Joseph Larmarange

Comparing modelled HIV incidence estimates with empirical HIV incidence observations in high-burden HIV African epidemic settings: systematic review and meta-regression

Joseph LARMARANGE — 2026-02-10T17:15:53Z

Authors

Oliver Stevens, Michelle Moffa, Joanne H. Hunt, Kyle Patel, Tihitna Aytenfisu, Adam Akullian, Rebecca L Anderson, Peter Bock, Amelia C Crampin, Sian Floyd, Simon Gregson, Richard J Hayes, Collins Iwuji, Ivan Kasamba, Daniel Kwaro, Joseph Larmarange, Shahin Lockman, Denna Michael, Louisa Moorhouse, Joseph Mugisha, Elphas Okango, Maya L Petersen, Victor Ssempijja, Emma Slaymaker, Frank Tanser, Cari van Schalkwyk, M. Kate Grabowski, Jeffrey W. Imai-Eaton

Abstract

Background

HIV incidence in sub-Saharan Africa has declined substantially since 2000 according to epidemic estimates published by UNAIDS. These estimates, derived by fitting mathematical models to national surveillance data, guide HIV programmes and epidemic response strategies. We assessed whether the level and age distribution of HIV incidence from modelled estimates were consistent with empirical HIV incidence observations, and whether incidence levels and trends were systematically different between study types, populations, and age groups.

Methods

We conducted an updated systematic review of adult HIV incidence data from sub-Saharan Africa published July 2019-February 2024 by searching Scopus, PubMed, Embase, and OVID databases, and combined with earlier systematic review data. We matched empirical incidence measurements between 1990-2023 to UNAIDS HIV incidence estimates by study area, sex, age group, and year. We used Bayesian mixed-effect Poisson regression to estimate (1) incidence rate ratios (IRR) between empirical observations and matched modelled incidence estimates adjusted for sex, year and study type/population; and (2) time trends in age-specific incidence from population-based cohort studies and household surveys.

Results

3560 HIV empirical incidence measurements were included from 179 studies conducted in 21 countries, comprising 23,000 new infections and 3.1 million person-years. Incidence observations from nationally-representative household surveys (IRR 1.07 95%CI 0.68, 1.67) and population-representative study populations (IRR 0.98 95%CI 0.51, 1.89) were not significantly different from matched modelled estimates, and declined at the same rate as modelled estimates (annual aRR 0.99 95%CI 0.98, 1.01). Studies among pregnant women (IRR 2.60 95%CI 1.58, 4.28), control arms of clinical trials (IRR 3.01 95%CI 1.90, 4.77) and key populations (FSW IRR: 6.46 95%CI 4.18, 10.00; MSM 44.02 95%CI 27.35, 70.87) had significantly higher incidence than modelled total population incidence estimates. Across population cohorts in Eastern and Southern Africa, HIV incidence among adults aged 15-49 declined by 75-90% between 2010-2023, and declined 7% (95%CI 4-10%) faster per year among young adults 15-24 compared to age 25+ years. Modelled incidence declined similarly to cohort data, but did not reflect the aging of the epidemic.

Conclusion

Observed incidence in population-representative studies in sub-Saharan Africa has declined steeply. Mathematical models that infer incidence from cross-sectional HIV surveillance data estimated the same incidence level and decline over time as population-representative studies. Studies with non-representative inclusion criteria had significantly higher incidence, including those among pregnant women and most HIV prevention/vaccine efficacy trials. The age pattern of incidence in modelled estimates should be reconsidered to capture the aging of the epidemic indicated by cohort studies.

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.

Adoption of HIV preexposure prophylaxis (PrEP) among female sex workers (FSWs) in Côte d'Ivoire: complex trajectories and early adopters

Joseph LARMARANGE — 2025-07-15T15:10:30Z

Adoption of HIV preexposure prophylaxis (PrEP) among female sex workers (FSWs) in Côte d'Ivoire: complex trajectories and early adopters

Joseph Larmarange , Mélanie Plazy , Marcellin Nouaman , Evelyne Kissi , Rose-Marcelle Dedocoton , Patrick Coffie , Serge Eholié , Valentine Becquet

IAS 2025, the 13th IAS Conference on HIV Science, International AIDS Society, Jul 2025, Kigali, Rwanda

Communication dans un congrès

hal-05163730

Authors

Joseph Larmarange, Mélanie Plazy, Marcellin Nouaman, Evelyne Kissi, Rose-Marcelle Dedocoton, Patrick Coffie, Serge Eholié, Valentine Becquet

Abstract

BACKGROUND: The ANRS 12381 PRINCESSE project (11/2019-06/2023) enrolled 489 FSWs and implemented community-based sexual and reproductive health care, including PrEP, delivered through mobile clinics at prostitution sites in the San Pedro region. This presentation aims to describe PrEP trajectories and the factors associated with its use, focusing on “early adopters”.

METHODS: This analysis included 400 FSWs eligible for PrEP (HIV-negative, HBsAg-negative) enrolled up to December 2022 (>6 months of follow-up). Clinical records were analyzed to describe PrEP cascade, follow-up, and PrEP trajectories. A multivariable logistic regression identified factors associated with PrEP early adopters.

RESULTS: Although 98% of eligible FSWs were interested in PrEP, only 62% initiated PrEP, and 39% renewed it at least once.
Follow-up was very short (<6 months) for 48%, short (6-12 months) for 15%, seasonal (>12 months with a gap of 6 months between two visits) for 31%, and regular (>12 months with no gap) for 6%.
PrEP initiation was high among FSWs with regular (96%), seasonal (83%), or short (80%) follow-up, vs. 39% for those with very short follow-up. Among those who initiated, only 88% (regular), 70% (seasonal), 74% (short), and 35% (very short) renewed PrEP.
Among 148 FSWs with regular/seasonal follow-up, four PrEP trajectories were identified (cf. figure showing individual trajectories): 15% “never initiated” PrEP, 39% “initiated and were later not interested anymore”, 18% “re-initiated after non-interest”, and 28% “initiated and never expressed non-interest”, the last two groups being considered as “early adopters”. Factors associated with early PrEP adoption included the usual price of intercourse with clients <1500 FCFA (aOR=2.4 [1.2-4.8]) and working in brothels (aOR=3.2 [1.6-6.6]).


Figure presenting individual PrEP trajectories of FSWs enrolled in the PRINCESSE project

CONCLUSIONS: In PRINCESSE, loss-to-follow-up and seasonality of risks limited PrEP adoption. FSWs who were more precarious and less mobile became early adopters of this new prevention tool and could serve as potential ambassadors for promoting its uptake.

ANRS 12381 PRINCESSE @ AIDSImpact 2025: PrEP adoption & perceptions of long acting PrEP

Joseph LARMARANGE — 2025-05-30T14:21:01Z

Adoption of HIV preexposure prophylaxis (PrEP) among female sex workers (FSWs) in Côte d'Ivoire: complex trajectories and early adopters

Joseph Larmarange , Mélanie Plazy , Marcellin Nouaman , Evelyne Kissi , Rose-Marcelle Dedocoton , Patrick Coffie , Serge Eholié , Valentine Becquet

16th AIDSImpact Conference, AIDSImpact, May 2025, Casablanca, Morocco

Communication dans un congrès

hal-05090841

Adoption of HIV preexposure prophylaxis (PrEP) among female sex workers (FSWs) in Côte d'Ivoire: complex trajectories and early adopters

Introduction

The ANRS 12381 PRINCESSE project (November 2019 - June 2023) implemented community-based sexual and reproductive health care, including preexposure prophylaxis (PrEP), for female sex workers (FSWs) in the San Pedro region of Côte d'Ivoire, delivered through mobile clinics at prostitution sites in the San Pedro region. This presentation aims to describe PrEP trajectories and the factors associated with its use, focusing on “early adopters”.

Methods

A total of 489 women were enrolled in the PRINCESSE cohort. This analysis included 400 FSWs eligible for PrEP (HIV-negative, HBsAg-negative at baseline) enrolled up to December 2022 (i.e. enrolled at least 6 months before cohort closure). Clinical records were analyzed to describe PrEP cascade, follow-up, and PrEP trajectories. A multivariable logistic regression identified factors associated with PrEP early adopters.

Results

The overall PrEP cascade showed that although 98% of eligible FSWs were interested in PrEP, only 62% initiated PrEP, and 39% renewed it at least once.

Follow-up was very short (<6 months) for 48% of FSWs, short (6-12 months) for 15%, seasonal (>12 months with a gap of 6 months between two visits) for 31%, and regular (>12 months with no gap) for 6%.

PrEP initiation was high among FSWs with regular (96%), seasonal (83%), or short (80%) follow-up, vs. 39% for those with very short follow-up. Among those who initiated, only 88% (regular), 70% (seasonal), 74% (short), and 35% (very short) renewed PrEP.

Among 148 FSWs with regular/seasonal follow-up, four PrEP trajectories were identified (cf. attached figure showing individual trajectories, each line representing a participant's PrEP journey): 15% never initiated PrEP; 39% initiated PrEP before stopping and expressing they were not interested anymore; 18% re-initiated PrEP after an episode of non-interest”; and 28% initiated and never expressed non-interest at a later stage. The last two groups were considered as “early adopters”. Significant factors associated with early PrEP adoption were the usual price of intercourse with clients <1500 FCFA (i.e. 2.3 EUR) (aOR=2.4 [1.2-4.8]) and working in brothels (aOR=3.2 [1.6-6.6]).

Conclusions

In PRINCESSE, loss-to-follow-up and seasonality of risks limited PrEP adoption. FSWs who were more precarious and less mobile became early adopters of this new prevention tool and could serve as potential ambassadors for promoting its uptake and demand creation.

Perception de la Prophylaxie préexposition à longue durée d'action chez les travailleuses du sexe et les HSH à San Pedro et Abidjan, Côte d'Ivoire

Evelyne Kissi , Joseph Larmarange , Rose-Marcelle Dedocoton , Mélanie Plazy , Marcellin Nouaman , Patrick Coffie , Serge Eholié , Valentine Becquet

16th AIDSImpact Conference, AIDSImpact, May 2025, Casablanca, Maroc

Communication dans un congrès

hal-05090784

Perception de la Prophylaxie préexposition à longue durée d'action chez les travailleuses du sexe et les HSH à San Pedro et Abidjan, Côte d'Ivoire

Introduction : Des recherches ont montré que l'utilisation et l'adhésion à la PrEP par voie orale peuvent être complexes au sein de certaines populations, telles que les travailleuses du sexe (TS) et les hommes ayant des relations sexuelles avec d'autres hommes (HSH), notamment en raison de leur grande mobilité, d'une vie quotidienne imprévisible ou d'effets secondaires. Dans ce contexte, la PrEP à longue durée d'action (actuellement à différents stades de développement), telle que les injectables, le gel, les implants, les suppositoires vaginaux, les douches vaginales/anales ou les anneaux vaginaux, pourraient contribuer à surmonter certaines difficultés rencontrées avec la PrEP orale. Cette étude visait à explorer les perceptions de ces formulations à longue durée d'action parmi les TS et les HSH en Côte d'Ivoire.

Méthodologie : Inscrite dans le projet ANRS 12381 PRINCESSE, cette sous-étude qualitative a été menée en novembre-décembre 2023 au sein de deux ONG communautaires : Aprosam à San Pedro et Espace Confiance à Abidjan auprès des TS et HSH. Au total, 32 TS (19 naïves de PrEP et 13 expérimentées) et 12 HSH (3 naïfs de PrEP et 9 expérimentés) ont été interrogés (lors de14 entretiens individuels et 5 focus groups). Une analyse thématique s'est concentrée sur l'aspect pratique, la discrétion, l'autonomie, l'efficacité perçue et les effets secondaires anticipés des différentes formulations de PrEP à longue durée d'action.

Résultats : Les participants ont généralement exprimé des opinions favorables à l'égard de la PrEP à longue durée d'action, considérée comme une forme moins contraingrante que la PrEP par voie orale. Les injections ont été particulièrement appréciées pour leur discrétion (pas de marque visible), les injections semestrielles étant préférées. Quelques inquiétudes ont été exprimées quant à la douleur liée à l'injection. Le gel, assimilé à un lubrifiant, a séduit par sa double fonction de protection et de plaisir. Toutefois, certains participants ont exprimé des doutes quant à son efficacité. Bien que la durée d'action de l'implant (1 an) ait été appréciée, elle n'a pas été plébiscitée en raison du manque de discrétion (cicatrice) et des effets secondaires potentiels anticipés. L'autonomie et la facilité d'utilisation des suppositoires vaginaux sont perçues comme avantageuses, à condition que les conditions d'hygiène soient optimales ; les HSH font le parallèle avec les suppositoires anaux. Même si les douches vaginales sont largement pratiquées par les TS, la lotion de nettoyage intime de la PrEP a reçu des réactions mitigées de la part des TS, conscientes des risques d'un usage excessif. Enfin, l'anneau vaginal a suscité peu d'intérêt en raison de la méconnaissance de l'outil.

Conclusion : Dans l'ensemble, la PrEP à longue durée d'action peut offrir des options alternatives pour la prévention du VIH. Les éléments clés favorisant l'adoption à un format (PrEP à longue durée d'action) sont la facilité d'utilisation, un suivi simplifié (le moins souvent possible), des règles claires pour le démarrage et l'arrêt, la discrétion, l'efficacité perçue et les effets secondaires anticipés.

Retrait du Pepfar : jusqu'à 56000 décès supplémentaires en Afrique de l'Ouest

Joseph LARMARANGE — 2025-04-30T15:02:44Z

Article de Fredérique Prabonnaud publié le 21 avril 2025 dans transveral, un magazine de Sidaction. Cet article présente des résultats préliminaires du projet Modélisation de l'impact épidémiologique potentiel du retrait du PEPFAR en Côte d'Ivoire, au Mali et au Sénégal.
L'arrêt comme la suspension du programme américain PEPFAR entraînera des conséquences sur l'épidémie de VIH en Afrique de l'Ouest : c'est la conclusion d'une modélisation dont les résultats préliminaires ont été présentés (…)

- Divers / Modélisation de l'impact d'un retrait du Pepfar, Côte d'Ivoire, Mali, Sénégal, Financement des programmes, Mesure d'impact, Pepfar, Politiques publiques, VIH / SIDA

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

Modélisation de l'impact épidémiologique potentiel du retrait du PEPFAR en Côte d'Ivoire, au Mali et au Sénégal

Joseph LARMARANGE — 2025-03-20T13:03:45Z

Responsables scientifiques

LARMARANGE Joseph, Ceped
NIANGORAN Serge, PAC-CI
SILHOL Romain, Imperial College London

Partenaires

Imperial College London https://www.imperial.ac.uk/
PAC-CI (programme ANRS de Côte d'Ivoire) https://web.pac-ci.org/
Université Mac Gill https://www.mcgill.ca/

Membres du projet

BOILY Marie-Claude, Imperial College London
LARMARANGE Joseph, IRD / Ceped
MAHEU-GIROUX Mathieu, McGill University
MIAN Anatole, PAC-CI
MOH Raoul, PAC-CI
NIANGORAN Serge, PAC-CI
SILHOL Romain, Imperial College London

Financement

ANRS|MIE

Résumé

La décision de la nouvelle administration américaine d'interrompre le financement du plan présidentiel d'urgence pour la lutte contre le Sida (PEPFAR), officiellement pour une durée minimale de 90 jours à partir du 20 Janvier 2025, pourrait avoir des effets dévastateurs sur les populations vivant en Afrique de l'Ouest. En effet, ces fonds apportaient une aide vitale, non seulement en finançant plus de la moitié de l'accès au diagnostic et traitement antirétroviral contre le VIH auprès des populations vivant avec le VIH (PVVIH), mais supportait également de nombreux programmes de prévention de l'infection VIH, notamment parmi les populations clés (i.e., les plus touchées par le VIH), comme les travailleuses du sexe (TS) et les hommes ayant des rapports sexuels avec d'autres hommes (HSH). Ces financements américains, conjugués aux efforts nationaux des pays d'Afrique de l'Ouest et de la communauté internationale, ont permis de diminuer de moitié le nombre de nouvelles infections et décès dus au VIH entre 2010 et 2023 dans la région.

Afin d'alerter l'opinion et les pouvoirs politiques et scientifiques, il est urgent de

Comprendre l'impact épidémiologique (nouvelles infections, décès) de l'interruption et ou/arrêt de ce support afin de plaider pour une reprise de l'aide américaine et/ou d'un support européen additionnel ;
Identifier les activités de prévention et de traitement du VIH dont le maintien doit être considéré comme une priorité afin de minimiser l'impact du retrait PEPFAR ;
Évaluer quelles populations pourraient être les plus affectées par ce retrait, en s'appuyant sur des données stratifiées par population clé, transmises par des programmes nationaux de lutte nationale contre le sida, ainsi que les organisations non-gouvernementales implémentant ces politiques sur le terrain.

Pour ce projet, nous proposons d'adapter et utiliser le modèle épidémiologique développé dans le projet ATLAS pour simuler le cours de l'épidémie VIH pour la période 1980-2040 (prenant d'abord pour hypothèse contrefactuelle un maintien des activités PEPFAR au cours du temps), comparé à des scenarios de diminution des niveaux de prévention, diagnostic et traitement du VIH au cours de 2025-2040, au sein de chaque pays. Ce modèle a été récemment calibré pour représenter les dynamiques de transmission et contrôle du VIH au cours du temps en Côte d'Ivoire, au Mali et au Sénégal séparément, afin de prédire les dynamiques futures les plus plausibles.

Mots-Clés

Lutte contre le VIH, Pepfar, politiques publiques, modélisations épidémiologiques

Pays

Côte d'Ivoire, Mali, Sénégal

Calendrier

2025

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.

VIH : des solutions préventives à longue durée prometteuses

Joseph LARMARANGE — 2024-12-02T17:58:04Z

VIH : des solutions préventives à longue durée prometteuses

Louise Hurel , Christian Laurent , Joseph Larmarange , Karna Coulibaly

2024

Article de blog scientifique

hal-04815258

La PrEP avec le lénacapavir injectable est une solution efficace et prometteuse pour les populations vulnérables, à condition d'être accessible.

Des outils de prévention toujours plus efficaces et moins contraignants, adaptés aux conditions de vie et besoins réels des populations les plus exposées : voilà le nerf de la guerre contre le VIH. Parmi eux, la PrEP avec le lénacapavir nourrit de grands espoirs comme outil de prévention. Ce médicament est déjà utilisé pour soigner les patients ayant développé des résistances aux traitements les plus courants. Deux études viennent de démontrer qu'il était également pleinement efficace pour empêcher les nouvelles infections, à raison d'une injection sous-cutanée tous les six mois. Une révolution dans le domaine de la prévention !

En quoi le lénacapavir injectable peut apporter une solution pérenne ? À qui et sous quelles conditions ?

Explications avec trois scientifiques impliqués dans des projets de recherche auprès de populations clés : Christian Laurent, épidémiologiste IRD à TransVIHMI, coordinateur du projet CohMSM-PrEP, centré sur les hommes ayant des rapports sexuels avec les hommes (HSH) en Afrique de l'Ouest ; Joseph Larmarange, démographe IRD au Ceped, coordinateur du projet Princesse auprès de travailleuses du sexe en Côte d'Ivoire ; et Karna Coulibaly, démographe Ined et chercheur associé au Ceped, impliqué dans le projet Makasi qui a été réalisé auprès d'immigrés d'Afrique subsaharienne en situation de précarité vivant en Île-de-France.

Building better HIV models : a framework for incorporating evidence on structural determinants and interventions to estimate their impacts on HIV epidemics

Joseph LARMARANGE — 2024-10-28T15:41:00Z

Poster presented at HIVR4P 2024, the 5th HIV Research for Prevention Conference, October 2024, Lima, Peru.

Building better HIV models: a framework for incorporating evidence on structural determinants and interventions to estimate their impacts on HIV epidemics

James Stannah , Jorge Luis Flores Anato , Michael Pickles , Joseph Larmarange , Kate M. Mitchell , Adelina Artenie , Kostyantyn Dumchev , Serge Niangoran , Lucy Platt , Fern Terris-Prestholt Terris-Prestholt , Amteshwar Singh , Jack Stone , Peter Vickerman , Andrew Phillips , Leigh F Johnson , Mathieu Maheu-Giroux , Marie-Claude Boily

HIVR4P 2024, the 5th HIV Research for Prevention Conference, Oct 2024, Lima, Peru

Poster de conférence

hal-04971981

Authors

James Stannah, Jorge Luis Flores Anato, Michael Pickles, Joseph Larmarange, Kate M. Mitchell, Adelina Artenie, Kostyantyn Dumchev, Serge Niangoran, Lucy Platt, Fern Terris-Prestholt Terris-Prestholt, Amteshwar Singh, Jack Stone, Peter Vickerman, Andrew Phillips, Leigh F Johnson, Mathieu Maheu-Giroux, Marie-Claude Boily

Abstract

BACKGROUND : Structural determinants (SDs) are social, economic, political, cultural, organizational, and environmental factors that shape HIV inequalities across individuals and populations. UNAIDS' 10-10-10 targets aim to reduce exposure to SDs including punitive regulations, violence, stigma, and discrimination. Evidence-based dynamic HIV transmission models can help quantify the population-level impacts of SDs and structural interventions to inform decision-making. We appraised previous representations of SDs in HIV models to develop a new framework that supports the modelling and analysis of SDs.

METHODS : We performed a scoping review of HIV transmission dynamic modelling studies that modelled SDs, published until August 28, 2023, using Ovid Embase and Medline databases. To develop our framework, we considered how models represented exposures to SDs (statically vs dynamically) and reproduced causal pathways to estimate impacts on HIV, and the data they used.

RESULTS : We found 17 HIV modelling studies of SDs and/or structural interventions including incarceration of people who inject drugs (n=5) or Black men (n=2), violence against women (n=3), HIV-stigma (n=1), and homelessness (n=1), among other less well-defined exposures (e.g., “positive and negative attitudes”). Eight studies modelled SDs dynamically using granular exposure histories (e.g., current, recent, non-recent) that captured variation in duration and intensity of exposure. SDs mostly influenced HIV indirectly through simple causal pathways with single intermediate variables (mediators) – largely sexual/injecting partner numbers (n=9), mixing patterns (n=8), or condom use (n=6). Effects of SDs were mostly informed by cross-sectional data. Only seven studies fitted to observed trends in SDs or their effects on mediators/HIV. Using this, we developed our framework (Figure).

CONCLUSIONS : The representation of SDs in models could be refined to improve projections of their impacts and interventions using our framework. Fundamentally, this requires better inputs : more longitudinal studies investigating heterogeneity in SDs and their causal effects. Methods, findings, and limitations should be transparently communicated.

Joseph Larmarange

Comparing modelled HIV incidence estimates with empirical HIV incidence observations in high-burden HIV African epidemic settings: systematic review and meta-regression

Comparing modelled HIV incidence estimates with empirical HIV incidence observations in high-burden HIV African epidemic settings: systematic review and meta-regression

Authors

Abstract

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

Adoption of HIV preexposure prophylaxis (PrEP) among female sex workers (FSWs) in Côte d'Ivoire: complex trajectories and early adopters

Adoption of HIV preexposure prophylaxis (PrEP) among female sex workers (FSWs) in Côte d'Ivoire: complex trajectories and early adopters

Authors

Abstract

See also

Perceptions regarding long-acting pre-exposure prevention (PrEP) among female sex workers and men having sex with men in San Pedro and Abidjan, Côte d'Ivoire

ANRS 12381 PRINCESSE @ AIDSImpact 2025: PrEP adoption & perceptions of long acting PrEP

Adoption of HIV preexposure prophylaxis (PrEP) among female sex workers (FSWs) in Côte d'Ivoire: complex trajectories and early adopters

Adoption of HIV preexposure prophylaxis (PrEP) among female sex workers (FSWs) in Côte d'Ivoire: complex trajectories and early adopters

Perception de la Prophylaxie préexposition à longue durée d'action chez les travailleuses du sexe et les HSH à San Pedro et Abidjan, Côte d'Ivoire

Perception de la Prophylaxie préexposition à longue durée d'action chez les travailleuses du sexe et les HSH à San Pedro et Abidjan, Côte d'Ivoire

Retrait du Pepfar : jusqu'à 56000 décès supplémentaires en Afrique de l'Ouest

La fin du sida est-elle toujours en vue ?

Modélisation de l'impact épidémiologique potentiel du retrait du PEPFAR en Côte d'Ivoire, au Mali et au Sénégal

Responsables scientifiques

Partenaires

Membres du projet

Financement

Résumé

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

VIH : des solutions préventives à longue durée prometteuses

VIH : des solutions préventives à longue durée prometteuses

Building better HIV models : a framework for incorporating evidence on structural determinants and interventions to estimate their impacts on HIV epidemics

Building better HIV models: a framework for incorporating evidence on structural determinants and interventions to estimate their impacts on HIV epidemics

Authors

Abstract