | | | - Issifou Yaya
- IRD, INSERM, Univ Montpellier, TransVIHMI, Montpellier, France
| | - Bruno Spire
- INSERM, IRD, Aix Marseille Univ, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale
- ORS PACA, Observatoire régional de la santé, Provence-Alpes-Côte d'Azur, Marseille
| | | | - Luis Sagaon-Teyssier
- INSERM, IRD, Aix Marseille Univ, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale
- ORS PACA, Observatoire régional de la santé, Provence-Alpes-Côte d'Azur, Marseille
| |
Collapse
|
6
|
Roux P, Mezaache S, Briand-Madrid L, Debrus M, Khatmi N, Maradan G, Protopopescu C, Rojas-Castro D, Carrieri P. Profile, risk practices and needs of people who inject morphine sulfate: Results from the ANRS-AERLI study. Int J Drug Policy 2018; 59:3-9. [PMID: 29966806 DOI: 10.1016/j.drugpo.2018.06.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/10/2018] [Accepted: 06/11/2018] [Indexed: 11/29/2022]
Abstract
AIMS In France, a non-negligible proportion of opioid-dependent individuals inject morphine sulfate. Although it has not yet been officially approved as an opioid substitution treatment (OST), some physicians can prescribe its use for people in methadone or buprenorphine treatment failure. Longitudinal data from the ANRS-AERLI study, which evaluated an educational intervention for safer injection called AERLI, provided us the opportunity to better characterize the profile, risk practices and needs of people who inject morphine sulfate (MSI), through comparison with other injectors, and to identify correlates of HIV/HCV risk practices in this group. METHODS The national multisite ANRS-AERLI study assessed the impact of AERLI offered in volunteer harm reduction (HR) centers ("with intervention") (n = 113) through comparison with standard HR centers ("without intervention") (n = 127). All participants were scheduled to be followed up for 12 months and have 3 telephone interviews: at baseline, 6 months and 12 months. We compared MSI (n = 79) with other opioid injectors (n = 161) and then used a mixed logistic model to identify factors associated with HIV/HCV risk practices among MSI. FINDINGS Of the 240 eligible participants, 79 were regular MSI. They were less likely to use cocaine, crack or buprenorphine and to receive OST than other participants. Conversely, MSI were more likely to inject drugs more than three times a day and to report HIV/HCV risk practices. Among MSI, multivariate analysis showed that those receiving morphine sulfate as an OST were less likely to report such practices than other participants (aOR [95%CI] = 0.11 [0.02-0.61]). CONCLUSION Our results show that while MSI use fewer stimulants, they have more HIV/HCV risk practices than other injectors. However, when MSI are prescribed morphine sulfate as a treatment, these practices tend to decrease. Our findings suggest the importance of increasing access to morphine sulfate as a new OST in France.
Collapse
Affiliation(s)
- Perrine Roux
- INSERM U912 (SESSTIM), Marseille, France; Aix Marseille Université, IRD, UMR-S912, Marseille, France; ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France; GRePS (Groupe de Recherche en Psychologie Sociale) (EA4163), Université de Lyon 2, France; AIDES, Pantin, France.
| | - Salim Mezaache
- INSERM U912 (SESSTIM), Marseille, France; Aix Marseille Université, IRD, UMR-S912, Marseille, France; ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France; GRePS (Groupe de Recherche en Psychologie Sociale) (EA4163), Université de Lyon 2, France; AIDES, Pantin, France
| | - Laélia Briand-Madrid
- INSERM U912 (SESSTIM), Marseille, France; Aix Marseille Université, IRD, UMR-S912, Marseille, France; ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France; GRePS (Groupe de Recherche en Psychologie Sociale) (EA4163), Université de Lyon 2, France; AIDES, Pantin, France
| | - Marie Debrus
- Médecins du Monde, Paris, France; GRePS (Groupe de Recherche en Psychologie Sociale) (EA4163), Université de Lyon 2, France; AIDES, Pantin, France
| | - Nicolas Khatmi
- INSERM U912 (SESSTIM), Marseille, France; Aix Marseille Université, IRD, UMR-S912, Marseille, France; ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France; GRePS (Groupe de Recherche en Psychologie Sociale) (EA4163), Université de Lyon 2, France; AIDES, Pantin, France
| | - Gwenaelle Maradan
- INSERM U912 (SESSTIM), Marseille, France; Aix Marseille Université, IRD, UMR-S912, Marseille, France; ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France; GRePS (Groupe de Recherche en Psychologie Sociale) (EA4163), Université de Lyon 2, France; AIDES, Pantin, France
| | - Camélia Protopopescu
- INSERM U912 (SESSTIM), Marseille, France; Aix Marseille Université, IRD, UMR-S912, Marseille, France; ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France; GRePS (Groupe de Recherche en Psychologie Sociale) (EA4163), Université de Lyon 2, France; AIDES, Pantin, France
| | - Daniela Rojas-Castro
- Médecins du Monde, Paris, France; GRePS (Groupe de Recherche en Psychologie Sociale) (EA4163), Université de Lyon 2, France; AIDES, Pantin, France
| | - Patrizia Carrieri
- INSERM U912 (SESSTIM), Marseille, France; Aix Marseille Université, IRD, UMR-S912, Marseille, France; ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France; GRePS (Groupe de Recherche en Psychologie Sociale) (EA4163), Université de Lyon 2, France; AIDES, Pantin, France
| |
Collapse
|