Joseph Larmarange

Knowledge, attitudes and practices relating to HIV self-testing following its introduction in the Bas-Sassandra region of Côte d'Ivoire: the case of the ATLAS project

Joseph LARMARANGE — 2026-01-30T17:14:26Z

Knowledge, attitudes and practices relating to HIV self-testing following its introduction in the Bas-Sassandra region of Côte d'Ivoire: the case of the ATLAS project

Arlette Simo Fotso , Christian Koukobo , Romain Silhol , Arsene Kra Kouassi , Marie-Claude Boily , Anthony Vautier , Joseph Larmarange

PLoS ONE, 2026, 21 (1), pp.e0314947. ⟨10.1371/journal.pone.0314947⟩

Article dans une revue

hal-05486495

Authors

Arlette Simo Fotso, Christian Koukobo, Romain Silhol, Arsène Kouassi Kra, Marie-Claude Boily, Anthony Vautier, Joseph Larmarange on behalf of the ATLAS team

Abstract

Background

Awareness of HIV status is crucial for accessing HIV care and prevention but remains suboptimal in West Africa. The ATLAS initiative, launched in Côte d'Ivoire, Mali, and Senegal, addressed this gap by distributing approximately 380,000 HIV self-testing (HIVST) kits from 2019 to 2021, primarily to key populations and their social networks. This study assessed levels and correlates of Knowledge, Attitudes, and Practices (KAP) related to HIVST in the Bas-Sassandra region of Côte d'Ivoire following ATLAS's introduction.

Method

A cross-sectional population-based survey was conducted in the Bas-Sassandra region in 2021 among individuals aged 15–49. A total of 6,271 people (3,203 men and 3,068 women) were interviewed. They were selected using a three-stage stratified sampling approach in the Bas-Sassandra region. Bivariate statistics and multivariable logistic regressions were used to assess KAP levels and the associated factors.

Results

Although few participants reported having heard about HIVST (11%) or having used it (3%), most of them reported that if it were freely available, they would be interested/very interested in using it for themselves (76%), as well as for their sexual partners (75%). Education and wealth were positively associated with knowledge and positive attitudes towards HIVST among both men and women, whereas age was positively correlated to knowledge and use of HIVST among men only. The number of sexual partners over the last 12 months was positively associated with knowledge of HIVST and willingness to use HIVST for themselves or their sexual partners among both sexes. We also found that high HIV-related knowledge and low levels of negative attitude were positively associated with positive attitudes towards HIVST, while exposure to the media appeared to be correlated to knowledge of HIVST.

Conclusion

The high level of positive attitudes towards HIVST calls for a scaling up of access to HIVST in the region. Specific attention to groups with the worst KAP, such as the less educated, the poor or those with more HIV-related negative attitude, could enhance the success of such initiatives.

Pilot Implementation of HIV Self-Testing Delivery in Private Pharmacies Combined With a Respondent-Driven Sampling Method to Improve HIV Testing for Men Who Have Sex With Men and Transgender Women in Phnom Penh (ANRS 0100s): Protocol for a Prospective Mixed Method Feasibility Study

Joseph LARMARANGE — 2025-06-27T09:45:00Z

Pilot Implementation of HIV Self-Testing Delivery in Private Pharmacies Combined With a Respondent-Driven Sampling Method to Improve HIV Testing for Men Who Have Sex With Men and Transgender Women in Phnom Penh (ANRS 0100s): Protocol for a Prospective Mixed Method Feasibility Study

Chhavarath Dary , Olivier Ségéral , Joseph Larmarange , Emilie Mosnier , Mohamed Ben Mechlia , Vichea Ouk , Bruno Spire , Vonthanak Saphonn

JMIR Research Protocols, 2025, 14, pp.e65351. ⟨10.2196/65351⟩

Article dans une revue

inserm-05471400

Authors

Chhavarath Dary, Olivier Ségéral, Joseph Larmarange, Emilie Mosnier, Mohamed Ben Mechlia, Vichea Ouk, Bruno Spire, Vonthanak Saphonn

Abstract

Background: Regular testing is recognized as a key strategy for HIV control. The 2023 Integrated Biological and Behavioral Survey (IBBS) in Cambodia revealed that nearly one-third of men who have sex with men (MSM) and one-fourth of transgender women (TGW) were never tested for HIV or not for more than 12 months. The majority of MSM and TGW were tested at community-based organizations (CBOs) facilities and by CBO outreach workers, while private facilities are poorly used for HIV testing (6% for MSM and 9% for TGW). Private pharmacies could be able to deliver HIV self-testing kits giving the advantage of confidentiality, anonymity, and time savings, in particular for those reluctant to visit CBOs. The recruitment of participants using a respondent-driven sampling method could provide the opportunity to reach MSM and TGW outside the network of CBOs.

Objective: This pilot study aims to evaluate the feasibility of free HIV self-testing delivery by a private pharmacy combined with a respondent-driven sampling method to improve HIV testing among MSM and TGW in Phnom Penh, Cambodia.

Methods: Both qualitative and quantitative approaches are used in this prospective feasibility study. The protocol was approved by the National Ethics Committee for Health Research in Cambodia (N0 351 NECHR). MSM and TGW aged more than 18 years old will be recruited via a respondent-driven sampling method with seeds recruited at hot spots and on social networks. The seeds will then distribute electronic and paper coupons to their networks physically and via social media, messaging, and calling applications. Each recruited peer will bring the coupon to receive direct and free access to one HIV self-testing kit at partner pharmacies as well as 10 additional coupons to recruit members of their networks. As for quantitative analysis, data from the study website will be imported, appended into a single matrix using Stata version 18SE (StataCorp), and analyzed using descriptive statistics, with a statistical significance level of .05. After 6 months, a qualitative assessment will be conducted among users, providers, and policymakers or key stakeholders to evaluate the acceptability and appropriateness of the strategy and to identify the barriers, facilitators, and recommendations. All transcripts will be analyzed according to the 6-phase reflexive thematic approach by Braun and Clarke. The results will be reported by participant-based and provider-based issues. QSR NVivo V.14 for Windows will be used to manage the data.

Results: The study was funded by Agence nationale de recherches sur le sida, les hépatites, et les maladies infectieuses émergentes (ANRS) in September 2023. Approval of the study protocol was successfully obtained from the NECHR in Cambodia and the Commission Nationale de l'Informatique et des Libertés (CNIL) in France (Autorisation Tacite) in February 2025. Data collection will be conducted between September 2024 and December 2025. The initial results are expected to be published in February 2026.

Conclusions: This public-private partnership intervention could allow the hidden population of MSM and TGW in Phnom Penh to be reached and tested.

Trial Registration: ClinicalTrials.gov NCT05745168; https://clinicaltrials.gov/study/NCT05745168

La fin du sida est-elle toujours en vue ?

Joseph LARMARANGE — 2025-03-27T10:47:15Z

La fin du sida est-elle toujours en vue ?
Joseph Larmarange Journée Scientifique Sidaction 2025, Sidaction, Mar 2025, Paris, France Communication dans un congrès hal-05008296
Plénière d'ouverture de Journée scientifique Sidaction 2025, le 27 mars 2025 à Paris.

- Communications / Accès aux soins, Dépistage, Financement des programmes, Mesure d'impact, Pepfar, Politiques publiques, Prévention, Santé publique, Santé sexuelle, Science de la mise en œuvre , Traitement antirétroviral (ARV), Treatment as Prevention (TasP), VIH / SIDA

Syndromic and biological screening for sexually transmitted infections in female sex workers in Côte d'Ivoire: the ANRS 12381 PRINCESSE cohort study

Joseph LARMARANGE — 2025-03-13T17:07:15Z

Syndromic and biological screening for sexually transmitted infections in female sex workers in Côte d'Ivoire: the ANRS 12381 PRINCESSE cohort study

Marcellin N'zebo Nouaman , Patrick Ahuatchi Coffie , Aline Agoua , Clémence Zébago , Hervé Dao , Evelyne Kissi , Séverin Lenaud , Mian Anatole , Valentine Becquet , Mélanie Plazy , François Dabis , Serge Eholie , Joseph Larmarange

Frontiers in Public Health, 2025, 13, ⟨10.3389/fpubh.2025.1535122⟩

Article dans une revue

hal-04990223

Authors

Marcellin N'zebo Nouaman, Patrick Ahuatchi Coffie, Aline Agoua, Clémence Zébago, Hervé Dao, Evelyne Kissi, Séverin Lenaud, Mian Anatole, Valentine Becquet, Mélanie Plazy, François Dabis, Serge Eholie, Joseph Larmarange for the ANRS 12381 Princesse Study group

Abstract

Background: Female sex workers (FSWs) are at high risk of contracting STIs, in particular in Sub-Saharan Africa. The implementation of oral HIV pre-exposure prophylaxis provided an opportunity to draw attention to the sexual health needs of FSWs. Innovative strategies to screen for and reduce the burden of STIs is thus a priority. This study describes STI screening among FSWs enrolled in the PRINCESSE project in Côte d'Ivoire.

Methods: The PRINCESSE project (2019–2023) was an interventional cohort of FSWs ≥18 years, evaluating a comprehensive, community-based sexual and reproductive health care package, including the management of STIs, offered through mobile clinics operating on prostitution sites in San Pedro area. HIV testing and syndromic STI testing were offered at baseline and every 3 months. Biological testing of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) was offered annually. Clinical forms included sociodemographic, behavioral and sex-work-related characteristics. We describe baseline characteristics, coverage of clinical examination, and vaginal, anal swab collection. Social, behavioral and sex work-related factors associated with an STI syndromic diagnosis were explored. A multivariable logistic regression model was used to identify factors associated with diagnosing a symptomatic STI.

Results: 489 FSWs were included in the PRINCESSE cohort. Median age was 29 years (24–35 years), 28.6% had had sex without a condom in the last 7 days. The prevalence of HIV at baseline was 10.5%. Only one case of HIV seroconversion was observed during the project. The most frequent symptom was ano-vaginal discharge (19.1%). The prevalence of STI based on clinical symptoms was 26.6%. The proportion of vaginal swab samples for which the PCR result was positive was 8.0% for CT and 4.0% for NG. Only age remained significantly associated with diagnosing a symptomatic STI in the multivariable analysis.

Conclusion: This study revealed a high prevalence of HIV and STIs, similar to national estimates among FSWs enrolled in a sexual health cohort. Screening for these generically asymptomatic bacterial STIs must be combined with the syndromic approach used in key populations, especially with the introduction of new PrEP programs, to reduce the exposure of individuals in these populations to STIs.

Cost-effectiveness analysis of community-led HIV self-testing among key populations in Côte d'Ivoire, Mali, and Senegal

Joseph LARMARANGE — 2024-07-21T15:55:00Z

Cost‐effectiveness analysis of community‐led HIV self‐testing among key populations in Côte d'Ivoire, Mali, and Senegal

Ingrid Jiayin Lu , Romain Silhol , Marc d'Elbée , Marie-Claude Boily , Nirali Soni , Odette Ky-Zerbo , Anthony Vautier , Arlette Simo Fotso , Kéba Badiane , Metogara Traoré , Fern Terris-Prestholt , Joseph Larmarange , Mathieu Maheu-Giroux

Journal of the International AIDS Society, 2024, 27 (7), pp.1-12. ⟨10.1002/jia2.26334⟩

Article dans une revue

hal-04660337

Authors

Ingrid Jiayin Lu, Romain Silhol, Marc d'Elbée, Marie-Claude Boily, Nirali Soni, Odette Ky-Zerbo, Anthony Vautier, Artlette Simo Fosto, Kéba Badiane, Metogara Traoré, Fern Terris-Prestholt, Joseph Larmarange, Mathieu Maheu-Giroux, for the ATLAS Team

Abstract

Introduction

HIV self-testing (HIVST) is a promising strategy to improve diagnosis coverage among key populations (KP). The ATLAS (Auto Test VIH, Libre d'Accéder à la connaissance de son Statut) programme implemented HIVST in three West African countries, distributing over 380,000 kits up between 2019 and 2021, focussing on community-led distribution by KP to their peers and subsequent secondary distribution to their partners and clients. We aim to evaluate the cost-effectiveness of community-led HIVST in Côte d'Ivoire, Mali and Senegal.

Methods

An HIV transmission dynamics model was adapted and calibrated to country-specific epidemiological data and used to predict the impact of HIVST. We considered the distribution of HIVST among two KP—female sex workers (FSW), and men who have sex with men (MSM)—and their sexual partners and clients. We compared the cost-effectiveness of two scenarios against a counterfactual without HIVST over a 20-year horizon (2019–2039). The ATLAS-only scenario mimicked the 2-year implemented ATLAS programme, whereas the ATLAS-scale-up scenario achieved 95% coverage of HIVST distribution among FSW and MSM by 2025 onwards. The primary outcome is the number of disability-adjusted life-years (DALY) averted. Scenarios were compared using incremental cost-effectiveness ratios (ICERs). Costing was performed using a healthcare provider's perspective. Costs were discounted at 4%, converted to $USD 2022 and estimated using a cost-function to accommodate economies of scale.

Results

The ATLAS-only scenario was highly cost-effective over 20 years, even at low willingness-to-pay thresholds. The median ICERs were $126 ($88–$210) per DALY averted in Côte d'Ivoire, $92 ($88–$210) in Mali and 27$ ($88–$210) in Senegal. Scaling-up the ATLAS programme would also be cost-effective, and substantial epidemiological impacts would be achieved. The ICERs for the scale-up scenario were $199 ($122–$338) per DALY averted in Côte d'Ivoire, $224 ($118–$415) in Mali and $61 ($18–$128) in Senegal.

Conclusions

Both the implemented and the potential scale-up of community-led HIVST programmes in West Africa, where KP are important to overall transmission dynamics, have the potential to be highly cost-effective, as compared to a scenario without HIVST. These findings support the scale-up of community-led HIVST to reach populations that otherwise may not access conventional testing services.

Potential population-level effects of HIV self-test distribution among key populations in Côte d'Ivoire, Mali, and Senegal : a mathematical modelling analysis

Joseph LARMARANGE — 2024-07-09T11:57:51Z

Authors

Romain Silhol, Mathieu Maheu-Giroux, Nirali Soni, Arlette Simo Fotso, Nicolas Rouveau, Anthony Vautier, Clémence Doumenc-Aïdara, Olivier Geoffroy, Kouassi Noel N'Guessan, Younoussa Sidibé, Odé Kanku Kabemba, Papa Alioune Gueye, Pauline Dama Ndeye, Christinah Mukandavire, Prof Peter Vickerman, Abdelaye Keita, Prof Cheikh Tidiane Ndour, Joseph Larmarange, Prof Marie-Claude Boily on behalf of theATLAS Team

Abstract

Background

During 2019–21, the AutoTest VIH, Libre d'accéder à la connaissance de son Statut (ATLAS) programme distributed around 380 000 HIV self-testing kits to key populations, including female sex workers, men who have sex with men, and their partners, in Côte d'Ivoire, Mali, and Senegal. We aimed to estimate the effects of the ATLAS programme and national scale-up of HIV self-test distribution on HIV diagnosis, HIV treatment coverage, HIV incidence, and HIV-related mortality.

Methods

We adapted a deterministic compartmental model of HIV transmission in Côte d'Ivoire, parameterised and fitted to country-specific demographic, behavioural, HIV epidemiological, and intervention data in Côte d'Ivoire, Mali, and Senegal separately during 1980–2020. We simulated dynamics of new HIV infections, HIV diagnoses, and HIV-related deaths within scenarios with and without HIV self-test distribution among key populations. Models were separately parameterised and fitted to country-specific sets of epidemiological and intervention outcomes (stratified by sex, risk, age group, and HIV status, if available) over time within a Bayesian framework. We estimated the effects on the absolute increase in the proportion of people with HIV diagnosed at the end of 2021 for the ATLAS-only scenario and at the end of 2028 and 2038 for the HIV self-testing scale-up scenario. We estimated cumulative numbers of additional HIV diagnoses and initiations of antiretroviral therapy and the proportion and absolute numbers of new HIV infections and HIV-related deaths averted during 2019–21 and 2019–28 for the ATLAS-only scenario and during 2019–28 and 2019–38 for the HIV self-testing scale-up scenario.

Findings

Our model estimated that ATLAS could have led to 700 (90% uncertainty interval [UI] 500–900) additional HIV diagnoses in Côte d'Ivoire, 500 (300–900) in Mali, and 300 (50–700) in Senegal during 2019–21, a 04 percentage point (90% UI 03–05) increase overall by the end of 2021. During 2019–28, ATLAS was estimated to avert 1900 (90% UI 1300–2700) new HIV infections and 600 (400–800) HIV-related deaths across the three countries, of which 386% (90% UI 318–483) of new infections and 701% (604–773) of HIV-related deaths would be among key populations. ATLAS would avert 15% (08–31) of all HIV-related deaths across the three countries during this period. Scaling up HIV self-testing would avert 162% (90% UI 100–231) of all new HIV infections during 2019–28 in Senegal, 53% (30–89) in Mali, and 16% (10–24) in Côte d'Ivoire. HIV self-testing scale-up among key populations was estimated to increase HIV diagnosis by the end of 2028 to 13 percentage points (90% UI 08–19) in Côte d'Ivoire, 106 percentage points (53–168) in Senegal, and 36 percentage points (20–64) in Mali.

Interpretation

Scaling up HIV self-test distribution among key populations in western Africa could attenuate disparities in access to HIV testing and reduce infections and deaths among key populations and their partners.

Funding

Unitaid, Solthis, the UK Medical Research Council Centre for Global Infectious Disease Analysis, the EU European & Developing Countries Clinical Trials Partnership programme, and the Wellcome Trust.

The impact of past HIV interventions and diagnosis gaps on new HIV acquisitions, transmissions, and HIV-related deaths in Côte d'Ivoire, Mali, and Senegal

Joseph LARMARANGE — 2024-07-02T17:54:28Z

The impact of past HIV interventions and diagnosis gaps on new HIV acquisitions, transmissions, and HIV-related deaths in Côte d'Ivoire, Mali, and Senegal

AIDS. Official journal of the international AIDS Society, 2024, ⟨10.1097/QAD.0000000000003974⟩

Article dans une revue

hal-04632874

Authors

Silhol Romain; Maheu-Giroux Mathieu; Soni Nirali; Simo Fotso Arlette; Rouveau Nicolas; Vautier Anthony; Doumenc-Aïdara Clémence; Geoffroy Olivier; N'guessan Kouassi Noel; Sidibé Younoussa; Kabemba Odé Kanku; Gueye Papa Alioune; Ndeye Pauline Dama; Mukandavire Christinah; Vickerman Peter; Keita Abdelaye; Ndour Cheikh Tidiane; Ehui Eboi; Larmarange Joseph; Boily Marie-Claude

Abstract

Objectives

To estimate the epidemiological impact of past HIV interventions and the magnitude and contribution of undiagnosed HIV among different risk groups on new HIV acquisitions in Côte d'Ivoire, Mali and Senegal.

Design

HIV transmission dynamic models among the overall population and key populations [female sex workers (FSW), their clients, and MSM].

Methods

Models were independently parameterized and calibrated for each set of country-specific demographic, behavioural, and epidemiological data. We estimated the fraction of new HIV infections over 2012–2021 averted by condom use and antiretroviral therapy (ART) uptake among key population and nonkey population, the direct and indirect contribution of specific groups to new infections [transmission population-attributable fraction (tPAF)] over 2012–2021 due to prevention gaps, and the distribution of undiagnosed PWH by risk group in January 2022 and their tPAF over 2022–2031.

Results

Condom use and ART may have averted 81–88% of new HIV infections over 2012–2021 across countries, mostly because of condom use by key population. The tPAF of all key populations combined over 2012–2021 varied between 27% (Côte d'Ivoire) and 79% (Senegal). Male key population (clients of FSW and MSM) contributed most to new infections (>60% in Mali and Senegal) owing to their higher HIV prevalence and larger prevention gaps. In 2022, men represented 56% of all PWH with an undiagnosed infection in Côte d'Ivoire (male key population = 15%), 46% in Mali (male key population = 23%), and 69% in Senegal (male key population = 55%). If HIV testing and ART initiation rates remain at current levels, 20% of new HIV infections could be due to undiagnosed key population PWH in Côte d'Ivoire over 2022–2031, 53% in Mali, and 65% in Senegal.

Conclusion

Substantial HIV diagnosis gaps remain in Western Africa, especially among male key population. Addressing these gaps is key to impacting the HIV epidemics in the region and achieving the goal of ending AIDS by 2030.

HIV self-testing positivity rate and linkage to confirmatory testing and care: a telephone survey in Côte d'Ivoire, Mali, and Senegal

Joseph LARMARANGE — 2024-06-14T13:29:00Z

HIV self-testing positivity rate and linkage to confirmatory testing and care: a telephone survey in Côte d'Ivoire, Mali, and Senegal

Arsene Kra Kouassi , Arlette Simo Fotso , Nicolas Rouveau , Mathieu Maheu-Giroux , Marie-Claude Boily , Romain Silhol , Marc d'Elbée , Anthony Vautier , Joseph Larmarange

Peer Community Journal, 2024, 4, pp.e56. ⟨10.24072/pcjournal.428⟩

Article dans une revue

hal-04612456

Authors

Arsène Kouassi Kra, Arlette Simo Fotso, Nicolas Rouveau, Mathieu Maheu-Giroux, Marie-Claude Boily, Romain Silhol, Marc d'Elbée, Anthony Vautier, Joseph Larmarange

Abstract

HIV self-testing (HIVST) empowers individuals to decide when and where to test and with whom to share their results. From 2019 to 2022, the ATLAS program distributed ∼ 400 000 HIVST kits in Côte d'Ivoire, Mali, and Senegal. It prioritised key populations, including female sex workers and men who have sex with men, and encouraged secondary distribution of HIVST to their partners, peers and clients.

To preserve the confidential nature of HIVST, use of kits and their results were not systematically tracked. Instead, an anonymous phone survey was carried out in two phases during 2021 to estimate HIVST positivity rates (phase 1) and linkage to confirmatory testing (phase 2). Initially, participants were recruited via leaflets from March to June and completed a sociobehavioural questionnaire. In the second phase (September-October), participants who had reported two lines or who reported a reactive result were recontacted to complete another questionnaire. Of the 2 615 initial participants, 89.7% reported a consistent response between the number of lines on the HIVST and their interpretation of the result (i.e., ‘non-reactive' for 1 line, ‘reactive' for 2 lines).

Overall positivity rate based on self-interpreted HIVST results was 2.5% considering complete responses, and could have ranged from 2.4% to 9.1% depending on the interpretation of incomplete responses. Using the reported number of lines, this rate was estimated at 4.5% (ranging from 4.4% to 7.2%). Positivity rates were significantly lower only among respondents with higher education. No significant difference was observed by age, key population profile, country or history of HIV testing.

The second phase saw 78 out of 126 eligible participants complete the questionnaire. Of the 27 who reported a consistent reactive response in the first phase, 15 (56%, 95%CI: 36 to 74%) underwent confirmatory HIV testing, with 12 (80%) confirmed as HIV-positive, all of whom began antiretroviral treatment.

The confirmation rate of HIVST results was fast, with 53% doing so within a week and 91% within three months of self-testing. Two-thirds (65%) went to a general public facility, and one-third to a facility dedicated to key populations.

The ATLAS HIVST distribution strategy reached people living with HIV in West Africa. Linkage to confirmatory testing following a reactive HIVST remained relatively low in these first years of HIVST implementation. However, if confirmed HIV-positive, almost all initiated treatment. HIVST constitutes a relevant complementary tool to existing screening services.

Organisation of testing services, structural barriers and facilitators of routine HIV self-testing during sexually transmitted infection consultations: a qualitative study of patients and providers in Abidjan, Côte d'Ivoire

Joseph LARMARANGE — 2024-02-27T17:28:12Z

Organisation of testing services, structural barriers and facilitators of routine HIV self-testing during sexually transmitted infection consultations: a qualitative study of patients and providers in Abidjan, Côte d'Ivoire

Sokhna Boye , Alexis Kouadio , Amélé Florence Kouvahe , Anthony Vautier , Odette Ky-Zerbo , Nicolas Rouveau , Mathieu Maheu-Giroux , Romain Silhol , Arlette Simo Fotso , Joseph Larmarange , Dolorès Pourette , Souleymane Sow

BMC Infectious Diseases, 2024, 22 (S1), pp.975. ⟨10.1186/s12879-023-08625-x⟩

Article dans une revue

hal-04480842

Authors

Sokhna Boye, Alexis Kouadio, Amélé Florence Kouvahe, Anthony Vautier, Odette Ky-Zerbo, Nicolas Rouveau, Mathieu Maheu-Giroux, Romain Silhol, Arlette Simo Fotso, Joseph Larmarange & Dolorès Pourette for ATLAS team

Abstract

Background

Consultations for sexually transmitted infection (STI) provide an opportunity to offer HIV testing to both patients and their partners. This study describes the organisation of HIV self-testing (HIVST) distribution during STI consultations in Abidjan (Côte d'Ivoire) and analyse the perceived barriers and facilitators associated with the use and redistribution of HIVST kits by STI patients.

Materials and methods

A qualitative study was conducted between March and August 2021 to investigate three services providing HIVST: an antenatal care clinic (ANC), a general health centre that also provided STI consultations, and a dedicated STI clinic. Data were collected through observations of medical consultations with STI patients (N = 98) and interviews with both health professionals involved in HIVST distribution (N = 18) and STI patients who received HIVST kits for their partners (N = 20).

Results

In the ANC clinic, HIV testing was routinely offered during the first prenatal visit. HIVST was commonly offered to women who had been diagnosed with an STI for their partner's use (27/29 observations). In the general health centre, two parallel pathways coexisted: before the consultation, a risk assessment tool was used to offer HIV testing to eligible patients and, after the consultation, patients who had been diagnosed with an STI were referred to a care assistant for HIVST. Due to this HIV testing patient flow, few offers of HIV testing and HIVST were made in this setting (3/16). At the dedicated STI clinic, an HIVST video was played in the waiting room. According to the health professionals interviewed, this video helped reduce the time required to offer HIVST after the consultation. Task-shifting was implemented there: patients were referred to a nurse for HIV testing, and HIVST was commonly offered to STI patients for their partners' use (28/53). When an HIVST was offered, it was generally accepted (54/58). Both health professionals and patients perceived HIVST positively despite experiencing a few difficulties with respect to offering HIVST to partners and structural barriers associated with the organisation of services.

Conclusion

The organisation of patient flow and task-shifting influenced HIV testing and offers of HIVST kits. Proposing HIVST is more systematic when HIV testing is routinely offered to all patients. Successful integration requires improving the organisation of services, including task-shifting.

L'auto-dépistage : une solution pour lutter contre le VIH en Afrique de l'Ouest

Joseph LARMARANGE — 2024-01-15T10:55:48Z

L'auto-dépistage : une solution pour lutter contre le VIH en Afrique de l'Ouest

Louise Hurel , Joseph Larmarange , Arsene Kra Kouassi

2024

Article de blog scientifique

hal-04394350

L'auto-dépistage du VIH a non seulement l'avantage d'être une méthode anonyme et rapide, mais a aussi et surtout le potentiel d'atteindre de nouveaux publics éloignés des milieux associatifs et médicaux. En effet, une fois distribués, les autotests peuvent être utilisés par les personnes qui les ont récupérés, mais aussi par leurs proches, partenaires sexuels ou collègues. C'est ce qu'on appelle la distribution secondaire et c'est l'un des grands succès du programme Atlas. Financé par Unitaid et mis en œuvre par Solthis et l'IRD, il promeut et déploie l'auto-dépistage du VIH en Côte d'Ivoire, au Mali et au Sénégal. Ainsi, quelque 400 000 autotests VIH y ont été distribués entre 2019 et 2022 auprès de populations clés, comme les travailleuses du sexe, les hommes ayant des rapports sexuels avec des hommes, et les personnes consommant des drogues.

ATLAS et la dispensation secondaire de kits d'autodépistage du VIH
par Projet ATLAS

https://www.youtube.com/watch?v=TJM...

Afin de connaître les pratiques des utilisatrices et utilisateurs finaux dans les trois pays, une enquête téléphonique anonyme a été réalisée de mars à juin 2021. Les retours sont encourageants : parmi les répondants, 30 % avaient reçu leur autotest via la distribution secondaire et, surtout, 41 % n'avait jamais effectué de dépistage avant d'utiliser l'autotest. Des résultats positifs qui confirment que la stratégie déployée par Atlas est une solution faisable, acceptable et soutenable sur le long terme pour lutter contre l'épidémie de VIH et ainsi poursuivre l'objectif 3 de développement durable de l'ONU.

Joseph Larmarange

Knowledge, attitudes and practices relating to HIV self-testing following its introduction in the Bas-Sassandra region of Côte d'Ivoire: the case of the ATLAS project

Knowledge, attitudes and practices relating to HIV self-testing following its introduction in the Bas-Sassandra region of Côte d'Ivoire: the case of the ATLAS project

Authors

Abstract

Pilot Implementation of HIV Self-Testing Delivery in Private Pharmacies Combined With a Respondent-Driven Sampling Method to Improve HIV Testing for Men Who Have Sex With Men and Transgender Women in Phnom Penh (ANRS 0100s): Protocol for a Prospective Mixed Method Feasibility Study

Pilot Implementation of HIV Self-Testing Delivery in Private Pharmacies Combined With a Respondent-Driven Sampling Method to Improve HIV Testing for Men Who Have Sex With Men and Transgender Women in Phnom Penh (ANRS 0100s): Protocol for a Prospective Mixed Method Feasibility Study

Authors

Abstract

La fin du sida est-elle toujours en vue ?

Syndromic and biological screening for sexually transmitted infections in female sex workers in Côte d'Ivoire: the ANRS 12381 PRINCESSE cohort study

Syndromic and biological screening for sexually transmitted infections in female sex workers in Côte d'Ivoire: the ANRS 12381 PRINCESSE cohort study

Authors

Abstract

Cost-effectiveness analysis of community-led HIV self-testing among key populations in Côte d'Ivoire, Mali, and Senegal

Cost‐effectiveness analysis of community‐led HIV self‐testing among key populations in Côte d'Ivoire, Mali, and Senegal

Authors

Abstract

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Abstract

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Abstract

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HIV self-testing positivity rate and linkage to confirmatory testing and care: a telephone survey in Côte d'Ivoire, Mali, and Senegal

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Abstract

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Authors

Abstract

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