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Rouveau N, Ky-Zerbo O, Boye S, Fotso AS, d'Elbée M, Maheu-Giroux M, Silhol R, Kouassi AK, Vautier A, Doumenc-Aïdara C, Breton G, Keita A, Ehui E, Ndour CT, Boilly MC, Terris-Prestholt F, Pourette D, Desclaux A, Larmarange J. Describing, analysing and understanding the effects of the introduction of HIV self-testing in West Africa through the ATLAS programme in Côte d'Ivoire, Mali and Senegal. BMC Public Health 2021; 21:181. [PMID: 33478470 PMCID: PMC7818756 DOI: 10.1186/s12889-021-10212-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 12/17/2020] [Accepted: 01/10/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The ATLAS programme aims to promote and implement HIV self-testing (HIVST) in three West African countries: Côte d'Ivoire, Mali, and Senegal. During 2019-2021, in close collaboration with the national AIDS implementing partners and communities, ATLAS plans to distribute 500,000 HIVST kits through eight delivery channels, combining facility-based, community-based strategies, primary and secondary distribution of HIVST. Considering the characteristics of West African HIV epidemics, the targets of the ATLAS programme are hard-to-reach populations: key populations (female sex workers, men who have sex with men, and drug users), their clients or sexual partners, partners of people living with HIV and patients diagnosed with sexually transmitted infections and their partners. The ATLAS programme includes research support implementation to generate evidence for HIVST scale-up in West Africa. The main objective is to describe, analyse and understand the social, health, epidemiological effects and cost-effectiveness of HIVST introduction in Côte d'Ivoire, Mali and Senegal to improve the overall HIV testing strategy (accessibility, efficacy, ethics). METHODS ATLAS research is organised into five multidisciplinary workpackages (WPs): Key Populations WP: qualitative surveys (individual in-depth interviews, focus group discussions) conducted with key actors, key populations, and HIVST users. Index testing WP: ethnographic observation of three HIV care services introducing HIVST for partner testing. Coupons survey WP: an anonymous telephone survey of HIVST users. Cost study WP: incremental economic cost analysis of each delivery model using a top-down costing with programmatic data, complemented by a bottom-up costing of a representative sample of HIVST distribution sites, and a time-motion study for health professionals providing HIVST. Modelling WP: Adaptation, parameterisation and calibration of a dynamic compartmental model that considers the varied populations targeted by the ATLAS programme and the different testing modalities and strategies. DISCUSSION ATLAS is the first comprehensive study on HIV self-testing in West Africa. The ATLAS programme focuses particularly on the secondary distribution of HIVST. This protocol was approved by three national ethic committees and the WHO's Ethical Research Committee.
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Affiliation(s)
- Nicolas Rouveau
- Ceped (Centre Population & Développement UMR 196), IRD, Université de Paris, Inserm, Paris, France.
| | - Odette Ky-Zerbo
- Institut de Recherche pour le Développement, Transvihmi (UMI 233 IRD, 1175 INSERM, Montpellier University), Montpellier, France
| | - Sokhna Boye
- Ceped (Centre Population & Développement UMR 196), IRD, Université de Paris, Inserm, Paris, France
| | - Arlette Simo Fotso
- Ceped (Centre Population & Développement UMR 196), IRD, Université de Paris, Inserm, Paris, France
| | - Marc d'Elbée
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Mathieu Maheu-Giroux
- Department of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global Health, McGill University, Montréal, QC, H3A 1A2, Canada
| | - Romain Silhol
- Analysis Department of Infectious Disease Epidemiology, Medical Research Council Centre for Global Infectious Disease, Imperial College London, London, UK
| | - Arsène Kra Kouassi
- Ceped (Centre Population & Développement UMR 196), IRD, Université de Paris, Inserm, Paris, France
| | | | | | | | - Abdelaye Keita
- Institut National de Recherche en Santé Publique (INRSP), Bamako, Mali
| | - Eboi Ehui
- Programme National de Lutte contre le Sida, Abidjan, Côte d'Ivoire
| | - Cheikh Tidiane Ndour
- Division de Lutte contre le Sida et les IST, Ministère de la Santé et de l'Action sociale, Dakar, Sénégal
| | - Marie-Claude Boilly
- Analysis Department of Infectious Disease Epidemiology, Medical Research Council Centre for Global Infectious Disease, Imperial College London, London, UK
| | - Fern Terris-Prestholt
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Dolorès Pourette
- Ceped (Centre Population & Développement UMR 196), IRD, Université de Paris, Inserm, Paris, France
| | - Alice Desclaux
- Institut de Recherche pour le Développement, Transvihmi (UMI 233 IRD, 1175 INSERM, Montpellier University), Montpellier, France.,CRCF, Dakar, Sénégal
| | - Joseph Larmarange
- Ceped (Centre Population & Développement UMR 196), IRD, Université de Paris, Inserm, Paris, France
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