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	<title>Joseph Larmarange</title>
	<link>https://joseph.larmarange.net/</link>
	<description>D&#233;mographe en sant&#233; publique, directeur de recherche HDR &#224; l'IRD,directeur adjoint du Ceped (UMR 196 Universit&#233; Paris Cit&#233;, IRD, Universit&#233; Sorbonne Paris Nord, Inserm)</description>
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		<title>Joseph Larmarange</title>
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<item xml:lang="en">
		<title>Population-level viremia predicts HIV incidence at the community level across the Universal Testing and Treatment Trials in eastern and southern Africa</title>
		<link>https://www.joseph.larmarange.net/population-level-viremia-predicts-351</link>
		<guid isPermaLink="true">https://www.joseph.larmarange.net/population-level-viremia-predicts-351</guid>
		<dc:date>2023-07-20T11:00:49Z</dc:date>
		<dc:format>text/html</dc:format>
		<dc:language>en</dc:language>
		<dc:creator>Joseph LARMARANGE</dc:creator>


		<dc:subject>Afrique du Sud</dc:subject>
		<dc:subject>Botswana</dc:subject>
		<dc:subject>Kenya</dc:subject>
		<dc:subject>Ouganda</dc:subject>
		<dc:subject>Zambie</dc:subject>
		<dc:subject>TasP (ANRS 12249)</dc:subject>
		<dc:subject>Cascade des soins</dc:subject>
		<dc:subject>Incidence du VIH</dc:subject>
		<dc:subject>Mesure d'impact</dc:subject>
		<dc:subject>Sant&#233; publique</dc:subject>
		<dc:subject>Treatment as Prevention (TasP)</dc:subject>
		<dc:subject>Universal Test &amp; Treat (UTT)</dc:subject>
		<dc:subject>VIH / SIDA</dc:subject>

		<description>
&lt;p&gt;Authors &lt;br class='autobr' /&gt;
Joseph Larmarange, Pamela Bachanas, Timothy Skalland, Laura B. Balzer, Collins Iwuji, Sian Floyd, Lisa A. Mills, Deenan Pillay, Diane Havlir, Moses R. Kamya, Helen Ayles, Kathleen Wirth, Fran&#231;ois Dabis, Richard Hayes, Maya Petersen, for the UT&#179;C consortium &lt;br class='autobr' /&gt;
Abstract &lt;br class='autobr' /&gt;
Universal HIV testing and treatment (UTT) strategies aim to optimize population-level benefits of antiretroviral treatment. Between 2012 and 2018, four large community randomized trials were conducted in eastern and&#160;(&#8230;)&lt;/p&gt;


-
&lt;a href="https://www.joseph.larmarange.net/-Publications-11-" rel="directory"&gt;Publications&lt;/a&gt;

/ 
&lt;a href="https://www.joseph.larmarange.net/+-Afrique-du-Sud-+" rel="tag"&gt;Afrique du Sud&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Botswana-+" rel="tag"&gt;Botswana&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Kenya-+" rel="tag"&gt;Kenya&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Ouganda-+" rel="tag"&gt;Ouganda&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Zambie-+" rel="tag"&gt;Zambie&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-TasP-ANRS-12249-97-+" rel="tag"&gt;TasP (ANRS 12249)&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Cascade-des-soins-+" rel="tag"&gt;Cascade des soins&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Incidence-du-VIH-+" rel="tag"&gt;Incidence du VIH&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Mesure-d-impact-+" rel="tag"&gt;Mesure d'impact&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Sante-publique-+" rel="tag"&gt;Sant&#233; publique&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Treatment-as-Prevention-TasP-105-+" rel="tag"&gt;Treatment as Prevention (TasP)&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Universal-Test-Treat-UTT-+" rel="tag"&gt;Universal Test &amp; Treat (UTT)&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-VIH-SIDA-+" rel="tag"&gt;VIH / SIDA&lt;/a&gt;

		</description>


 <content:encoded>&lt;img src='https://www.joseph.larmarange.net/local/cache-vignettes/L150xH97/reduction-6d9e3.png?1715096187' class='spip_logo spip_logo_right' width='150' height='97' alt=&#034;&#034; /&gt;
		&lt;div class='rss_texte'&gt;&lt;div class=&#034;hal-resultats&#034;&gt; &lt;div class=&#034;hal-resultat hal-resultat-4166973&#034;&gt; &lt;div class=&#034;hal-thumb&#034;&gt;&lt;a href=&#034;https://hal.science/hal-04166971v1/document&#034; class=&#034;hal-thumb-link&#034;&gt;&lt;img src='https://www.joseph.larmarange.net/local/cache-vignettes/L75xH56/thumb-d2e8de50-6500a.png?1702907818' alt=&#034;Image document&#034; width='75' height='56' /&gt; &lt;/a&gt;&lt;/div&gt; &lt;div class=&#034;hal-preview&#034;&gt; &lt;a href=&#034;https://hal.science/hal-04166971v1&#034; class=&#034;hal-titre&#034;&gt; &lt;h3 class=&#034;hal-titre-heading&#034;&gt;Population-level viremia predicts HIV incidence at the community level across the Universal Testing and Treatment Trials in eastern and southern Africa&lt;/h3&gt; &lt;/a&gt; &lt;div class=&#034;hal-auteurs&#034;&gt; &lt;a href=&#034;https://hal.science/search/index/q/*/authIdHal_s/joseph-larmarange&#034; class=&#034;hal-auteur&#034;&gt;Joseph Larmarange&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authIdPerson_i=7426731271686&#034; class=&#034;hal-auteur&#034;&gt;Pamela Bachanas&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=Timothy+Skalland&#034; class=&#034;hal-auteur&#034;&gt;Timothy Skalland&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=Laura+Balzer&#034; class=&#034;hal-auteur&#034;&gt;Laura Balzer&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authIdPerson_i=7426731271687&#034; class=&#034;hal-auteur&#034;&gt;Collins Iwuji&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authIdPerson_i=7426731271688&#034; class=&#034;hal-auteur&#034;&gt;Sian Floyd&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authIdPerson_i=7426731271689&#034; class=&#034;hal-auteur&#034;&gt;Lisa Mills&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=Deenan+Pillay&#034; class=&#034;hal-auteur&#034;&gt;Deenan Pillay&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=Diane+Havlir&#034; class=&#034;hal-auteur&#034;&gt;Diane Havlir&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authIdPerson_i=7426731271690&#034; class=&#034;hal-auteur&#034;&gt;Moses Kamya&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authIdPerson_i=7426731271691&#034; class=&#034;hal-auteur&#034;&gt;Helen Ayles&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=Kathleen+Wirth&#034; class=&#034;hal-auteur&#034;&gt;Kathleen Wirth&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authIdPerson_i=7426731196998&#034; class=&#034;hal-auteur&#034;&gt;Fran&#231;ois Dabis&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authIdPerson_i=7426731271692&#034; class=&#034;hal-auteur&#034;&gt;Richard Hayes&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=Maya+Petersen&#034; class=&#034;hal-auteur&#034;&gt;Maya Petersen&lt;/a&gt; &lt;/div&gt; &lt;div class=&#034;hal-citation&#034;&gt;&lt;i&gt;PLOS Global Public Health&lt;/i&gt;, 2023, 3 (7), pp.e0002157. &lt;a target=&#034;_blank&#034; href=&#034;https://dx.doi.org/10.1371/journal.pgph.0002157&#034; rel=&#034;noreferrer noopener&#034;&gt;&#10216;10.1371/journal.pgph.0002157&#10217;&lt;/a&gt;&lt;/div&gt; &lt;div class=&#034;hal-typedoc hal-typedoc-art&#034;&gt;Article dans une revue&lt;/div&gt; &lt;div class=&#034;hal-links&#034;&gt; &lt;a href=&#034;https://hal.science/hal-04166971v1&#034; class=&#034;hal-link hal-link-hal&#034;&gt;hal-04166971&lt;/a&gt; &lt;/div&gt; &lt;/div&gt; &lt;/div&gt; &lt;/div&gt;&lt;h2 class=&#034;spip&#034;&gt;
Authors&lt;/h2&gt;
&lt;p&gt;Joseph Larmarange, Pamela Bachanas, Timothy Skalland, Laura B. Balzer, Collins Iwuji, Sian Floyd, Lisa A. Mills, Deenan Pillay, Diane Havlir, Moses R. Kamya, Helen Ayles, Kathleen Wirth, Fran&#231;ois Dabis, Richard Hayes, Maya Petersen, for the UT&#179;C consortium&lt;/p&gt;
&lt;h2 class=&#034;spip&#034;&gt;
Abstract&lt;/h2&gt;
&lt;p&gt;Universal HIV testing and treatment (UTT) strategies aim to optimize population-level benefits of antiretroviral treatment. Between 2012 and 2018, four large community randomized trials were conducted in eastern and southern Africa. While their results were broadly consistent showing decreased population-level viremia reduces HIV incidence, it remains unclear how much HIV incidence can be reduced by increasing suppression among people living with HIV (PLHIV).&lt;/p&gt;
&lt;p&gt;We conducted a pooled analysis across the four UTT trials. Leveraging data from 105 communities in five countries, we evaluated the linear relationship between i) population-level viremia (prevalence of non-suppression&#8211;defined as plasma HIV RNA &gt;500 or &gt;400 copies/mL&#8211;among all adults, irrespective of HIV status) and HIV incidence; and ii) prevalence of non-suppression among PLHIV and HIV incidence, using parametric g-computation.&lt;/p&gt;
&lt;p&gt;HIV prevalence, measured in 257 929 persons, varied from 2 to 41% across the communities; prevalence of non-suppression among PLHIV, measured in 31 377 persons, from 3 to 70%; population-level viremia, derived from HIV prevalence and non-suppression, from &lt; 1% to 25%; and HIV incidence, measured over 345 844 person-years (PY), from 0.03/100PY to 3.46/100PY.&lt;/p&gt;
&lt;p&gt;Decreases in population-level viremia were strongly associated with decreased HIV incidence in all trials (between 0.45/100PY and 1.88/100PY decline in HIV incidence per 10 percentage points decline in viremia). Decreases in non-suppression among PLHIV were also associated with decreased HIV incidence in all trials (between 0.06/100PY and 0.17/100PY decline in HIV incidence per 10 percentage points decline in non-suppression).&lt;/p&gt;
&lt;p&gt;Our results support both the utility of population-level viremia as a predictor of incidence, and thus a tool for targeting prevention interventions, and the ability of UTT approaches to reduce HIV incidence by increasing viral suppression. Implementation of universal HIV testing approaches, coupled with interventions to leverage linkage to treatment, adapted to local contexts, can reduce HIV acquisition at population level.&lt;/p&gt;&lt;/div&gt;
		
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<item xml:lang="en">
		<title>Achieving the UNAIDS 90&#8211;90-90 targets: a comparative analysis of four large community randomised trials delivering universal testing and treatment to reduce HIV transmission in sub-Saharan Africa</title>
		<link>https://www.joseph.larmarange.net/achieving-the-unaids-90-90-90</link>
		<guid isPermaLink="true">https://www.joseph.larmarange.net/achieving-the-unaids-90-90-90</guid>
		<dc:date>2022-12-18T12:26:51Z</dc:date>
		<dc:format>text/html</dc:format>
		<dc:language>en</dc:language>
		<dc:creator>Joseph LARMARANGE</dc:creator>


		<dc:subject>TasP (ANRS 12249)</dc:subject>
		<dc:subject>Botswana</dc:subject>
		<dc:subject>Kenya</dc:subject>
		<dc:subject>Ouganda</dc:subject>
		<dc:subject>Zambie</dc:subject>
		<dc:subject>Afrique du Sud</dc:subject>
		<dc:subject>Cascade des soins</dc:subject>
		<dc:subject>Mesure d'impact</dc:subject>
		<dc:subject>Mesure des indicateurs</dc:subject>
		<dc:subject>Universal Test &amp; Treat (UTT)</dc:subject>
		<dc:subject>VIH / SIDA</dc:subject>

		<description>
&lt;p&gt;Authors &lt;br class='autobr' /&gt;
K. Sabapathy, L. Balzer, J. Larmarange, L. Block, S. Floyd, C. Iwuji, K. Wirth, H. Ayles, S. Fidler, M. Kamya, M. Petersen, D. Havlir, F. Dabis, J. Moore &amp; R. Hayes &lt;br class='autobr' /&gt;
Abstract &lt;br class='autobr' /&gt;
Background Four large community-randomized trials examining universal testing and treatment (UTT) to reduce HIV transmission were conducted between 2012&#8211;2018 in Botswana, Kenya, Uganda, Zambia and South Africa. In 2014, the UNAIDS 90&#8211;90-90 targets were adopted as a useful metric to monitor coverage. We&#160;(&#8230;)&lt;/p&gt;


-
&lt;a href="https://www.joseph.larmarange.net/-Publications-11-" rel="directory"&gt;Publications&lt;/a&gt;

/ 
&lt;a href="https://www.joseph.larmarange.net/+-TasP-ANRS-12249-97-+" rel="tag"&gt;TasP (ANRS 12249)&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Botswana-+" rel="tag"&gt;Botswana&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Kenya-+" rel="tag"&gt;Kenya&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Ouganda-+" rel="tag"&gt;Ouganda&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Zambie-+" rel="tag"&gt;Zambie&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Afrique-du-Sud-+" rel="tag"&gt;Afrique du Sud&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Cascade-des-soins-+" rel="tag"&gt;Cascade des soins&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Mesure-d-impact-+" rel="tag"&gt;Mesure d'impact&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Validite-de-la-mesure-+" rel="tag"&gt;Mesure des indicateurs&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Universal-Test-Treat-UTT-+" rel="tag"&gt;Universal Test &amp; Treat (UTT)&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-VIH-SIDA-+" rel="tag"&gt;VIH / SIDA&lt;/a&gt;

		</description>


 <content:encoded>&lt;img src='https://www.joseph.larmarange.net/local/cache-vignettes/L113xH150/pexels-mithul-varshan-3023211-33e3a.jpg?1715100940' class='spip_logo spip_logo_right' width='113' height='150' alt=&#034;&#034; /&gt;
		&lt;div class='rss_texte'&gt;&lt;div class=&#034;hal-resultats&#034;&gt; &lt;div class=&#034;hal-resultat hal-resultat-3905396&#034;&gt; &lt;div class=&#034;hal-thumb&#034;&gt;&lt;a href=&#034;https://ird.hal.science/ird-03905396v1/document&#034; class=&#034;hal-thumb-link&#034;&gt;&lt;img src='https://www.joseph.larmarange.net/local/cache-vignettes/L57xH75/thumb-ea05c02d-bcb0e.png?1702991341' alt=&#034;Image document&#034; width='57' height='75' /&gt; &lt;/a&gt;&lt;/div&gt; &lt;div class=&#034;hal-preview&#034;&gt; &lt;a href=&#034;https://ird.hal.science/ird-03905396v1&#034; class=&#034;hal-titre&#034;&gt; &lt;h3 class=&#034;hal-titre-heading&#034;&gt;Achieving the UNAIDS 90&#8211;90-90 targets: a comparative analysis of four large community randomised trials delivering universal testing and treatment to reduce HIV transmission in sub-Saharan Africa&lt;/h3&gt; &lt;/a&gt; &lt;div class=&#034;hal-auteurs&#034;&gt; &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authIdPerson_i=7426731208195&#034; class=&#034;hal-auteur&#034;&gt;K. Sabapathy&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=L.+Balzer&#034; class=&#034;hal-auteur&#034;&gt;L. Balzer&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/q/*/authIdHal_s/joseph-larmarange&#034; class=&#034;hal-auteur&#034;&gt;Joseph Larmarange&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=L.+Block&#034; class=&#034;hal-auteur&#034;&gt;L. Block&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=S.+Floyd&#034; class=&#034;hal-auteur&#034;&gt;S. Floyd&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=C.+Iwuji&#034; class=&#034;hal-auteur&#034;&gt;C. Iwuji&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=K.+Wirth&#034; class=&#034;hal-auteur&#034;&gt;K. Wirth&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=H.+Ayles&#034; class=&#034;hal-auteur&#034;&gt;H. Ayles&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=S.+Fidler&#034; class=&#034;hal-auteur&#034;&gt;S. Fidler&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=M.+Kamya&#034; class=&#034;hal-auteur&#034;&gt;M. Kamya&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=M.+Petersen&#034; class=&#034;hal-auteur&#034;&gt;M. Petersen&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=D.+Havlir&#034; class=&#034;hal-auteur&#034;&gt;D. Havlir&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=F.+Dabis&#034; class=&#034;hal-auteur&#034;&gt;F. Dabis&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=J.+Moore&#034; class=&#034;hal-auteur&#034;&gt;J. Moore&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=R.+Hayes&#034; class=&#034;hal-auteur&#034;&gt;R. Hayes&lt;/a&gt; &lt;/div&gt; &lt;div class=&#034;hal-citation&#034;&gt;&lt;i&gt;BMC Public Health&lt;/i&gt;, 2022, 22 (1), pp.2333. &lt;a target=&#034;_blank&#034; href=&#034;https://dx.doi.org/10.1186/s12889-022-14713-5&#034; rel=&#034;noreferrer noopener&#034;&gt;&#10216;10.1186/s12889-022-14713-5&#10217;&lt;/a&gt;&lt;/div&gt; &lt;div class=&#034;hal-typedoc hal-typedoc-art&#034;&gt;Article dans une revue&lt;/div&gt; &lt;div class=&#034;hal-links&#034;&gt; &lt;a href=&#034;https://ird.hal.science/ird-03905396v1&#034; class=&#034;hal-link hal-link-hal&#034;&gt;ird-03905396&lt;/a&gt; &lt;/div&gt; &lt;/div&gt; &lt;/div&gt; &lt;/div&gt;&lt;h2 class=&#034;spip&#034;&gt;
Authors&lt;/h2&gt;
&lt;p&gt;K. Sabapathy, L. Balzer, J. Larmarange, L. Block, S. Floyd, C. Iwuji, K. Wirth, H. Ayles, S. Fidler, M. Kamya, M. Petersen, D. Havlir, F. Dabis, J. Moore &amp; R. Hayes&lt;/p&gt;
&lt;h2 class=&#034;spip&#034;&gt;
Abstract&lt;/h2&gt;
&lt;p&gt;&lt;strong&gt;Background&lt;/strong&gt;&lt;br class='autobr' /&gt;
Four large community-randomized trials examining universal testing and treatment (UTT) to reduce HIV transmission were conducted between 2012&#8211;2018 in Botswana, Kenya, Uganda, Zambia and South Africa. In 2014, the UNAIDS 90&#8211;90-90 targets were adopted as a useful metric to monitor coverage. We systematically review the approaches used by the trials to measure intervention delivery, and estimate coverage against the 90&#8211;90-90 targets. We aim to provide in-depth understanding of the background contexts and complexities that affect estimation of population-level coverage related to the 90&#8211;90-90 targets.&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Methods&lt;/strong&gt;&lt;br class='autobr' /&gt;
Estimates were based predominantly on &#8220;process&#8221; data obtained during delivery of the interventions which included a combination of home-based and community-based services. Cascade coverage data included routine electronic health records, self-reported data, survey data, and active ascertainment of HIV viral load measurements in the field.&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Results&lt;/strong&gt;&lt;br class='autobr' /&gt;
The estimated total adult populations of trial intervention communities included in this study ranged from 4,290 (TasP) to 142,250 (Zambian PopART Arm-B). The estimated total numbers of PLHIV ranged from 1,283 (TasP) to 20,541 (Zambian PopART Arm-B). By the end of intervention delivery, the first-90 target (knowledge of HIV status among all PLHIV) was met by all the trials (89.2%-94.0%). Three of the four trials also achieved the second- and third-90 targets, and viral suppression in BCPP and SEARCH exceeded the UNAIDS target of 73%, while viral suppression in the Zambian PopART Arm-A and B communities was within a small margin ( 3%) of the target.&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Conclusions&lt;/strong&gt;&lt;br class='autobr' /&gt;
All four UTT trials aimed to implement wide-scale testing and treatment for HIV prevention at population level and showed substantial increases in testing and treatment for HIV in the intervention communities. This study has not uncovered any one estimation approach which is superior, rather that several approaches are available and researchers or policy makers seeking to measure coverage should reflect on background contexts and complexities that affect estimation of population-level coverage in their specific settings.&lt;/p&gt;
&lt;p&gt;All four trials surpassed UNAIDS targets for universal testing in their intervention communities ahead of the 2020 milestone. All but one of the trials also achieved the 90&#8211;90 targets for treatment and viral suppression. UTT is a realistic option to achieve 95&#8211;95-95 by 2030 and fast-track the end of the HIV epidemic.&lt;/p&gt;&lt;/div&gt;
		
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	</item>
<item xml:lang="en">
		<title>Trends in HIV testing, the treatment cascade, and HIV incidence among men who have sex with men in Africa: A systematic review and meta-regression analysis</title>
		<link>https://www.joseph.larmarange.net/trends-in-hiv-testing-the</link>
		<guid isPermaLink="true">https://www.joseph.larmarange.net/trends-in-hiv-testing-the</guid>
		<dc:date>2022-11-19T08:57:53Z</dc:date>
		<dc:format>text/html</dc:format>
		<dc:language>en</dc:language>
		<dc:creator>Joseph LARMARANGE</dc:creator>


		<dc:subject>Afrique subsaharienne</dc:subject>
		<dc:subject>Acc&#232;s aux soins</dc:subject>
		<dc:subject>Cascade des soins</dc:subject>
		<dc:subject>D&#233;pistage</dc:subject>
		<dc:subject>Homo / Bisexualit&#233;s</dc:subject>
		<dc:subject>VIH / SIDA</dc:subject>
		<dc:subject>Incidence du VIH</dc:subject>

		<description>
&lt;p&gt;Authors &lt;br class='autobr' /&gt;
James Stannah, Nirali Soni, Jin Keng Stephen Lam, Katia Gigu&#232;re, Kate M Mitchell, Nadine Kronfli, Joseph Larmarange, Raoul Moh, Marcelin N'zebo Nouaman, G&#233;rard Menan Kouam&#233;, Mathieu Maheu-Giroux, Marie-Claude Boily &lt;br class='autobr' /&gt;
Abstract &lt;br class='autobr' /&gt;
Background Gay, bisexual, and other men who have sex with men (MSM) are disproportionately affected by HIV. In Africa, MSM face structural barriers to HIV prevention and treatment including socio-economic disadvantages, stigma, and criminalization that&#160;(&#8230;)&lt;/p&gt;


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&lt;a href="https://www.joseph.larmarange.net/-Publications-11-" rel="directory"&gt;Publications&lt;/a&gt;

/ 
&lt;a href="https://www.joseph.larmarange.net/+-Afrique-subsaharienne-+" rel="tag"&gt;Afrique subsaharienne&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Acces-aux-soins-+" rel="tag"&gt;Acc&#232;s aux soins&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Cascade-des-soins-+" rel="tag"&gt;Cascade des soins&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Depistage-+" rel="tag"&gt;D&#233;pistage&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-MSM-Homo-Bisexualite-+" rel="tag"&gt;Homo / Bisexualit&#233;s&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-VIH-SIDA-+" rel="tag"&gt;VIH / SIDA&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Incidence-du-VIH-+" rel="tag"&gt;Incidence du VIH&lt;/a&gt;

		</description>


 <content:encoded>&lt;img src='https://www.joseph.larmarange.net/local/cache-vignettes/L150xH100/pexels-ketut-subiyanto-4827490-a95c3.jpg?1715104600' class='spip_logo spip_logo_right' width='150' height='100' alt=&#034;&#034; /&gt;
		&lt;div class='rss_texte'&gt;&lt;div class=&#034;hal-resultats&#034;&gt; &lt;div class=&#034;hal-resultat hal-resultat-3880543&#034;&gt; &lt;div class=&#034;hal-thumb&#034;&gt;&lt;a href=&#034;https://hal.science/hal-03880020v1/document&#034; class=&#034;hal-thumb-link&#034;&gt;&lt;img src='https://www.joseph.larmarange.net/local/cache-vignettes/L58xH75/thumb-8baac758-8fe68.png?1702936996' alt=&#034;Image document&#034; width='58' height='75' /&gt; &lt;/a&gt;&lt;/div&gt; &lt;div class=&#034;hal-preview&#034;&gt; &lt;a href=&#034;https://hal.science/hal-03880020v1&#034; class=&#034;hal-titre&#034;&gt; &lt;h3 class=&#034;hal-titre-heading&#034;&gt;Trends in HIV Testing, the Treatment Cascade, and HIV Incidence among Men Who Have Sex with Men in Africa: A Systematic Review and Meta-Regression Analysis&lt;/h3&gt; &lt;/a&gt; &lt;div class=&#034;hal-auteurs&#034;&gt; &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=James+Stannah&#034; class=&#034;hal-auteur&#034;&gt;James Stannah&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=Nirali+Soni&#034; class=&#034;hal-auteur&#034;&gt;Nirali Soni&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=Jin+Keng+Stephen+Lam&#034; class=&#034;hal-auteur&#034;&gt;Jin Keng Stephen Lam&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=Katia+Gigu%C3%A8re&#034; class=&#034;hal-auteur&#034;&gt;Katia Gigu&#232;re&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=Kate+M.+Mitchell&#034; class=&#034;hal-auteur&#034;&gt;Kate M. Mitchell&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=Nadine+Kronfli&#034; class=&#034;hal-auteur&#034;&gt;Nadine Kronfli&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/q/*/authIdHal_s/joseph-larmarange&#034; class=&#034;hal-auteur&#034;&gt;Joseph Larmarange&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=Raoul+Moh&#034; class=&#034;hal-auteur&#034;&gt;Raoul Moh&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=Marcelin+N%27Zebo+Nouaman&#034; class=&#034;hal-auteur&#034;&gt;Marcelin N'Zebo Nouaman&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=G%C3%A9rard+Menan+Kouam%C3%A9&#034; class=&#034;hal-auteur&#034;&gt;G&#233;rard Menan Kouam&#233;&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=Mathieu+Maheu-Giroux&#034; class=&#034;hal-auteur&#034;&gt;Mathieu Maheu-Giroux&lt;/a&gt; , &lt;a href=&#034;https://hal.science/search/index/?q=*&amp;authFullName_s=Marie-Claude+Boily&#034; class=&#034;hal-auteur&#034;&gt;Marie-Claude Boily&lt;/a&gt; &lt;/div&gt; &lt;div class=&#034;hal-citation&#034;&gt;2022&lt;/div&gt; &lt;div class=&#034;hal-typedoc hal-typedoc-undefined&#034;&gt;Pr&#233;-publication, Document de travail&lt;/div&gt; &lt;div class=&#034;hal-links&#034;&gt; &lt;a href=&#034;https://hal.science/hal-03880020v1&#034; class=&#034;hal-link hal-link-hal&#034;&gt;hal-03880020&lt;/a&gt; &lt;/div&gt; &lt;/div&gt; &lt;/div&gt; &lt;/div&gt;&lt;h2 class=&#034;spip&#034;&gt;
Authors&lt;/h2&gt;
&lt;p&gt;James Stannah, Nirali Soni, Jin Keng Stephen Lam, Katia Gigu&#232;re, Kate M Mitchell, Nadine Kronfli, Joseph Larmarange, Raoul Moh, Marcelin N'zebo Nouaman, G&#233;rard Menan Kouam&#233;, Mathieu Maheu-Giroux, Marie-Claude Boily&lt;/p&gt;
&lt;h2 class=&#034;spip&#034;&gt;
Abstract&lt;/h2&gt;
&lt;p&gt;&lt;strong&gt;Background&lt;/strong&gt; Gay, bisexual, and other men who have sex with men (MSM) are disproportionately affected by HIV. In Africa, MSM face structural barriers to HIV prevention and treatment including socio-economic disadvantages, stigma, and criminalization that increase their vulnerability to HIV acquisition and transmission and undermine progress towards ending AIDS. This systematic review explores progress towards increases in HIV testing, improving engagement in the HIV treatment cascade, and HIV incidence reductions among MSM in Africa.&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Methods&lt;/strong&gt; We searched Embase, Medline, Global Health, Scopus, and Web of Science from January 1980-March 2022 for cross-sectional and longitudinal studies reporting HIV testing, knowledge of status, care, antiretroviral therapy (ART) use, viral suppression, and/or HIV incidence among MSM in Africa. We pooled surveys using Bayesian generalized linear mixed-effects models, used meta-regression to assess time trends, and compared HIV incidence estimates among MSM with those of all men.&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Findings&lt;/strong&gt; Of 8,992 articles identified, we included 148 unique studies published from 2005-2022. HIV testing increased over time in Central/Western and Eastern Africa and in 2020, we estimate that 88% (95% credible interval (CrI) 57-97%) of MSM had tested in the past 12 months, but 66% (19-94%) of MSM living with HIV knew their HIV status, although this is probably underestimated given non-disclosure. Current ART use increased over time in Central/Western (ORyear=1.4, 95%CrI 1.1-2.0, N=8) and Eastern/Southern Africa (ORyear=1.4, 1.0-1.8, N=17) and in 2020 we estimate that 75% (18-98%) of MSM living with HIV in Africa were currently on ART. Nevertheless, we did not find strong evidence viral suppression increased, and in 2020 we estimate that only 62% (12-95%) of MSM living with HIV were virally suppressed. HIV incidence among MSM did not decrease over time (IRRyear=1.0, 0.7-1.3, N=38) and remained high in 2020 (5.4 per 100 person-years, 0.9-33.9) and substantially higher (27-150 times higher) than among all men.&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Interpretation&lt;/strong&gt; No decreases in HIV incidence have been observed among MSM in Africa over time, despite some increases in HIV testing and ART use. Achieving the UNAIDS 95-95-95 targets for diagnosis, treatment, and viral suppression equitably for all requires renewed focus on this key population. Combination interventions for MSM are urgently required to reduce disparities in HIV incidence and tackle the social, structural, and behavioural factors that make MSM vulnerable to HIV acquisition.&lt;/p&gt;&lt;/div&gt;
		
		</content:encoded>


		

	</item>
<item xml:lang="fr">
		<title>D&#233;crire les &#233;pid&#233;mies, Comprendre les populations&#160;: une d&#233;mographie du VIH en Afrique subsaharienne</title>
		<link>https://www.joseph.larmarange.net/hdr</link>
		<guid isPermaLink="true">https://www.joseph.larmarange.net/hdr</guid>
		<dc:date>2022-10-14T06:38:12Z</dc:date>
		<dc:format>text/html</dc:format>
		<dc:language>fr</dc:language>
		<dc:creator>Joseph LARMARANGE</dc:creator>


		<dc:subject>Afrique subsaharienne</dc:subject>
		<dc:subject>ATLAS</dc:subject>
		<dc:subject>CAP-CoV-Soignants-BF</dc:subject>
		<dc:subject>DOD-CI (ANRS 12287 / 12323)</dc:subject>
		<dc:subject>ELIHoS (ANRS 12139)</dc:subject>
		<dc:subject>PrEP CI (ANRS 12361)</dc:subject>
		<dc:subject>Pr&#233;valences du VIH (ANRS 12114)</dc:subject>
		<dc:subject>prevR</dc:subject>
		<dc:subject>PRINCESSE</dc:subject>
		<dc:subject>TasP (ANRS 12249)</dc:subject>
		<dc:subject>Afrique du Sud</dc:subject>
		<dc:subject>Burkina Faso</dc:subject>
		<dc:subject>C&#244;te d'Ivoire</dc:subject>
		<dc:subject>Mali</dc:subject>
		<dc:subject>S&#233;n&#233;gal</dc:subject>
		<dc:subject>Acc&#232;s aux soins</dc:subject>
		<dc:subject>Analyse de s&#233;quences</dc:subject>
		<dc:subject>Approches biographiques</dc:subject>
		<dc:subject>Approches communautaires</dc:subject>
		<dc:subject>Autotests VIH</dc:subject>
		<dc:subject>Cartographie</dc:subject>
		<dc:subject>Cascade des soins</dc:subject>
		<dc:subject>Comparaison de cohortes</dc:subject>
		<dc:subject>Comportements sexuels</dc:subject>
		<dc:subject>D&#233;mographie</dc:subject>
		<dc:subject>D&#233;pistage</dc:subject>
		<dc:subject>EDS (Enqu&#234;tes D&#233;mographiques et de Sant&#233;)</dc:subject>
		<dc:subject>Enqu&#234;tes par t&#233;l&#233;phone</dc:subject>
		<dc:subject>Enseignement acad&#233;mique</dc:subject>
		<dc:subject>Lien vers les soins</dc:subject>
		<dc:subject>&#201;pid&#233;miologie</dc:subject>
		<dc:subject>Essais cliniques</dc:subject>
		<dc:subject>Estimateurs &#224; noyau (kernel density estimation)</dc:subject>
		<dc:subject>Femmes enceintes</dc:subject>
		<dc:subject>Financement des programmes</dc:subject>
		<dc:subject>H&#233;patites virales</dc:subject>
		<dc:subject>Homo / Bisexualit&#233;s</dc:subject>
		<dc:subject>Identit&#233;s sexuelles</dc:subject>
		<dc:subject>Incidence du VIH</dc:subject>
		<dc:subject>Interpolation spatiale</dc:subject>
		<dc:subject>IST (Infections Sexuellement Transmissibles)</dc:subject>
		<dc:subject>Itin&#233;raires th&#233;rapeutiques</dc:subject>
		<dc:subject>Masculinit&#233;s</dc:subject>
		<dc:subject>M&#233;nages</dc:subject>
		<dc:subject>Mesure d'impact</dc:subject>
		<dc:subject>Mesure des indicateurs</dc:subject>
		<dc:subject>M&#233;thodologie</dc:subject>
		<dc:subject>Migrations</dc:subject>
		<dc:subject>Observatoire de population</dc:subject>
		<dc:subject>Partenaires sexuel(le)s</dc:subject>
		<dc:subject>PrEP</dc:subject>
		<dc:subject>Pr&#233;valence du VIH</dc:subject>
		<dc:subject>Pr&#233;vention</dc:subject>
		<dc:subject>Prise en charge</dc:subject>
		<dc:subject>Recherche interventionnelle</dc:subject>
		<dc:subject>Recherche participative/communautaire</dc:subject>
		<dc:subject>Recrutement &#171;&lt;small class=&#034;fine d-inline&#034;&gt;&#160;&lt;/small&gt;boules de neige&lt;small class=&#034;fine d-inline&#034;&gt;&#160;&lt;/small&gt;&#187;</dc:subject>
		<dc:subject>Repr&#233;sentations / Perceptions</dc:subject>
		<dc:subject>Repr&#233;sentativit&#233; et Biais</dc:subject>
		<dc:subject>Sant&#233; publique</dc:subject>
		<dc:subject>Sant&#233; sexuelle</dc:subject>
		<dc:subject>Structure des populations</dc:subject>
		<dc:subject>Structures de sant&#233;</dc:subject>
		<dc:subject>Surveillance sentinelle</dc:subject>
		<dc:subject>T&#233;l&#233;phones mobiles</dc:subject>
		<dc:subject>Temporalit&#233;s</dc:subject>
		<dc:subject>Traitement antir&#233;troviral (ARV)</dc:subject>
		<dc:subject>Travail du sexe</dc:subject>
		<dc:subject>Treatment as Prevention (TasP)</dc:subject>
		<dc:subject>Universal Test &amp; Treat (UTT)</dc:subject>
		<dc:subject>Usager&lt;span aria-hidden='true'&gt;&#183;&lt;/span&gt;e&lt;span aria-hidden='true'&gt;&#183;&lt;/span&gt;s de drogue</dc:subject>
		<dc:subject>VIH / SIDA</dc:subject>

		<description>
&lt;p&gt;Habilitation &#224; Diriger des Recherches soutenue le 12&#160;octobre 2012 par Joseph Larmarange &#224; l'Universit&#233; Paris Cit&#233;. &lt;br class='autobr' /&gt; D&#233;crire les &#233;pid&#233;mies, Comprendre les populations&#160;: une d&#233;mographie du VIH en Afrique subsaharienne &lt;br class='autobr' /&gt; Joseph Larmarange D&#233;mographie. Universit&#233; Paris Cit&#233;, 2022 HDR tel-03814024&lt;/p&gt;


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&lt;a href="https://www.joseph.larmarange.net/+-Afrique-subsaharienne-+" rel="tag"&gt;Afrique subsaharienne&lt;/a&gt;, 
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&lt;a href="https://www.joseph.larmarange.net/+-Prevalences-du-VIH-ANRS-12114-+" rel="tag"&gt;Pr&#233;valences du VIH (ANRS 12114)&lt;/a&gt;, 
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&lt;a href="https://www.joseph.larmarange.net/+-Senegal-+" rel="tag"&gt;S&#233;n&#233;gal&lt;/a&gt;, 
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		&lt;div class='rss_chapo'&gt;&lt;p&gt;Habilitation &#224; Diriger des Recherches soutenue le 12&#160;octobre 2012 par Joseph Larmarange &#224; l'Universit&#233; Paris Cit&#233;.&lt;/p&gt;&lt;/div&gt;
		&lt;div class='rss_texte'&gt;&lt;div class=&#034;hal-resultats&#034;&gt; &lt;div class=&#034;hal-resultat hal-resultat-3814024&#034;&gt; &lt;div class=&#034;hal-thumb&#034;&gt;&lt;a href=&#034;https://theses.hal.science/tel-03814024v1/document&#034; class=&#034;hal-thumb-link&#034;&gt;&lt;img src='https://www.joseph.larmarange.net/local/cache-vignettes/L53xH75/thumb-877a2ad2-17cac.png?1702907846' alt=&#034;Image document&#034; width='53' height='75' /&gt; &lt;/a&gt;&lt;/div&gt; &lt;div class=&#034;hal-preview&#034;&gt; &lt;a href=&#034;https://theses.hal.science/tel-03814024v1&#034; class=&#034;hal-titre&#034;&gt; &lt;h3 class=&#034;hal-titre-heading&#034;&gt;D&#233;crire les &#233;pid&#233;mies, Comprendre les populations : une d&#233;mographie du VIH en Afrique subsaharienne&lt;/h3&gt; &lt;/a&gt; &lt;div class=&#034;hal-auteurs&#034;&gt; &lt;a href=&#034;https://hal.science/search/index/q/*/authIdHal_s/joseph-larmarange&#034; class=&#034;hal-auteur&#034;&gt;Joseph Larmarange&lt;/a&gt; &lt;/div&gt; &lt;div class=&#034;hal-citation&#034;&gt;D&#233;mographie. Universit&#233; Paris Cit&#233;, 2022&lt;/div&gt; &lt;div class=&#034;hal-typedoc hal-typedoc-hdr&#034;&gt;HDR&lt;/div&gt; &lt;div class=&#034;hal-links&#034;&gt; &lt;a href=&#034;https://theses.hal.science/tel-03814024v1&#034; class=&#034;hal-link hal-link-hal&#034;&gt;tel-03814024&lt;/a&gt; &lt;/div&gt; &lt;/div&gt; &lt;/div&gt; &lt;/div&gt;&lt;iframe width=&#034;100%&#034; height=&#034;500&#034; src=&#034;https://www.youtube.com/embed/me6rDSq0p0k&#034; title=&#034;YouTube video player&#034; frameborder=&#034;0&#034; allow=&#034;accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture&#034; allowfullscreen&gt;&lt;/iframe&gt;&lt;h2 class=&#034;spip&#034;&gt;
Jury&lt;/h2&gt;&lt;ul class=&#034;spip&#034; role=&#034;list&#034;&gt;&lt;li&gt; Didier Breton (Universit&#233; de Strasbourg, rapporteur)&lt;/li&gt;&lt;li&gt; Val&#233;rie Delauney (IRD, rapportrice)&lt;/li&gt;&lt;li&gt; Annabel Desgr&#233;es du Lo&#251; (IRD, garante)&lt;/li&gt;&lt;li&gt; G&#233;raldine Duth&#233; (Ined, rapportrice)&lt;/li&gt;&lt;li&gt; Didier Ekouevi (Inserm, Universit&#233; de Lom&#233;, examinateur)&lt;/li&gt;&lt;li&gt; V&#233;ronique Petit (Universit&#233; Paris Cit&#233;, pr&#233;sidente)&lt;/li&gt;&lt;/ul&gt;&lt;/div&gt;
		
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<item xml:lang="en">
		<title>Population-level Viremia Predicts HIV Incidence across the Universal Test and Treat Studies</title>
		<link>https://www.joseph.larmarange.net/population-level-viremia-predicts</link>
		<guid isPermaLink="true">https://www.joseph.larmarange.net/population-level-viremia-predicts</guid>
		<dc:date>2020-03-19T11:06:07Z</dc:date>
		<dc:format>text/html</dc:format>
		<dc:language>en</dc:language>
		<dc:creator>Joseph LARMARANGE</dc:creator>


		<dc:subject>Afrique du Sud</dc:subject>
		<dc:subject>Kenya</dc:subject>
		<dc:subject>Ouganda</dc:subject>
		<dc:subject>Zambie</dc:subject>
		<dc:subject>Botswana</dc:subject>
		<dc:subject>TasP (ANRS 12249)</dc:subject>
		<dc:subject>Cascade des soins</dc:subject>
		<dc:subject>Incidence du VIH</dc:subject>
		<dc:subject>Mesure d'impact</dc:subject>
		<dc:subject>Mesure des indicateurs</dc:subject>
		<dc:subject>Pr&#233;valence du VIH</dc:subject>
		<dc:subject>Sant&#233; publique</dc:subject>
		<dc:subject>Treatment as Prevention (TasP)</dc:subject>
		<dc:subject>Universal Test &amp; Treat (UTT)</dc:subject>
		<dc:subject>VIH / SIDA</dc:subject>

		<description>
&lt;p&gt;Oral communication virtually presented at CROI 2020 the 9&lt;sup class=&#034;typo_exposants&#034;&gt;th&lt;/sup&gt; of March 2020 &lt;br class='autobr' /&gt; Authors &lt;br class='autobr' /&gt;
Maya Petersen, Joseph Larmarange, Kathleen Wirth, Timothy Skalland, Helen Ayles, Moses Kamya, Shahin Lockman, Collins Iwuji, Fran&#231;ois Dabis, Joseph Makhema, Diane Havlir, Sian Floyd, Richard Hayes for the UT3C Consortium &lt;br class='autobr' /&gt;
Abstract &lt;br class='autobr' /&gt;
Improved understanding of the extent to which increased population-level viral suppression will reduce HIV incidence is needed. Using data from four large&#160;(&#8230;)&lt;/p&gt;


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		</description>


 <content:encoded>&lt;img src='https://www.joseph.larmarange.net/local/cache-vignettes/L150xH100/arton273-ec29b.jpg?1715148444' class='spip_logo spip_logo_right' width='150' height='100' alt=&#034;&#034; /&gt;
		&lt;div class='rss_chapo'&gt;&lt;p&gt;Oral communication virtually presented at CROI 2020 the 9&lt;sup class=&#034;typo_exposants&#034;&gt;th&lt;/sup&gt; of March 2020&lt;/p&gt;&lt;/div&gt;
		&lt;div class='rss_texte'&gt;&lt;h2 class=&#034;spip&#034;&gt;
Authors&lt;/h2&gt;
&lt;p&gt;Maya Petersen, Joseph Larmarange, Kathleen Wirth, Timothy Skalland, Helen Ayles, Moses Kamya, Shahin Lockman, Collins Iwuji, Fran&#231;ois Dabis, Joseph Makhema, Diane Havlir, Sian Floyd, Richard Hayes for the UT3C Consortium&lt;/p&gt;
&lt;h2 class=&#034;spip&#034;&gt;
Abstract&lt;/h2&gt;
&lt;p&gt;Improved understanding of the extent to which increased population-level viral suppression will reduce HIV incidence is needed. Using data from four large Universal Test and Treat Trials, we evaluated the relationship between viremia and incidence and its consistency across epidemic contexts.&lt;/p&gt;
&lt;p&gt;We analyzed data from 105 communities in the PopART (21 communities in South Africa and Zambia,&#160;25,000 adults each), BCPP (30 communities in Botswana,&#160;3,600 adults each), ANRS 12249 TasP (22 communities in South Africa,&#160;1,300 adults each) and SEARCH (32 communities in Uganda and Kenya,&#160;5,000 adults each) studies. Communities ranged from rural to urban and varied in the mobility of their populations and their sex ratio (&#160;30% to 50% male). HIV incidence was measured via repeat testing between 2012-2018. Population viremia &#173;&#8211;&lt;small class=&#034;fine d-inline&#034;&gt;&#160;&lt;/small&gt;% of all adults (HIV+ or HIV-) with HIV viremia &#8211; was estimated at midpoint of follow-up based on HIV prevalence and non-suppression among HIV+, with adjustment for differences between the measurement cohort and underlying population. Community-level regression, adjusted for study, was used to quantify the association between HIV incidence and viremia and to evaluate cross-study heterogeneity.&lt;/p&gt;
&lt;p&gt;HIV prevalence (measured in 257,929 total persons, PopART: 37,006; BCPP: 12,570; TasP: 20,978; SEARCH: 187,375), ranged from 2% to 40% by community. Non-suppression among HIV+ (measured in 39,928 persons, PopART: 6,233; BCPP: 2,318; TasP: 6,617; SEARCH: 16,209) ranged from 3% to 70%. HIV incidence (measured over 345,844 person-years, PopART: 39,702; BCPP: 8,551; TasP: 26,832; SEARCH: 270,759) ranged from 0.03 to 3.4 per 100PY. Population-level viremia was strongly associated with HIV incidence; pooling across studies, HIV incidence decreased by 0.07/100PY (95% CI: 0.05,0.10, p&lt;0.001) for each 1% absolute decrease in viremia. Incidence was significantly associated with viremia in each study; however, both strength of the incidence-viremia relationship (slope) and projected incidence at 0% viremia (intercept) differed (Figure).&lt;/p&gt;
&lt;p&gt;Lower population-level HIV viremia was associated with lower HIV incidence in all four Universal Test and Treat Studies, conducted in a wide range of epidemic contexts in sub-Saharan Africa. Differences in external infection rate (due to variation in community size, mobility, and sex ratio) may have contributed to heterogeneity between studies.&lt;/p&gt;
&lt;h2 class=&#034;spip&#034;&gt;
Reference&lt;/h2&gt;
&lt;p&gt;&lt;abbr class=&#034;unapi-id&#034; title=&#034;8FBGANYF&#034;&gt;&lt;/abbr&gt;&lt;span class=&#034;csl-bib-body&#034;&gt;&lt;span class=&#034;csl-entry&#034;&gt;&lt;span style=&#034;font-variant: small-caps;&#034;&gt;Petersen&lt;/span&gt; Maya, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Larmarange&lt;/span&gt; Joseph, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Wirth&lt;/span&gt; Kathleen E, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Skalland&lt;/span&gt; Timothy, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Ayles&lt;/span&gt; Helen, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Kamya&lt;/span&gt; Moses, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Lockman&lt;/span&gt; Shahin, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Iwuji&lt;/span&gt; Collins, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Dabis&lt;/span&gt; Fran&#231;ois, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Makhema&lt;/span&gt; Joseph, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Havlir&lt;/span&gt; Diane, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Floyd&lt;/span&gt; Sian, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Hayes&lt;/span&gt; Richard and &lt;span style=&#034;font-variant: small-caps;&#034;&gt;UT3C Consortium&lt;/span&gt; (2020) &#8220;Population-level Viremia Predicts HIV Incidence across the Universal Test and Treat Studies&#8221; (communication orale), presented at the &lt;span style=&#034;font-style: italic;&#034; &gt;Conference on Retroviruses and Opportunitic Infections (CROI)&lt;/span&gt;, Boston. http://www.croiconference.org/sessions/population-level-viremia-predicts-hiv-incidence-across-universal-test-treat-studies.&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;&lt;/div&gt;
		
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<item xml:lang="en">
		<title>What do the Universal Test and Treat trials tell us about the path to HIV epidemic control?</title>
		<link>https://www.joseph.larmarange.net/What-do-the-Universal-Test-and</link>
		<guid isPermaLink="true">https://www.joseph.larmarange.net/What-do-the-Universal-Test-and</guid>
		<dc:date>2020-02-25T09:49:53Z</dc:date>
		<dc:format>text/html</dc:format>
		<dc:language>en</dc:language>
		<dc:creator>Joseph LARMARANGE</dc:creator>


		<dc:subject>Afrique subsaharienne</dc:subject>
		<dc:subject>TasP (ANRS 12249)</dc:subject>
		<dc:subject>Cascade des soins</dc:subject>
		<dc:subject>&#201;pid&#233;miologie</dc:subject>
		<dc:subject>Incidence du VIH</dc:subject>
		<dc:subject>Mesure d'impact</dc:subject>
		<dc:subject>Sant&#233; publique</dc:subject>
		<dc:subject>Treatment as Prevention (TasP)</dc:subject>
		<dc:subject>Universal Test &amp; Treat (UTT)</dc:subject>
		<dc:subject>VIH / SIDA</dc:subject>

		<description>
&lt;p&gt;Authors Diane Havlir, Shahin Lockman, Helen Ayles, Joseph Larmarange, Gabriel Chamie, Tendani Gaolathe, Collins Iwuji, Sarah Fidler, Moses Kamya, Sian Floyd, Janet Moore, Richard Hayes, Maya Petersen, Francois Dabis on behalf of the (Universal Test and Treat Trials) UT3 Consortium &lt;br class='autobr' /&gt;
Abstract &lt;br class='autobr' /&gt;
Introduction &lt;br class='autobr' /&gt;
Achieving HIV epidemic control globally will require new strategies to accelerate reductions in HIV incidence and mortality. Universal test and treat (UTT) was evaluated in four&#160;(&#8230;)&lt;/p&gt;


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		</description>


 <content:encoded>&lt;img src='https://www.joseph.larmarange.net/local/cache-vignettes/L150xH100/arton272-9bb2d.jpg?1715148445' class='spip_logo spip_logo_right' width='150' height='100' alt=&#034;&#034; /&gt;
		&lt;div class='rss_texte'&gt;&lt;h2 class=&#034;spip&#034;&gt;
Authors&lt;/h2&gt;
&lt;p&gt;Diane Havlir, Shahin Lockman, Helen Ayles, Joseph Larmarange, Gabriel Chamie, Tendani Gaolathe, Collins Iwuji, Sarah Fidler, Moses Kamya, Sian Floyd, Janet Moore, Richard Hayes, Maya Petersen, Francois Dabis on behalf of the (Universal Test and Treat Trials) UT3 Consortium&lt;/p&gt;
&lt;h2 class=&#034;spip&#034;&gt;
Abstract&lt;/h2&gt;
&lt;p&gt;&lt;strong&gt;Introduction&lt;/strong&gt;&lt;/p&gt;
&lt;p&gt;Achieving HIV epidemic control globally will require new strategies to accelerate reductions in HIV incidence and mortality. Universal test and treat (UTT) was evaluated in four randomized population&#8208;based trials (BCPP/Ya Tsie, HPTN 071/PopART, SEARCH, ANRS 12249/TasP) conducted in sub&#8208;Saharan Africa (SSA) during expanded antiretroviral treatment (ART) eligibility by World Health Organization guidelines and the UNAIDS 90&#8208;90&#8208;90 campaign.&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Discussion&lt;/strong&gt;&lt;/p&gt;
&lt;p&gt;These three&#8208;year studies were conducted in Botswana, Zambia, Uganda, Kenya and South Africa in settings with baseline HIV prevalence from 4% to 30%. Key observations across studies were: (1) Universal testing (implemented via a variety of home and community&#8208;based testing approaches) achieved &gt;90% coverage in all studies. (2) When coupled with robust linkage to HIV care, rapid ART start and patient&#8208;centred care, UTT achieved among the highest reported population levels of viral suppression in SSA. Significant gains in population&#8208;level viral suppression were made in regions with both low and high baseline population viral load; however, viral suppression gains were not uniform across all sub&#8208;populations and were lower among youth. (3) UTT resulted in marked reductions in community HIV incidence when universal testing and robust linkage were present. However, HIV elimination targets were not reached. In BCPP and HPTN 071, annualized HIV incidence was approximately 20% to 30% lower in the intervention (which included universal testing) compared to control arms (no universal testing). In SEARCH (where both arms had universal testing), incidence declined 32% over three years. (4) UTT reduced HIV associated mortality by 23% in the intervention versus control communities in SEARCH, a study in which mortality was comprehensively measured.&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Conclusions&lt;/strong&gt;&lt;/p&gt;
&lt;p&gt;These trials provide strong evidence that UTT inclusive of universal testing increases population&#8208;level viral suppression and decreases HIV incidence and mortality faster than the status quo in SSA and should be adapted at a sub&#8208;country level as a public health strategy. However, more is needed, including integration of new prevention interventions into UTT, in order to reach UNAIDS HIV elimination targets.&lt;/p&gt;
&lt;h2 class=&#034;spip&#034;&gt;
Reference&lt;/h2&gt;
&lt;p&gt;&lt;abbr class=&#034;unapi-id&#034; title=&#034;W2KH9JIL&#034;&gt;&lt;/abbr&gt;&lt;span class=&#034;csl-bib-body&#034;&gt;&lt;span class=&#034;csl-entry&#034;&gt;&lt;span style=&#034;font-variant: small-caps;&#034;&gt;Havlir&lt;/span&gt; Diane, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Lockman&lt;/span&gt; Shahin, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Ayles&lt;/span&gt; Helen, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Larmarange&lt;/span&gt; Joseph, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Chamie&lt;/span&gt; Gabriel, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Gaolathe&lt;/span&gt; Tendani, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Iwuji&lt;/span&gt; Collins, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Fidler&lt;/span&gt; Sarah, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Kamya&lt;/span&gt; Moses, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Floyd&lt;/span&gt; Sian, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Moore&lt;/span&gt; Janet, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Hayes&lt;/span&gt; Richard, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Petersen&lt;/span&gt; Maya and &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Dabis&lt;/span&gt; Francois (2020) &#8220;What do the Universal Test and Treat trials tell us about the path to HIV epidemic control?&#8221;, &lt;span style=&#034;font-style: italic;&#034; &gt;Journal of the International AIDS Society&lt;/span&gt;, 23 (2) (February 24), p.&#160;e25455. DOI&#160;: 10.1002/jia2.25455. https://onlinelibrary.wiley.com/doi/abs/10.1002/jia2.25455.&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;&lt;/div&gt;
		
		</content:encoded>


		

	</item>
<item xml:lang="en">
		<title>Temporal trends of population viral suppression in the context of Universal Test and Treat: the ANRS 12249 TasP trial in rural South Africa</title>
		<link>https://www.joseph.larmarange.net/Temporal-trends-of-population-262</link>
		<guid isPermaLink="true">https://www.joseph.larmarange.net/Temporal-trends-of-population-262</guid>
		<dc:date>2019-10-28T09:56:48Z</dc:date>
		<dc:format>text/html</dc:format>
		<dc:language>en</dc:language>
		<dc:creator>Joseph LARMARANGE</dc:creator>


		<dc:subject>Afrique du Sud</dc:subject>
		<dc:subject>TasP (ANRS 12249)</dc:subject>
		<dc:subject>Acc&#232;s aux soins</dc:subject>
		<dc:subject>Approches biographiques</dc:subject>
		<dc:subject>Cascade des soins</dc:subject>
		<dc:subject>Comparaison de cohortes</dc:subject>
		<dc:subject>Lien vers les soins</dc:subject>
		<dc:subject>Itin&#233;raires th&#233;rapeutiques</dc:subject>
		<dc:subject>Mesure d'impact</dc:subject>
		<dc:subject>Mesure des indicateurs</dc:subject>
		<dc:subject>Temporalit&#233;s</dc:subject>
		<dc:subject>Traitement antir&#233;troviral (ARV)</dc:subject>
		<dc:subject>VIH / SIDA</dc:subject>

		<description>
&lt;p&gt;This paper was published in the Journal of the International AIDS Society in October 2019. &lt;br class='autobr' /&gt; Authors &lt;br class='autobr' /&gt;
Joseph Larmarange, Mamadou H Diallo, Nuala McGrath, Collins Iwuji, M&#233;lanie Plazy, Rodolphe Thi&#233;baut, Frank Tanser, Till B&#228;rnighausen, Joanna Orne&#8208;Gliemann, Deenan Pillay, Fran&#231;ois Dabis for the ANRS 12249 TasP Study Group &lt;br class='autobr' /&gt;
Abstract &lt;br class='autobr' /&gt;
Introduction &lt;br class='autobr' /&gt;
The universal test&#8208;and&#8208;treat (UTT) strategy aims to maximize population viral suppression (PVS), that is, the proportion of all people&#160;(&#8230;)&lt;/p&gt;


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&lt;a href="https://www.joseph.larmarange.net/+-Afrique-du-Sud-+" rel="tag"&gt;Afrique du Sud&lt;/a&gt;, 
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&lt;a href="https://www.joseph.larmarange.net/+-Acces-aux-soins-+" rel="tag"&gt;Acc&#232;s aux soins&lt;/a&gt;, 
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&lt;a href="https://www.joseph.larmarange.net/+-VIH-SIDA-+" rel="tag"&gt;VIH / SIDA&lt;/a&gt;

		</description>


 <content:encoded>&lt;img src='https://www.joseph.larmarange.net/local/cache-vignettes/L150xH100/arton262-f7e56.jpg?1643663962' class='spip_logo spip_logo_right' width='150' height='100' alt=&#034;&#034; /&gt;
		&lt;div class='rss_chapo'&gt;&lt;p&gt;This paper was published in the &lt;i&gt;Journal of the International AIDS Society&lt;/i&gt; in October 2019.&lt;/p&gt;&lt;/div&gt;
		&lt;div class='rss_texte'&gt;&lt;h2 class=&#034;spip&#034;&gt;
Authors&lt;/h2&gt;
&lt;p&gt;Joseph Larmarange, Mamadou H Diallo, Nuala McGrath, Collins Iwuji, M&#233;lanie Plazy, Rodolphe Thi&#233;baut, Frank Tanser, Till B&#228;rnighausen, Joanna Orne&#8208;Gliemann, Deenan Pillay, Fran&#231;ois Dabis for the ANRS 12249 TasP Study Group&lt;/p&gt;
&lt;h2 class=&#034;spip&#034;&gt;
Abstract&lt;/h2&gt;
&lt;p&gt;&lt;strong&gt;Introduction&lt;/strong&gt;&lt;/p&gt;
&lt;p&gt;The universal test&#8208;and&#8208;treat (UTT) strategy aims to maximize population viral suppression (PVS), that is, the proportion of all people living with HIV (PLHIV) on antiretroviral treatment (ART) and virally suppressed, with the goal of reducing HIV transmission at the population level. This article explores the extent to which temporal changes in PVS explain the observed lack of association between universal treatment and cumulative HIV incidence seen in the ANRS 12249 TasP trial conducted in rural South Africa.&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Methods&lt;/strong&gt;&lt;/p&gt;
&lt;p&gt;The TasP cluster&#8208;randomized trial (2012 to 2016) implemented six&#8208;monthly repeat home&#8208;based HIV counselling and testing (RHBCT) and referral of PLHIV to local HIV clinics in 2 &#215; 11 clusters opened sequentially. ART was initiated according to national guidelines in control clusters and regardless of CD4 count in intervention clusters. We measured residency status, HIV status, and HIV care status for each participant on a daily basis. PVS was computed per cluster among all resident PLHIV (&#8805;16, including those not in care) at cluster opening and daily thereafter. We used a mixed linear model to explore time patterns in PVS, adjusting for sociodemographic changes at the cluster level.&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Results&lt;/strong&gt;&lt;/p&gt;
&lt;p&gt;8563 PLHIV were followed. During the course of the trial, PVS increased significantly in both arms (23.5% to 46.2% in intervention, +22.8, p &lt; 0.001; 26.0% to 44.6% in control, +18.6, p&#8201;&lt;&#8201;0.001). That increase was similar in both arms (p = 0.514). In the final adjusted model, PVS increase was most associated with increased RHBCT and the implementation of local trial clinics (measured by time since cluster opening). Contextual changes (measured by calendar time) also contributed slightly. The effect of universal ART (trial arm) was positive but limited.&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Conclusions&lt;/strong&gt;&lt;/p&gt;
&lt;p&gt;PVS was improved significantly but similarly in both trial arms, explaining partly the null effect observed in terms of cumulative HIV incidence between arms. The PVS gains due to changes in ART&#8208;initiation guidelines alone are relatively small compared to gains obtained by strategies to maximize testing and linkage to care. The achievement of the 90&#8208;90&#8208;90 targets will not be met if the operational and implementational challenges limiting access to care and treatment, often context&#8208;specific, are not properly addressed. Clinical trial number: NCT01509508 (clinicalTrials.gov)/DOH&#8208;27&#8208;0512&#8208;3974 (South African National Clinical Trials Register).&lt;/p&gt;
&lt;h2 class=&#034;spip&#034;&gt;
Reference&lt;/h2&gt;
&lt;p&gt;&lt;abbr class=&#034;unapi-id&#034; title=&#034;KIZS88WB&#034;&gt;&lt;/abbr&gt;&lt;span class=&#034;csl-bib-body&#034;&gt;&lt;span class=&#034;csl-entry&#034;&gt;&lt;span style=&#034;font-variant: small-caps;&#034;&gt;Larmarange&lt;/span&gt; Joseph, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Diallo&lt;/span&gt; Mamadou H, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;McGrath&lt;/span&gt; Nuala, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Iwuji&lt;/span&gt; Collins, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Plazy&lt;/span&gt; M&#233;lanie, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Thi&#233;baut&lt;/span&gt; Rodolphe, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Tanser&lt;/span&gt; Frank, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;B&#228;rnighausen&lt;/span&gt; Till, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Orne-Gliemann&lt;/span&gt; Joanna, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Pillay&lt;/span&gt; Deenan, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Dabis&lt;/span&gt; Fran&#231;ois and &lt;span style=&#034;font-variant: small-caps;&#034;&gt;ANRS 12249 TasP Study Group&lt;/span&gt; (2019) &#8220;Temporal trends of population viral suppression in the context of Universal Test and Treat: the ANRS 12249 TasP trial in rural South Africa&#8221;, &lt;span style=&#034;font-style: italic;&#034; &gt;Journal of the International AIDS Society&lt;/span&gt;, 22 (10) (October 22), p.&#160;e25402. DOI&#160;: 10.1002/jia2.25402. https://onlinelibrary.wiley.com/doi/full/10.1002/jia2.25402.&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;&lt;/div&gt;
		
		</content:encoded>


		

	</item>
<item xml:lang="fr">
		<title>Un m&#234;me objet biographique sous l'angle de plusieurs approches m&#233;thodologiques</title>
		<link>https://www.joseph.larmarange.net/un-meme-objet-biographique-sous-l</link>
		<guid isPermaLink="true">https://www.joseph.larmarange.net/un-meme-objet-biographique-sous-l</guid>
		<dc:date>2018-10-19T14:03:53Z</dc:date>
		<dc:format>text/html</dc:format>
		<dc:language>fr</dc:language>
		<dc:creator>Joseph LARMARANGE</dc:creator>


		<dc:subject>M&#233;thodologie</dc:subject>
		<dc:subject>Mesure des indicateurs</dc:subject>
		<dc:subject>Acc&#232;s aux soins</dc:subject>
		<dc:subject>Repr&#233;sentativit&#233; et Biais</dc:subject>
		<dc:subject>R&#233;gression logistique</dc:subject>
		<dc:subject>D&#233;mographie</dc:subject>
		<dc:subject>Programmation / Code</dc:subject>
		<dc:subject>Analyse de s&#233;quences</dc:subject>
		<dc:subject>Classification hi&#233;rarchique</dc:subject>
		<dc:subject>Cascade des soins</dc:subject>
		<dc:subject>Approches biographiques</dc:subject>

		<description>
&lt;p&gt;Communication orale pr&#233;sent&#233;e le 18&#160;octobre 2018 &#224; Paris dans le cadre du colloque Parcours de vie et sant&#233;&#160;: apports des m&#233;thodes biographiques en sant&#233; publique. &lt;br class='autobr' /&gt; L'ensemble des analyses et le code correspondant est disponible sur http://larmarange.github.io/analyse-R/trajectoires-de-soins.html R&#233;f&#233;rence &lt;br class='autobr' /&gt;
Larmarange Joseph (2018) &#8220;Un m&#234;me objet biographique sous l'angle de plusieurs approches m&#233;thodologiques&#8221; (communication orale), presented at the Parcours de vie et sant&#233;&#160;: apports&#160;(&#8230;)&lt;/p&gt;


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 <content:encoded>&lt;img src='https://www.joseph.larmarange.net/local/cache-vignettes/L150xH100/arton241-cadd5.jpg?1715127904' class='spip_logo spip_logo_right' width='150' height='100' alt=&#034;&#034; /&gt;
		&lt;div class='rss_chapo'&gt;&lt;p&gt;Communication orale pr&#233;sent&#233;e le 18&#160;octobre 2018 &#224; Paris dans le cadre du colloque &lt;i&gt;Parcours de vie et sant&#233;&#160;: apports des m&#233;thodes biographiques en sant&#233; publique&lt;/i&gt;.&lt;/p&gt;&lt;/div&gt;
		&lt;div class='rss_texte'&gt;&lt;p&gt;L'ensemble des analyses et le code correspondant est disponible sur &lt;a href=&#034;http://larmarange.github.io/analyse-R/trajectoires-de-soins.html&#034; class=&#034;spip_url spip_out auto&#034; rel=&#034;nofollow external&#034;&gt;http://larmarange.github.io/analyse-R/trajectoires-de-soins.html&lt;/a&gt;&lt;/p&gt;
&lt;iframe width=&#034;100%&#034; height=&#034;450&#034; src=&#034;https://www.youtube.com/embed/SCaiB3YCC2U&#034; frameborder=&#034;0&#034; allow=&#034;accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture&#034; allowfullscreen&gt;&lt;/iframe&gt;&lt;h2 class=&#034;spip&#034;&gt;
R&#233;f&#233;rence&lt;/h2&gt;
&lt;p&gt;&lt;abbr class=&#034;unapi-id&#034; title=&#034;F7I4FJY3&#034;&gt;&lt;/abbr&gt;&lt;span class=&#034;csl-bib-body&#034;&gt;&lt;span class=&#034;csl-entry&#034;&gt;&lt;span style=&#034;font-variant: small-caps;&#034;&gt;Larmarange&lt;/span&gt; Joseph (2018) &#8220;Un m&#234;me objet biographique sous l'angle de plusieurs approches m&#233;thodologiques&#8221; (communication orale), presented at the &lt;span style=&#034;font-style: italic;&#034; &gt;Parcours de vie et sant&#233; : apports des m&#233;thodes biographiques en sant&#233; publique&lt;/span&gt;, Paris. https://biographiesante2018.sciencesconf.org/.&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;&lt;/div&gt;
		
		</content:encoded>


		
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	</item>
<item xml:lang="en">
		<title>Temporal trends of population viral suppression in the context of Universal Test and Treat: results from the ANRS 12249 TasP trial in rural South Africa</title>
		<link>https://www.joseph.larmarange.net/Temporal-trends-of-population</link>
		<guid isPermaLink="true">https://www.joseph.larmarange.net/Temporal-trends-of-population</guid>
		<dc:date>2018-07-30T10:02:03Z</dc:date>
		<dc:format>text/html</dc:format>
		<dc:language>en</dc:language>
		<dc:creator>Joseph LARMARANGE</dc:creator>


		<dc:subject>VIH / SIDA</dc:subject>
		<dc:subject>Mesure des indicateurs</dc:subject>
		<dc:subject>Milieu rural</dc:subject>
		<dc:subject>Afrique du Sud</dc:subject>
		<dc:subject>Mesure d'impact</dc:subject>
		<dc:subject>TasP (ANRS 12249)</dc:subject>
		<dc:subject>Traitement antir&#233;troviral (ARV)</dc:subject>
		<dc:subject>Treatment as Prevention (TasP)</dc:subject>
		<dc:subject>Lien vers les soins</dc:subject>
		<dc:subject>Cascade des soins</dc:subject>
		<dc:subject>Universal Test &amp; Treat (UTT)</dc:subject>
		<dc:subject>Temporalit&#233;s</dc:subject>

		<description>
&lt;p&gt;Oral communication presented at the 22&lt;sup class=&#034;typo_exposants&#034;&gt;nd&lt;/sup&gt; International AIDS Conference in Amsterdam the 24&lt;sup class=&#034;typo_exposants&#034;&gt;th&lt;/sup&gt; of July, 2018, in a abstract session entitled Forging new pathways towards HIV elimination. &lt;br class='autobr' /&gt; Authors &lt;br class='autobr' /&gt;
Joseph Larmarange, Mamadou Hassimiou Diallo, Nuala McGrath, Collins Iwuji, M&#233;lanie Plazy, Rodolphe Thi&#233;baut, Frank Tanser, Till B&#228;rninghausen, Joanna Orne-Gliemann, Deenan Pillay, Fran&#231;ois Dabis for the ANRS 12249 TasP Study Group &lt;br class='autobr' /&gt;
Abstract &lt;br class='autobr' /&gt;
Background: The universal test-and-treat strategy&#160;(&#8230;)&lt;/p&gt;


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&lt;a href="https://www.joseph.larmarange.net/+-Milieu-rural-+" rel="tag"&gt;Milieu rural&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Afrique-du-Sud-+" rel="tag"&gt;Afrique du Sud&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Mesure-d-impact-+" rel="tag"&gt;Mesure d'impact&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-TasP-ANRS-12249-97-+" rel="tag"&gt;TasP (ANRS 12249)&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Traitement-antiretroviral-ARV-98-98-+" rel="tag"&gt;Traitement antir&#233;troviral (ARV)&lt;/a&gt;, 
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&lt;a href="https://www.joseph.larmarange.net/+-Universal-Test-Treat-UTT-+" rel="tag"&gt;Universal Test &amp; Treat (UTT)&lt;/a&gt;, 
&lt;a href="https://www.joseph.larmarange.net/+-Temporalites-142-+" rel="tag"&gt;Temporalit&#233;s&lt;/a&gt;

		</description>


 <content:encoded>&lt;img src='https://www.joseph.larmarange.net/local/cache-vignettes/L150xH113/arton238-6aceb.jpg?1715148431' class='spip_logo spip_logo_right' width='150' height='113' alt=&#034;&#034; /&gt;
		&lt;div class='rss_chapo'&gt;&lt;p&gt;Oral communication presented at the &lt;a href=&#034;http://www.aids2018.org/&#034; class=&#034;spip_out&#034; rel=&#034;external&#034;&gt;22&lt;sup&gt;nd&lt;/sup&gt; International AIDS Conference&lt;/a&gt; in Amsterdam the 24&lt;sup class=&#034;typo_exposants&#034;&gt;th&lt;/sup&gt; of July, 2018, in a abstract session entitled &lt;i&gt;Forging new pathways towards HIV elimination&lt;/i&gt;.&lt;/p&gt;&lt;/div&gt;
		&lt;div class='rss_texte'&gt;&lt;h2 class=&#034;spip&#034;&gt;
Authors&lt;/h2&gt;
&lt;p&gt;Joseph Larmarange, Mamadou Hassimiou Diallo, Nuala McGrath, Collins Iwuji, M&#233;lanie Plazy, Rodolphe Thi&#233;baut, Frank Tanser, Till B&#228;rninghausen, Joanna Orne-Gliemann, Deenan Pillay, Fran&#231;ois Dabis for the ANRS 12249 TasP Study Group&lt;/p&gt;
&lt;h2 class=&#034;spip&#034;&gt;
Abstract&lt;/h2&gt;
&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; The universal test-and-treat strategy (UTT) aims to maximize the proportion of all people living with HIV (PLWHIV) on antiretroviral treatment (ART) and virally suppressed in a community, i.e. to reach population viral suppression (PVS). The ANRS 12249 TasP trial did not demonstrate an impact of universal ART on HIV incidence at population level (Lancet HIV 2017). Here, we investigated whether PVS improved during the course of the trial: differentially by arm, according to trial interventions or contextual changes.&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt; The TasP cluster-randomized trial (2012-2016) implemented six-monthly repeated home-based HIV counselling and testing (RHBCT) and referral of PLWHIV to local HIV clinics in 2&#215;11 clusters opened sequentially. ART was initiated according to national guidelines in control clusters vs. regardless of CD4 count in intervention clusters.&lt;br class='autobr' /&gt;
Test results, clinic visits, ART prescriptions, viral loads, CD4 counts, migrations and deaths were used to produce information on residency status, HIV status and HIV care status for each participant. PVS was computed daily and per cluster among all resident PLWHIV (&#8805;16, including those not in care). We used a mixed linear model to explore the relation between PVS with calendar time, time since cluster opening, trial arm and interaction between arm and time since cluster opening, adjusting on sociodemographic changes at cluster level.&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; 8,646 PLWHIV were observed. Between January 1&lt;sup class=&#034;typo_exposants&#034;&gt;st&lt;/sup&gt;, 2013 and January 1&lt;sup class=&#034;typo_exposants&#034;&gt;st&lt;/sup&gt;, 2016, PVS increased significantly in both arms (intervention: 29.0% to 46.2%, +17.2, p&lt; 0.001; control: 32.4% to 44.6%, +12.2, p &lt; 0.001), but difference in temporal variation (+5.0%) was not significant (p=0.175).&lt;br class='autobr' /&gt;
According to adjusted model (figure) this increase was mainly attributable to RHBCT (measured by time since cluster opening). They were also some effect due to contextual changes (measured by calendar time). The effect attributable to universal ART (interaction term) was limited.&lt;/p&gt;
&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Although suboptimal, the UTT strategy implemented in TasP trial improved PVS over time. As it was mainly due to RHBCT rather than universal ART, it did not induce differences between arms, explaining the null effect observed on cumulative incidence, the main trial finding. Changes in ART initiation guidelines alone are not enough to significantly increase PVS.&lt;/p&gt;
&lt;h2 class=&#034;spip&#034;&gt;
Video&lt;/h2&gt;&lt;iframe width=&#034;100%&#034; height=&#034;500&#034; src=&#034;https://www.youtube-nocookie.com/embed/Osam4cXugac?rel=0&amp;start=1745&#034; frameborder=&#034;0&#034; allow=&#034;autoplay; encrypted-media&#034; allowfullscreen&gt;&lt;/iframe&gt;&lt;h2 class=&#034;spip&#034;&gt;
Medias&lt;/h2&gt;&lt;ul class=&#034;spip&#034; role=&#034;list&#034;&gt;&lt;li&gt; &lt;a href=&#034;http://www.anrs.fr/fr/presse/communiques-de-presse/520/anrs-tasp-benefices-dun-depistage-domicile-et-de-cliniques-de&#034; class=&#034;spip_out&#034; rel=&#034;external&#034;&gt;ANRS&lt;/a&gt;&lt;/li&gt;&lt;li&gt; &lt;a href=&#034;http://vih.org/20180724/tasp-benefices-dun-depistage-domicile-et-cliniques-proximite-en-afrique-du-sud/140272&#034; class=&#034;spip_out&#034; rel=&#034;external&#034;&gt;vih.org&lt;/a&gt;&lt;/li&gt;&lt;li&gt; &lt;a href=&#034;https://transversalmag.fr/articles/815-Afrique-du-Sud-impact-benefique-du-depistage-du-VIH-a-domicile-et-des-centres-de-soins-de-proximite&#034; class=&#034;spip_out&#034; rel=&#034;external&#034;&gt;Transversal&lt;/a&gt;&lt;/li&gt;&lt;li&gt; &lt;a href=&#034;https://www.ird.fr/toute-l-actualite/communiques-et-dossiers-de-presse/cp-2018/lutte-contre-le-vih-benefices-d-un-depistage-a-domicile-et-de-cliniques-de-proximite-en-afrique-du-sud&#034; class=&#034;spip_out&#034; rel=&#034;external&#034;&gt;IRD&lt;/a&gt;&lt;/li&gt;&lt;/ul&gt;&lt;h2 class=&#034;spip&#034;&gt;
Reference&lt;/h2&gt;
&lt;p&gt;&lt;abbr class=&#034;unapi-id&#034; title=&#034;IEBQUQGL&#034;&gt;&lt;/abbr&gt;&lt;span class=&#034;csl-bib-body&#034;&gt;&lt;span class=&#034;csl-entry&#034;&gt;&lt;span style=&#034;font-variant: small-caps;&#034;&gt;Larmarange&lt;/span&gt; Joseph, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Diallo&lt;/span&gt; Mamadou Hassimiou, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;McGrath&lt;/span&gt; Nuala, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Iwuji&lt;/span&gt; Collins, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Plazy&lt;/span&gt; M&#233;lanie, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Thi&#233;baut&lt;/span&gt; Rodolphe, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Tanser&lt;/span&gt; Frank, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;B&#228;rnighausen&lt;/span&gt; Till, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Orne-Gliemann&lt;/span&gt; Joanna, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Pillay&lt;/span&gt; Deenan, &lt;span style=&#034;font-variant: small-caps;&#034;&gt;Dabis&lt;/span&gt; Fran&#231;ois and &lt;span style=&#034;font-variant: small-caps;&#034;&gt;ANRS 12249 TasP Study Group&lt;/span&gt; (2018) &#8220;Temporal trends of population viral suppression in the context of Universal Test and Treat: results from the ANRS 12249 TasP trial in rural South Africa&#8221; (communication orale TUAC0103), presented at the &lt;span style=&#034;font-style: italic;&#034; &gt;22nd International AIDS Conference&lt;/span&gt;, Amsterdam. http://programme.aids2018.org/Programme/Session/105.&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;&lt;/div&gt;
		
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<item xml:lang="en">
		<title>Mobility in Africa: human rights and the HIV care cascade</title>
		<link>https://www.joseph.larmarange.net/Mobility-in-Africa-human-rights</link>
		<guid isPermaLink="true">https://www.joseph.larmarange.net/Mobility-in-Africa-human-rights</guid>
		<dc:date>2018-07-30T09:37:10Z</dc:date>
		<dc:format>text/html</dc:format>
		<dc:language>en</dc:language>
		<dc:creator>Joseph LARMARANGE</dc:creator>


		<dc:subject>VIH / SIDA</dc:subject>
		<dc:subject>Pr&#233;vention</dc:subject>
		<dc:subject>Afrique subsaharienne</dc:subject>
		<dc:subject>Migrations</dc:subject>
		<dc:subject>Droits humains</dc:subject>
		<dc:subject>TasP (ANRS 12249)</dc:subject>
		<dc:subject>Prise en charge</dc:subject>
		<dc:subject>Cascade des soins</dc:subject>
		<dc:subject>Europe</dc:subject>

		<description>
&lt;p&gt;Oral communication presented at the 22&lt;sup class=&#034;typo_exposants&#034;&gt;nd&lt;/sup&gt; International AIDS Conference in Amsterdam the 24&lt;sup class=&#034;typo_exposants&#034;&gt;th&lt;/sup&gt; of July, 2018, in a satellite session entitled Population Mobility: Challenges for Universal HIV Testing and Treatment. Author &lt;br class='autobr' /&gt;
Joseph Larmarange See also &lt;br class='autobr' /&gt;
The impact of population dynamics on the population HIV care cascade&#160;: results from the ANRS 12249 Treatment as Prevention trial in rural KwaZulu&#8208;Natal (South Africa) Medias aidsmap Reference &lt;br class='autobr' /&gt;
Larmarange Joseph (2018) &#8220;Mobility in Africa:&#160;(&#8230;)&lt;/p&gt;


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 <content:encoded>&lt;img src='https://www.joseph.larmarange.net/local/cache-vignettes/L150xH100/arton237-c6e7d.jpg?1715148446' class='spip_logo spip_logo_right' width='150' height='100' alt=&#034;&#034; /&gt;
		&lt;div class='rss_chapo'&gt;&lt;p&gt;Oral communication presented at the &lt;a href=&#034;http://www.aids2018.org/&#034; class=&#034;spip_out&#034; rel=&#034;external&#034;&gt;22&lt;sup&gt;nd&lt;/sup&gt; International AIDS Conference&lt;/a&gt; in Amsterdam the 24&lt;sup class=&#034;typo_exposants&#034;&gt;th&lt;/sup&gt; of July, 2018, in a satellite session entitled &lt;i&gt;Population Mobility: Challenges for Universal HIV Testing and Treatment&lt;/i&gt;.&lt;/p&gt;&lt;/div&gt;
		&lt;div class='rss_texte'&gt;&lt;h2 class=&#034;spip&#034;&gt;
Author&lt;/h2&gt;
&lt;p&gt;Joseph Larmarange&lt;/p&gt;
&lt;h2 class=&#034;spip&#034;&gt;
See also&lt;/h2&gt;
&lt;p&gt;&lt;a href='https://www.joseph.larmarange.net/The-impact-of-population-dynamics' class=&#034;spip_in&#034; hreflang=&#034;fr&#034;&gt;The impact of population dynamics on the population HIV care cascade&#160;: results from the ANRS 12249 Treatment as Prevention trial in rural KwaZulu&#8208;Natal (South Africa)&lt;/a&gt;&lt;/p&gt;
&lt;h2 class=&#034;spip&#034;&gt;
Medias&lt;/h2&gt;&lt;ul class=&#034;spip&#034; role=&#034;list&#034;&gt;&lt;li&gt; &lt;a href=&#034;http://www.aidsmap.com/page/3313860/&#034; class=&#034;spip_out&#034; rel=&#034;external&#034;&gt;aidsmap&lt;/a&gt;&lt;/li&gt;&lt;/ul&gt;&lt;h2 class=&#034;spip&#034;&gt;
Reference&lt;/h2&gt;
&lt;p&gt;&lt;abbr class=&#034;unapi-id&#034; title=&#034;4GK2B3MK&#034;&gt;&lt;/abbr&gt;&lt;span class=&#034;csl-bib-body&#034;&gt;&lt;span class=&#034;csl-entry&#034;&gt;&lt;span style=&#034;font-variant: small-caps;&#034;&gt;Larmarange&lt;/span&gt; Joseph (2018) &#8220;Mobility in Africa: human rights and the HIV care cascade&#8221; (communication orale TUSA1802), presented at the &lt;span style=&#034;font-style: italic;&#034; &gt;22nd International AIDS Conference&lt;/span&gt;, Amsterdam. http://programme.aids2018.org/Programme/Session/221.&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;&lt;/div&gt;
		
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