Sexual prevention of HIV within the couple after prenatal HIV-testing in West Africa AIDS IMPACT

International audienceThe resumption of sexual activity after delivery is a key moment in the management of the risk of sexual HIV transmission within the couple for women who had been prenatally tested for HIV. In this study, we have investigated consistent condom use during the resumption of sexual activity and its evolution over time among women tested for HIV infection during pregnancy. We tested for HIV during pregnancy 546 HIV-infected and 393 HIV-negative women within the Ditrame Plus ANRS project in Abidjan; these women were followed-up for two years after delivery. Most HIV-negative women (96.7%) disclosed their HIV-test result to their partners, whereas only 45.6% of HIV-infected women did it (p<0.001). Partners of HIV-infected women were more likely to be tested for HIV before resuming sexual activity than partners of HIV-negative women (11.7% versus 7.4% p=0.054). Less than one third of both HIV-infected and HIV-negative women reported having systematically used condoms during the resumption of sexual activity. The proportions of HIV-infected and HIV-negative women having consistently used condom were respectively 26.2% and 19.8% (p=0.193) at 3 months post-partum, 12.1% and 15.9% (p=0.139) at 12 months post-partum, 8.4% and 10.6%, (p=0.302) at 18 months post-partum. In our study, although women had been prenatally tested for HIV and properly counselled on the sexual risk of HIV transmission, male partners were not tested for HIV before the resumption of sexual activity after delivery, very few couples were using condoms systematically and condom use was decreasing over time

Dialogue conjugal sur le préservatif après un dépistage prénatal à Abidjan

Poster. 4ème Conférence Francophone VIH/sida, Cité des Sciences et de L'Industrie 29-31 Paris, mars 200

Social and mental health risks faced by undocumented migrants during the COVID-19 pandemic: Evidence from three surveys in France

International audienceThe often-precarious life circumstances of undocumented migrants are likely to heighten the detrimental impact of the COVID-19 pandemic on their lives. Given the paucity of research exploring how undocumented migrants are affected by the COVID-19 pandemic, we set out to explore the association between being an undocumented migrant and a range of social and mental health measures. Methods Our study draws on three complementary surveys conducted among migrants in France between April 1st and June 7th 2020 (APART TOGETHER, MAKASI, ECHO; n = 716). We tested associations between eight outcome measures, covering health literacy, prevention behaviours, perceptions of government responses, livelihoods and mental health (PHQ-9 score), and the participants' legal status as either undocumented or documented. We modelled the probability of food insecurity increase, job loss, depression, and responses to SARS-COV-2 symptoms with logistic regression models, adjusted for age, gender and legal status. Results Undocumented migrants had a higher probability of experiencing food insecurity increase (aORs=10.40 [3.59, 30.16], and 2.19 [1.39, 3.50] in APART TOGETHER and ECHO), a higher probability of depression (aOR=2.65 [1.01, 6.97] in MAKASI). In all three surveys, undocumented migrants were more likely to lose their job (aORs=6.51 [1.18, 36.00], 8.36 [1.08, 64.70] and 3.96 [1.79, 9.16] in APART TOGETHER, MAKASI and ECHO respectively). Conclusion Our results suggest that the lives of undocumented migrants have been dramatically worsened by the COVID-19 pandemic, exposing and amplifying the inequalities facing this group. There is an urgent need for action to address these inequalities

Social and mental health risks faced by undocumented migrants during the COVID-19 pandemic: Evidence from three surveys in France

International audienceThe often-precarious life circumstances of undocumented migrants are likely to heighten the detrimental impact of the COVID-19 pandemic on their lives. Given the paucity of research exploring how undocumented migrants are affected by the COVID-19 pandemic, we set out to explore the association between being an undocumented migrant and a range of social and mental health measures. Methods Our study draws on three complementary surveys conducted among migrants in France between April 1st and June 7th 2020 (APART TOGETHER, MAKASI, ECHO; n = 716). We tested associations between eight outcome measures, covering health literacy, prevention behaviours, perceptions of government responses, livelihoods and mental health (PHQ-9 score), and the participants' legal status as either undocumented or documented. We modelled the probability of food insecurity increase, job loss, depression, and responses to SARS-COV-2 symptoms with logistic regression models, adjusted for age, gender and legal status. Results Undocumented migrants had a higher probability of experiencing food insecurity increase (aORs=10.40 [3.59, 30.16], and 2.19 [1.39, 3.50] in APART TOGETHER and ECHO), a higher probability of depression (aOR=2.65 [1.01, 6.97] in MAKASI). In all three surveys, undocumented migrants were more likely to lose their job (aORs=6.51 [1.18, 36.00], 8.36 [1.08, 64.70] and 3.96 [1.79, 9.16] in APART TOGETHER, MAKASI and ECHO respectively). Conclusion Our results suggest that the lives of undocumented migrants have been dramatically worsened by the COVID-19 pandemic, exposing and amplifying the inequalities facing this group. There is an urgent need for action to address these inequalities

Effect of early antiretroviral therapy on sexual behaviors and HIV-1 transmission risk in adults with diverse heterosexual partnership status in Cote d'Ivoire.: Effect of early ART on sexual behaviors

International audienceBackground. The effect of early antiretroviral therapy (ART) on sexual behaviors and HIV-1 transmission risk has not been documented beyond the specific population of stable serodiscordant couples.Methods. Based on a behavioral study nested in a randomized controlled trial (Temprano-ANRS12136) of early ART, we compared proportions of risky sex (unprotected sex with a partner of negative/unknown HIV status) reported 12 months after inclusion between participants randomized to initiate ART immediately ('early ART') or according to WHO criteria ('standard ART'). Group-specific HIV-transmission rates were estimated based on sexual behaviors and viral load-specific per-act HIV-1 transmission probabilities. Their ratio was computed to estimate the protective effect of early ART.Results. Among 957 participants (baseline CD4: 478/mm(3)), 46.0% reported sexual activity in the past month, 41.5% of them with non-cohabiting partners. Proportion of risky sex was 10.0% vs. 12.8%, respectively, in participants on early vs. standard ART (p=0.17). Accounting for sexual behaviors and viral load, the estimated protective effect of early ART was 90% (95%CI 81-95%).Conclusion. Twelve months after inclusion, patients on early and standard ART reported similar sexual behaviors. Early ART decreased the estimated risk of HIV transmission by 90%, suggesting a major prevention benefit among both stable and casual partners

Refusal to Provide Healthcare to Sub-Saharan Migrants in France: A Comparison According to Their HIV and HBV Status

International audienc