Comparing the Information and Support Needs of Different Population Groups in Preparation for 2015 Government Approval for HIV Self-testing in France

<div><p>Context</p><p>HIV self-tests are currently being introduced in France with the aim of promoting screening both for the general population and for high-risk populations.</p><p>Objective</p><p>The current study aimed to identify and compare the information and support needs of the different target population groups.</p><p>Methods</p><p>The Delphi process was used to synthesize expert opinions for each population group. Experts were chosen for their experience and expertise in the area of HIV and HIV screening for each population. Each group developed recommendations for a specific population: six high HIV prevalence populations (men who have sex with men; transgender people; substance users; migrants from sub-Saharan Africa; French West Indies; French Guiana) and two low prevalence populations (the general population; people under 25). Each group included expertise from four areas: research, screening and care, policy-making, and community groups.</p><p>Results</p><p>A final total of 263 recommendations were grouped into eight main themes: <i>Communicating at both national and community levels about self-test arrival</i> (24% of all recommendations); <i>Providing information adapted to the different community groups’ needs</i> (23%); <i>Providing counselling on self-test use and access to care</i> (15%); <i>Making self-tests available to all in terms of accessibility and cost</i> (13%); <i>Preparing community healthcare and screening systems for the arrival of the self-test</i> (11%); <i>Approving only high quality self-tests</i> (6%); <i>Defending self-test users’ legal rights</i> (5%); <i>Evaluating self-test use</i> (3%). Although a large number of recommendations were common to several groups of experts, the study highlighted a certain number of recommendations specific to each different population group, particularly with regard to information content and access both to information and to the self-tests themselves.</p><p>Conclusion</p><p>Results from the current study should make a significant contribution to policy decisions concerning catering for the specific access, information and support needs of different potential HIV self-test user groups in France.</p></div

Number of recommendations for each expert group.

<p>Number of recommendations for each expert group.</p

Characteristics of the experts in each population group.

<p>Characteristics of the experts in each population group.</p

Number of recommendations for each major theme.

<p>Number of recommendations for each major theme.</p

Variants of HCV entry factors found in HIV-infected, HCV-uninfected patients but not in HIV/HCV-coinfected controls.

<p>^a Database single nucleotide polymorphism. ^b 1000 Genomes database. ^c refSNP reference identification number of single nucleotide polymorphism. ^d Not attributed. ^e Minor allele frequency. ^f Intravenous drug users.</p

Primers used to sequence the SCARB1 gene.

<p>Primers used to sequence the SCARB1 gene.</p

Primers used to sequence the CLDN6, CLDN9 and OCLN genes.

<p>Primers used to sequence the CLDN6, CLDN9 and OCLN genes.</p

Schematic representation of of CLDN6, CLDN9, OCLN and SCARB1 genes.

<p>Exons are represented by numbered gray rectangles and introns or non coding regions by double blue lines. Positions of primers pairs used for direct genomic sequencing are shown. Reference sequences of the transcripts are NM_021195.4 (CLDN6), NM_020982.3 (CLDN9), NM_002538.3 (OCLN) and NM_005505.4 (SCARB1). The numbering starts at the first base of the initiation codon ATG, and stops at the first base of the termination codon of the corresponding transcripts. The sequences of corresponding primers are shown in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0142698#pone.0142698.t001" target="_blank">Table 1</a> and <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0142698#pone.0142698.t002" target="_blank">Table 2</a>. F: Forward primer, R: Reverse primer, LR: Long Range PCR primer. SNPs identified by direct genomic sequencing are indicated, in red SNPs specific of the case population HIV+ HCV-.</p

Baseline characteristics of the 987 patients from the ANRS PRIMO cohort 1999–2010.

<p>TPHA = <i>Treponema palladium</i> haemagglutination assay; VDRL = Venereal Diseases Research Laboratory test; HBV = hepatits B virus; HCV = hepatitis C virus.</p

CLDN6/R209Q and OCLN/P24A mutations do not affect the kinetics of HCV entry and cellular physiology.

<p>Huh-7 cells were transduced with CLDN6/wt or CLDN6/R209Q and OCLN/wt or OCLN/P24A either alone or in combination. (<b>A</b>) Forty-eight hours after the last transduction round, cells were infected with HCVcc for 2h, 1h30, 1h or 30min. After infection, cells were rinsed and fresh medium was added. At 30h post-infection, cells were lysed and <i>Gaussia</i>-luciferase activities were measured. Results were normalized to luciferase activities measured in cells expressing the wt forms of CLDN6 and OCLN. (<b>B</b>) Cells were infected with HCVcc at indicated m.o.i. in serum-free DMEM for 2 h. At 30 h post-infection, cells were lysed and <i>Gaussia</i>-luciferase activities were measured. Results were normalized to luciferase activities measured in cells expressing the wt forms of CLDN6 and OCLN. Results are presented as mean ± SD of two independent experiments. (<b>C</b>) Huh-7-Lunet-CD81-FLuc cells, which endogenously expressed the <i>Firefly</i>-luciferase reporter gene, were transduced with CLDN6/wt or CLDN6/R209Q and OCLN/wt or OCLN/P24A either alone or in combination. Forty-eight hours after the last transduction round, cells were infected with HCVcc expressing the <i>Gaussia</i>-luciferase reporter gene. At 30h post-infection, cells were lysed and luciferase activities were measured with the Dual-luciferase^® reporter assay system (Promega). <i>Gaussia</i>-luciferase activities were normalized to Huh-7-Lunet-CD81 cells <i>Firefly</i>-luciferase activities. Results were adjusted to 100% infection for cells expressing the wt forms of CLDN6 and OCLN. Results are presented as mean ± SD of at least three independent experiments.</p