August Eubanks1,2, Bintou Dembélé Keita3, Camille Anoma4, Ter T E Dah5,6, Ephrem Mensah7, Gwenaëlle Maradan1,2, Michel Bourrelly1,2, Marion Mora1,2, Lucas Riegel8, Daniela Rojas Castro1,8, Issifou Yaya9, Bruno Spire1,2, Christian Laurent9, Luis Sagaon-Teyssier1,2. 1. Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques and Sociales de la Santé and Traitement de l'Information Médicale, Marseille, France. 2. ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France. 3. ARCAD-SIDA, Bamako, Mali. 4. Espace Confiance, Abidjan, Côte d'Ivoire. 5. Association African Solidarité, Ouagadougou, Burkina Faso. 6. Institut National de Santé Publique, Centre Muraz, Bobo-Dioulasso, Burkina Faso. 7. Espoir Vie Togo, Lomé, Togo. 8. Coalition Plus, Community Research Laboratory Pantin, Pantin, France. 9. IRD, INSERM, Univ Montpellier, TransVIHMI, Montpellier, France.
Abstract
BACKGROUND: In West Africa, few HIV services target men who have sex with men (MSM). In 2015, the interventional cohort CohMSM started offering a community-based prevention package for MSM. Participants expressed interest in pre-exposure prophylaxis (PrEP) and their eligibility was demonstrated. In 2017, PrEP was added to services already offered as part of a new program, CohMSM-PrEP, which recruited CohMSM participants and new participants. We aimed to determine whether the introduction of PrEP as an additional prevention tool influenced the type of participant signing up for CohMSM-PrEP. METHODS: CohMSM-PrEP recruited HIV-negative MSM in community-based clinics in Mali, Cote d'Ivoire, Burkina Faso, and Togo. Quarterly follow-up included free clinical examinations, PrEP, HIV/sexually transmitted infection screening, peer education, condoms, and lubricants. Sociobehavioral data were collected every 3 months using face-to-face questionnaires. Our outcome was participant type: new participants vs CohMSM participants. Logistic regression was performed to identify the factors associated with being a new participant. RESULTS: Of the 524 MSM included in CohMSM-PrEP, 41% were new participants. After adjustment, multivariate analysis showed they were more socioeconomically disadvantaged with financial insecurity, social isolation-including isolation within the MSM community-and riskier sexual practices. CONCLUSION: The introduction of PrEP as an additional prevention tool and the use of peer-based outreach services over time influenced the type of participant signing up for a community-based HIV prevention cohort in West Africa. Adding these elements to existing interventions in Sub-Saharan Africa could be the key to reaching MSM marginalized from HIV prevention and care programs.
BACKGROUND: In West Africa, few HIV services target men who have sex with men (MSM). In 2015, the interventional cohort CohMSM started offering a community-based prevention package for MSM. Participants expressed interest in pre-exposure prophylaxis (PrEP) and their eligibility was demonstrated. In 2017, PrEP was added to services already offered as part of a new program, CohMSM-PrEP, which recruited CohMSM participants and new participants. We aimed to determine whether the introduction of PrEP as an additional prevention tool influenced the type of participant signing up for CohMSM-PrEP. METHODS:CohMSM-PrEP recruited HIV-negative MSM in community-based clinics in Mali, Cote d'Ivoire, Burkina Faso, and Togo. Quarterly follow-up included free clinical examinations, PrEP, HIV/sexually transmitted infection screening, peer education, condoms, and lubricants. Sociobehavioral data were collected every 3 months using face-to-face questionnaires. Our outcome was participant type: new participants vs CohMSM participants. Logistic regression was performed to identify the factors associated with being a new participant. RESULTS: Of the 524 MSM included in CohMSM-PrEP, 41% were new participants. After adjustment, multivariate analysis showed they were more socioeconomically disadvantaged with financial insecurity, social isolation-including isolation within the MSM community-and riskier sexual practices. CONCLUSION: The introduction of PrEP as an additional prevention tool and the use of peer-based outreach services over time influenced the type of participant signing up for a community-based HIV prevention cohort in West Africa. Adding these elements to existing interventions in Sub-Saharan Africa could be the key to reaching MSM marginalized from HIV prevention and care programs.
Authors: August Eubanks; Bakary Coulibaly; Bintou Dembélé Keita; Camille Anoma; Ter Tiero Elias Dah; Ephrem Mensah; Gwenaëlle Maradan; Michel Bourrelly; Marion Mora; Lucas Riegel; Daniela Rojas Castro; Issifou Yaya; Bruno Spire; Christian Laurent; Luis Sagaon-Teyssier Journal: AIDS Behav Date: 2022-04-25
Authors: Maxime Inghels; Hae-Young Kim; Frank Tanser; Anita Hettema; Shannon A McMahon; Catherine E Oldenburg; Sindy Matse; Stefan Kohler; Pascal Geldsetzer; Till Bärnighausen Journal: AIDS Behav Date: 2022-04-16
Authors: August Eubanks; Bakary Coulibaly; Bintou Dembélé Keita; Camille Anoma; Ter Tiero Elias Dah; Ephrem Mensah; Sékou Kaba; Kpassou Julien Lokrou; Faïçal Rodrigue Ouedraogo; Alèda M Fidèle Badjassim; Gwenaëlle Maradan; Michel Bourrelly; Marion Mora; Lucas Riegel; Daniela Rojas Castro; Issifou Yaya; Bruno Spire; Christian Laurent; Luis Sagaon-Teyssier Journal: BMC Public Health Date: 2022-09-29 Impact factor: 4.135