Joseph Larmarange

Alter George, Gregory Arofan, Mceachern Steven, Bell Darren S., Burke Derek, Chen Robert, Cardacino Alessio, Chaya Nada, Barraclough David, Brownlee Rowan, Emery Tom, Gerland Patrick, Giudici Cristina, Gozalov Abdulla, Greising Edgardo, Ionescu Sanda, Jääskeläinen Taina, Kanjala Chifundo, Kantorova Vladimira, Larmarange Joseph, Lattes Pablo, Lyle Jared, Magnuson Diana, Meinhart Melissa, Mishra Santosh Kumar, Silva Romesh, Spoorenberg Thomas, Ueffing Philipp et Winkler Jay (2023) FAIR Vocabularies in Population Research: report of the IUSSP-CODATA Working Group on FAIR Vocabularies, Report, IUSSP ; CODATA. https://hal.science/hal-04096418.

Résumé : This report describes the role of controlled vocabularies in the documentation and dissemination of demographic data in the light of the FAIR principles that all data should be “Findable, Accessible, Interoperable, and Reusable” by both humans and machines (Wilkinson et al., 2016). Population research is an empirically focused field with a long tradition of widely shared, easily accessible, data collections. The FAIR Principles point to ways that this tradition can be enhanced by taking advantage of emerging standards and technologies. Our work builds on the “Ten Simple Rules for making a vocabulary FAIR” (Cox et al., 2021), prepared by a group formed at a workshop convened by CODATA and DDI to describe how a FAIR vocabulary will work with international standards for documenting and sharing social science data. Controlled vocabularies play a central role in data sharing by associating data with concepts and by defining which categories or codes may be applied. FAIR vocabularies specify globally accessible persistent identifiers to distinguish data items that are the same from those that are different. Consider the most basic variable in demographic analysis: age. The Organization for Economic Cooperation and Development (OECD) has a list of 643 age categories, while the UN Population Division copes with more than 1100 age groups. If the meanings of variables in a dataset are only available through human-readable documentation, like a pdf, harmonizing data from two providers will remain a tedious manual process. However, if the age categories are linked to persistent identifiers in machine actionable metadata, software can be programmed to harmonize age groupings. If these operations are performed across dozens of variables in hundreds of data sources, enormous amounts of human time will be saved. Construction of the infrastructure for FAIR data has begun. Demographic concepts are already included in vocabularies developed by other disciplines, like medicine, with definitions that conflict with usage in population research. Therefore, there is a need for a FAIR vocabulary of demographic concepts endorsed by an authoritative institution in the field of population science. IUSSP has a long history of working with the UN and other agencies to define demographic concepts (International Union for the Scientific Study of Population, 1954; Vincent, 1953). Those efforts currently exist in electronic forms (Demopædia and Demovoc) that provide a base for a multilingual FAIR Vocabulary of Demography. We argue that a FAIR Vocabulary of Demography will have important benefits for the population research community represented by IUSSP, and we conclude with recommendations for IUSSP and other important organizations. In addition to summarizing the activities of the Working Group, this report is intended to serve as an introduction to the standards and infrastructure used to share social science data. Most demographers have never heard of URIs, SDMX, or DDI, even though they use services from the UN, ILO, OECD, CESSDA, IPUMS, and other organizations that depend on these standards. Understanding key features of the international data infrastructure will help IUSSP leadership to influence its development.

Alter et al_2023_FAIR Vocabularies in Population Research.pdf 6.8 Mio (source)

Becquet Valentine, Plazy Mélanie, Kissi Evelyne, Nouaman Marcellin N., Coffie Patrick, Eholié Serge et Larmarange Joseph (2023) « “It’s hard to take it every day”: initiations, discontinuations& perceptions of oral preexposure prophylaxis among female sex workers in Côte d’Ivoire » (communication orale), présenté à AIDS Impact Conference, Stockholm. https://hal.science/hal-04119974.

Résumé : Introduction/objective(s) The paper aims to describe oral preexposure prophylaxis (PrEP) initiations and discontinuations among female sex workers (FSWs) in Côte d’Ivoire, and to elaborate broader considerations about their perceptions, through barriers and facilitators of PrEP use. Methods The ANRS 12381 PRINCESSE project provides a comprehensive sexual and reproductive healthcare package, including PrEP, among a cohort of FSWs aged ≥18 years in the San Pedro region. This package is offered in a community clinic and through a mobile clinic operating on 10 prostitution sites (visited every two weeks) for 45 months (12/2019-06/2023). The analysis is based on qualitative interviews with 38 FSWs conducted in December 2019, September 2021, March and May 2022, and clinical records related to PrEP use filled out by the physicians. Results Interviews showed that many women identified the protective effect of PrEP against HIV despite sometimes being afraid of side effects. Few women reported perceiving no benefit of PrEP compared to condoms. End-February 2023, 406 HIV- and HBV-negative women were included : 388 (96%) declared their interest in PrEP. Among them, 218 (56%) exited care within 6 weeks, 4 were not interested in PrEP anymore, and only 165 (43%) initiated PrEP. In interviews, some women explained having stopped PrEP immediately because of side effects. Some women also reported having stopped PrEP after a few weeks because of their difficulties in taking a daily treatment at a fixed time. FSWs also shared that a major reason for PrEP discontinuation is related to periods of mobility when they leave to visit their families and no longer work. These women sometimes re-initiated PrEP, but not immediately after starting sex work again. Among the 165 FSWs who initiated PrEP, 60 (36%) attended their first PrEP follow-up visit, of whom 16 (27%) reported having discontinued PrEP. Among the latest, 4 (25%) reported not being interested anymore. The other 12 and the 44 who did not discontinue PrEP received a second prescription. At each subsequent visit of PrEP follow-up, a part of the women reported PrEP discontinuation, and some decided to stop PrEP. More broadly, the confidence in PrEP is not total among women interviewed. Some reported rumours and fear of being identified as HIV-positive among colleagues. Others used simultaneously other means to protect against HIV, such as enema after condomless sex, because PrEP is taken once a day and not after each intercourse. Discussion/conclusion/implications Although loss to follow-up was a major issue, it was not the only barrier to PrEP initiation and retention. Despite high levels of interest in PrEP, PrEP discontinuation was frequent, partly linked to periods of mobility. Oral daily PrEP is not a magic bullet : it sometimes appears difficult for FSWs to articulate PrEP with other daily priorities. FSWs regularly evaluate the balance between constraints and benefits at each step of the process. In this specific population of FSWs, there is an urgent need to find new ways of simplifying HIV biomedical prevention.

d’Elbée Marc, Terris-Prestholt Fern, Briggs Andrew, Griffiths Ulla Kou, Larmarange Joseph, Medley Graham Francis et Gomez Gabriella Beatriz (2023) « Estimating health care costs at scale in low- and middle-income countries: Mathematical notations and frameworks for the application of cost functions », Health Economics, 2023 (juin 18), p. 1-18. DOI : 10.1002/hec.4722. https://onlinelibrary.wiley.com/doi/abs/10.1002/hec.4722.

Résumé : Appropriate costing and economic modeling are major factors for the successful scale-up of health interventions. Various cost functions are currently being used to estimate costs of health interventions at scale in low- and middle-income countries (LMICs) potentially resulting in disparate cost projections. The aim of this study is to gain understanding of current methods used and provide guidance to inform the use of cost functions that is fit for purpose. We reviewed seven databases covering the economic and global health literature to identify studies reporting a quantitative analysis of costs informing the projected scale-up of a health intervention in LMICs between 2003 and 2019. Of the 8725 articles identified, 40 met the inclusion criteria. We classified studies according to the type of cost functions applied—accounting or econometric—and described the intended use of cost projections. Based on these findings, we developed new mathematical notations and cost function frameworks for the analysis of healthcare costs at scale in LMICs setting. These notations estimate variable returns to scale in cost projection methods, which is currently ignored in most studies. The frameworks help to balance simplicity versus accuracy and increase the overall transparency in reporting of methods.

Mots-clés : cost functions, econometrics, health economics, low- and middle-income countries, microeconomics, production costs.

Snapshot (source)

d’Elbée et al_2023_Estimating health care costs at scale in low- and middle-income countries.pdf 2 Mio (source)

Fotso Arlette Simo, Kouassi Arsene Kra, Boily Marie-Claude, Silhol Romain, Vautier Anthony et Larmarange Joseph (2023) « Knowledge, attitude and practices towards HIV testing following the introduction of self-testing: The case of the ATLAS project in Côte d’Ivoire » (poster), présenté à AIDS Impact Conference, Stockholm. https://hal.science/hal-04120627.

Résumé : Background HIV testing is a central element of the strategy to end AIDS epidemic, as status awareness is the entry point to HIV care. In West Africa, only 68% of people living with HIV (PLHIV) were aware of their HIV status in 2019. To address the testing gap, the ATLAS project distributed a total of 400000 self-tests (HIVST) in three West African countries between 2019 and 2022, including 200 000 kits in Côte d’Ivoire. The aim of this study is to assess levels and correlates of knowledge, attitude and practice towards HIV conventional testing (tests other than HIVST) and self-testing after the introduction of HIVST in Cote d’Ivoire. Method We conducted the population-based cross-sectional in the Bas-Sassandra District of Côte d’Ivoire, 24 months after HIVST was introduced in the region by ATLAS. ATLAS Household Survey (AHS) used a three-stage stratified sampling approach – 3 of the strata are the 3 departments with ATLAS activities and 1 includes departments with almost none, each further stratified on urban and rural settings. Face-to- face interviews were conducted in a representative a sample of the population aged 15-49. One main objective of the survey was to assess the effect of the ATLAS initiative on HIV testing. Weighed proportions and chi-square tests were used to assess knowledge of, attitude towards and practice of HIV conventional and self testing, comparing male and female on the one hand and departments with and without ATLAS HIVST distribution activities on the other hand. Logistic regressions were used to identified factors associated with knowledge of, attitude towards and practice of HIV conventional and self testing (ongoing analysis). Preliminary results A total of 6274 people with median age of 29 were interviewed and completed the questionnaire (3205 males and 3069 females). Most participants were in couple (44% males and 59% females) and have attended school (63% males and 45% females). Despite most participants knowing about HIV-AIDS (97 % Males and 96% females), very few reported having heard about HIVST (11% males and 10% females). However, most participants showed a positive attitude toward HIVST and reported that they would be interested/very interested to use it if freely available for themselves (75% males and 71% females), as well as for their sexual partners. About 18% of females and 10% of males reported having performed at least 1 conventional test in the last 12 months, while 3% of participants had already used a HIVST in the past. Conclusion Although knowledge and use of HIVST remain relatively low in the region, participants show a positive attitude toward HIVST, and express willingness to use it if freely available. Next results will tell how the observed results differ between participants living in department with ATLAS HIVST distribution and others, and how significant are the differences. It will also provide an overview of associated factors. This will provide policy makers with tools for potential actions in order to improve HIV testing and advance progress towards UNAIDS targets to achieve 95 % of PLHIV who know their status by 2025.

Kouassi Arsene Kra, Fotso Arlette Simo, Rouveau Nicolas, Maheu-Giroux Mathieu, Boily Marie-Claude, Silhol Romain, d’Elbée Marc, Vautier Anthony et Larmarange Joseph (2023) « Estimating HIV self-testing positivity rate and linkage to confirmatory testing and care: a telephone survey in Côte d’Ivoire, Mali and Senegal » (communication orale), présenté à AIDS Impact Conference, Stockholm. https://hal.science/hal-04120705.

Résumé : Background HIV self-testing (HIVST) empowers individuals and allow them to decide when/where to test and with whom to share their result. Between 2019 and 2022, the ATLAS program distributed 400 000 HIVST kits in a mixed epidemic context (Côte d’Ivoire, Mali and Senegal), prioritizing key populations, including female sex workers (FSW) and men who have sex with men (MSM), and encouraged secondary distribution of HIVST to their partners, peers and FSW clients. To preserve its confidential nature, distributed HIVST kits were not systematically tracked. An anonymous phone survey was implemented among its users to estimate test positivity rates and linkage to confirmatory testing and care. Methods We conducted a two-step survey. Between March and June 2021, participants were recruited using dedicated leaflets distributed with HIVST kits, inviting users to call a free phone number anonymously (participation was rewarded USD $3.40) and to complete a sociobehavioural questionnaire (phase 1), including the self-reported number of visible lines on their HIVST kits and their interpretation of results. In September and October 2021, participants who reported a reactive HIVST result in phase 1 and agreed to be re-contacted were recalled to complete a short questionnaire (phase 2) on linkage to confirmatory testing and care. Results During phase 1, 2 615 participants were recruited: 2 346 (89.7%) reported a consistent HIVST result (2 visible lines and result interpreted as reactive; one line and interpreted as non-reactive; or no/one line and interpreted as invalid), 48 (1.8%) reported an inconsistent result and 221 (8.5%) did not know (DK) how to interpret their result or refused to answer. HIVST positivity rates ranged from 2.4% to 4.5%, depending on different assumptions (self-interpreted result or reported number of lines, inclusion or exclusion of DK and refusals). Among men who received an HIVST through activities targeting MSM, positivity rates ranged from 3.2% to 4.8%, and from 2.2% to 4.2% for women reached through activities targeting FSW. Among 126 phase 1 participants eligible for phase 2, 120 agreed to be re-contacted, and 78 fully completed the phase 2 questionnaire. Among the 27 who reported a consistent reactive result in the phase 1 questionnaire, 15 (56%, 95%CI: 36-74%) linked to confirmatory test, including 12 (80%) confirmed HIV-positive, which all started treatment (100%). Linkage was lower among those who reported an inconsistent result in phase 1(37%, 95%CI: 24-52%). Among those confirming reactive self-tests, 53% did it in less than one week following self-testing, and 91% in less than three months. Two-thirds (65%) went to a general public facility and one-third to a facility dedicated to key populations. Conclusion Our HIVST distribution strategy successfully reached people living with HIV in West Africa. Linkage to confirmatory testing remained sub-optimal in these first years of HIVST implementation. However, if confirmed HIV-positive, almost all initiated treatment. The majority of those who linked to confirmatory testing went to a general facility, suggesting that HIVST has the potential to reach more discrete populations. HIVST constitutes a complementary tool to existing screening services.

Kra Arsène Kouassi, Fosto Arlette Simo, N’guessan Kouassi Noël, Geoffroy Olivier, Younoussa Sidibé, Kabemba Odé Kanku, Gueye Papa Alioune, Ndeye Pauline Dama, Rouveau Nicolas, Boily Marie-Claude, Silhol Romain, d’Elbée Marc, Maheu-Giroux Mathieu, Vautier Anthony, Larmarange Joseph et on behalf of the ATLAS team (2023) « Can HIV self-testing reach first-time testers? A telephone survey among self-test end users in Côte d’Ivoire, Mali, and Senegal », BMC Infectious Diseases, 22 (1) (septembre 25), p. 972. DOI : 10.1186/s12879-023-08626-w. https://doi.org/10.1186/s12879-023-08626-w.

Résumé : Coverage of HIV testing remains sub-optimal in West Africa. Between 2019 and 2022, the ATLAS program distributed ~400 000 oral HIV self-tests (HIVST) in Côte d’Ivoire, Mali, and Senegal, prioritising female sex workers (FSW) and men having sex with men (MSM), and relying on secondary redistribution of HIVST to partners, peers and clients to reach individuals not tested through conventional testing. This study assesses the proportion of first-time testers among HIVST users and the associated factors.

Mots-clés : Côte d’Ivoire, HIV self-testing, Key populations, Mali, Phone‐based survey, Senegal, West Africa.

Kra et al_2023_Can HIV self-testing reach first-time testers.pdf 1.8 Mio (source)

Snapshot (source)

Ky-Zerbo Odette, Desclaux Alice, Boye Sokhna, Maheu-Giroux Mathieu, Rouveau Nicolas, Vautier Anthony, Camara Cheick Sidi, Kouadio Brou Alexis, Sow Souleymane, Doumenc-Aidara Clémence, Gueye Papa Alioune, Geoffroy Olivier, Kamemba Odé Kanku, Ehui Eboi, Ndour Cheick Tidiane, Keita Abdelaye, Larmarange Joseph et for the ATLAS team (2023) « “I take it and give it to my partners who will give it to their partners”: Secondary distribution of HIV self-tests by key populations in Côte d’Ivoire, Mali, and Senegal », BMC Infectious Diseases, 22 (1) (mai 24), p. 970. DOI : 10.1186/s12879-023-08319-4. https://doi.org/10.1186/s12879-023-08319-4.

Résumé : HIV epidemics in Western and Central Africa (WCA) remain concentrated among key populations, who are often unaware of their status. HIV self-testing (HIVST) and its secondary distribution among key populations, and their partners and relatives, could reduce gaps in diagnosis coverage.

Mots-clés : ATLAS, HIVST, Key population, Secondary distribution, West and Central Africa.

Ky-Zerbo et al_2023_“I take it and give it to my partners who will give it to their partners”.pdf 1.2 Mio (source)

Snapshot (source)

Larmarange Joseph (2023) « Recherche interventionnelle : transformer des innovations efficaces en interventions efficientes » (communication orale), présenté à Journées scientifiques 2023 de l'ANRS | Maladies infectieuses émergentes, Paris. https://hal.ird.fr/ird-04039578.

Larmarange - 2023 - Recherche interventionnelle transformer des inno.pdf 2.6 Mio

Larmarange Joseph (2023) PrevR: Estimating Regional Trends of a Prevalence from a DHS and Similar Surveys, version 5.0.0. https://cran.r-project.org/web/packages/prevR/index.html.

Résumé : Spatial estimation of a prevalence surface or a relative risks surface, using data from a Demographic and Health Survey (DHS) or an analog survey, see Larmarange et al. (2011) <doi:10.4000/cybergeo.24606>.

Mots-clés : OfficialStatistics.

Larmarange Joseph (2023) « Transforming effective innovations into efficient interventions: contributions from social and implementation sciences » (communication orale), présenté à 40 years of HIV science, par Institut Pasteur et ANRS|MIE, Paris, France. https://hal.science/hal-04316678.

Résumé : The history of the fight against AIDS has been marked by the development of major scientific and biomedical innovations: antiretroviral treatments, rapid screening tests, pre-exposure prophylaxis... However, these innovations have often been insufficient on their own to curve the epidemics. It has also been essential to innovate in terms of funding, organisation of services and care, advanced "out-of-hospital" strategies, human rights, taking account of the specific characteristics of the most vulnerable populations, etc. Effective innovation will be ineffective if it is not adapted to the social, cultural, and legal constraints faced by populations and to the structural, organisational, and economic constraints of healthcare systems. Hence the need for a genuine science of implementation that is necessarily interdisciplinary and intersectoral.

Larmarange_2023_Transforming effective innovations into efficient interventions.pdf 2.3 Mio (source)

Larmarange Joseph (2023) « Santé sexuelle & Consentement \times Introduction par le grand témoin » (communication orale), présenté à Colloque Santé sexuelle et consentement par URACA Basiliade et COREVIH IDF-Nord, Paris, France. https://hal.science/hal-04307854.

Larmarange_2023_Santé sexuelle & Consentement -times Introduction par le grand témoin.pdf 2.7 Mio (source)

Larmarange Joseph (2023) « PrEP injectable dans les pays à ressources limitées, promesses et défis », Vih.org, avril 26. https://vih.org/20230426/prep-injectable-dans-les-pays-a-ressources-limitees-une-modelisation-prometteuse/.

Résumé : Une étude de modélisation publiée fin 2022 tente de répondre, pour le cas sud-africain, à deux questions: quels seraient les impacts de santé publique d’un programme de PrEP injectable par rapport à un programme de PrEP orale ? à quel coût de la PrEP injectable celle-ci serait-elle plus coût-efficace que la PrEP orale ?

Snapshot (source)

Larmarange - 2023 - PrEP injectable dans les pays à ressources limitée.pdf 576.2 kio

Larmarange Joseph (2023) « Recherche interventionnelle dans la lutte contre le VIH : apport des sciences sociales et des sciences de la mise en œuvre pour transformer des innovations efficaces en interventions efficientes » (communication orale), présenté à Afrique Global Health, Dakar. https://hal.science/hal-04133715.

Larmarange Joseph, Bachanas Pamela, Skalland Timothy, Balzer Laura B., Iwuji Collins, Floyd Sian, Mills Lisa A., Pillay Deenan, Havlir Diane, Kamya Moses R., Ayles Helen, Wirth Kathleen, Dabis François, Hayes Richard, Petersen Maya et UT³C consortium (2023) « Population-level viremia predicts HIV incidence at the community level across the Universal Testing and Treatment Trials in eastern and southern Africa », PLOS global public health, 3 (7), p. e0002157. DOI : 10.1371/journal.pgph.0002157.

Résumé : 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). 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-defined as plasma HIV RNA >500 or >400 copies/mL-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. 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 < 1% to 25%; and HIV incidence, measured over 345 844 person-years (PY), from 0.03/100PY to 3.46/100PY. 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). 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.

PubMed entry

Larmarange Joseph et Broqua Christophe (2023) « Les hommes bisexuels sont moins exposés au virus de l’immunodéficience humaine que les homosexuels exclusifs en Afrique subsaharienne », Santé Publique, 34 (HS2) (mai 7), p. 123. DOI : 10.3917/spub.hs2.0123. https://hal.science/hal-04136246.

Résumé : Introduction : En Afrique subsaharienne, comme dans le reste du monde, les hommes ayant des rapports sexuels avec des hommes (HSH) sont plus exposés à l’infection par le virus de l’immunodéficience humaine (VIH) que la population générale. Les bisexuels sont souvent perçus comme plus à risque que les homosexuels exclusifs. But de l’étude : Nous proposons une synthèse des connaissances sur l’exposition au VIH des homo-bisexuels à partir d’une revue des enquêtes épidémiologiques réalisées en Afrique subsaharienne depuis 2005. Résultats : Nous avons étudié 355 publications et avons identifié 62 mesures de l’association entre bisexualité et prévalence du VIH et 8 mesures de l’association entre bisexualité et incidence. À l’exception de 4 mesures sur 62, la prévalence du VIH observée parmi les bisexuels était inférieure ou égale à celle des homosexuels exclusifs. En matière d’incidence, toutes les études identifiées sauf une observent une incidence du VIH plus faible ou égale parmi les bisexuels. Du point de vue comportemental, la majorité des études n’ont pas relevé de différence d’utilisation du préservatif. Les bisexuels ont parfois une fréquence de rapports sexuels moindre et systématiquement moins de rapports anaux réceptifs. Ils ont commencé leur vie homosexuelle plus tardivement, ont eu moins de partenaires et sont moins nombreux à connaître leur statut VIH. Conclusions : Les bisexuels sont moins exposés au VIH que les homosexuels exclusifs, notamment en raison de différences comportementales. Il importe que les programmes de prévention et de traitement à destination des HSH prennent en compte les spécificités des bisexuels et conçoivent des offres différenciées.

Larmarange Joseph et Broqua Christophe (2023) « Bisexual men are at less risk of HIV infection than exclusive gay men in sub-Saharan Africa », Sante Publique, 34 (HS2) (septembre 25), p. 123-132. DOI : 10.3917/spub.hs2.0123. https://www.cairn-int.info/journal-sante-publique-2022-HS2-page-123.htm.

Larmarange et al_2023_Bisexual men are at less risk of HIV infection than exclusive gay men in.pdf 1.8 Mio (source)

Larmarange Joseph et Broqua Christophe (2023) « Orientation sexuelle et identité de genre : quelles catégories d'enquête en Afrique subsaharienne ? », in Minorités de genre et de sexualité : objectivation, catégorisations et pratiques d'enquête, éd. par Wilfried Rault et Mathieu Trachman, Ined Éditions, p. 191-207. (Méthodes et Savoirs). https://hal.science/hal-04194856.

Résumé : À l’inverse de quelques travaux pionniers en sciences humaines et sociales, la question de l’homosexualité masculine est restée inexistante dans les enquêtes quantitatives en Afrique subsaharienne jusqu’au début des années 2000, malgré les épidémies de VIH qui ravageaient le continent. C’est en 2005 qu’est publiée, pour la première fois, une étude quantitative bio-comportementale (Wade et al., 2005) sur une population d’hommes ayant des rapports sexuels avec des hommes (HSH) en Afrique – en l’occurrence au Sénégal. Le principal résultat concernait la prévalence du VIH : sur les 463 hommes interrogés, 22 % étaient infectés par le VIH, et ce dans un pays, le Sénégal, connu pour sa faible prévalence en population générale (moins de 1 %). Mais l’enquête apportait aussi d’autres informations importantes, notamment au sujet de l’orientation sexuelle : 94 % des répondants déclaraient avoir eu des relations sexuelles avec des femmes au moins une fois au cours de leur vie. Cette proportion élevée d’hommes ayant des pratiques bisexuelles est devenue un élément récurrent des enquêtes sur les HSH en Afrique, et l’un des aspects les plus discutés. Depuis le milieu des années 2000, parallèlement à une attention internationale croissante accordée aux HSH dans les pays à ressources limitées et une pression politique des bailleurs internationaux pour la prise en compte des populations dites « clés » dans la riposte aux épidémies de VIH, les enquêtes quantitatives sur les HSH se sont développées exponentiellement en Afrique subsaharienne. À partir des années 2010, une partie d’entre elles aussi exploré l’identité de genre et certaines publications ont concerné plus, spécifiquement, les personnes « transgenres ». Ce chapitre fait le point sur ces dimensions telles qu’elles apparaissent dans la littérature disponible, en examinant les connaissances dont nous disposons sur les différentes populations que recouvre la catégorie HSH. À partir d’une revue de littérature exhaustive, nous recensons les catégories que mettent en évidence les enquêtes quantitatives du point de vue de l’orientation sexuelle (articulant plusieurs dimensions, dont le pôle d’activité sexuelle, l’orientation sexuelle déclarée et l’attirance sexuelle) et de l’identité de genre. L’objectif est de savoir si les dimensions investiguées sont suffisantes pour la compréhension fine, tant des logiques sociales de la sexualité que des comportements et des identités, et de questionner la façon dont est pensée la diversité des profils au sein de la catégorie HSH. Nous faisons l’hypothèse que les catégories utilisées sont importées des pays du Nord et plaquées sur les pays africains au détriment des catégories et représentations locales, en suivant un agenda international lié à l’épidémie de VIH, qui dicte la définition des catégories à investiguer. Après de nombreuses décennies au cours desquelles s’est construite l’image d’un continent exclusivement hétérosexuel, le développement exponentiel des enquêtes épidémiologiques sur les HSH en Afrique ne témoigne-t-il pas lui aussi d’un travers, certes inverse, en dessinant des formes d’orientation sexuelle et d’identité de genre minoritaires de manière réductrice et schématique ?

HAL Snapshot (source)

Larmarange Joseph, Fotso Arlette Simo, Yabo Yao, Dahourou Désiré Lucien, Godin Zélie, Kadio Kadidiatou, Sondo Apoline, Valentin Louis, Altmann Mathias et Bekelynck Anne (2023) « Réalisation d’une enquête téléphonique répétée auprès de médecins burkinabés en contexte Covid : retour d’expérience de l’enquête CAP-CoV-BF » (communication orale), présenté à 12e Colloque Francophone sur les Sondages. https://hal.ird.fr/ird-04043479.

Résumé : Introduction. Les médecins, premières personnes exposées et victimes des épidémies, sont au cœur des dispositifs de riposte à l’épidémie de Covid-19. Au printemps 2020, au cœur de la première vague épidémique, il est apparu essentiel de pouvoir documenter les connaissances, attitudes et pratiques (CAP) de ces maillons essentiels de la lutte contre la Covid-19 au Burkina Faso. Leur compréhension de la maladie, l’impact de la maladie sur leurs pratiques professionnelles, leur accès au matériel de protection, etc. sont autant d’aspects qui peuvent impacter directement la santé publique, nécessitant des prises de mesures par les autorités nationales. L’objectif principal de cette étude était de fournir aux acteurs nationaux impliqués dans la gestion de la crise des données probantes régulières et représentatives à l’échelle nationale sur les connaissances, attitudes et pratiques des médecins au Burkina Faso. Méthode. L’enquête CAP-CoV-BF a pu être financée dans le cadre du programme Aphro-CoV financé par l’Agence Française le Développement et mis en œuvre par le consortium REACTing. Le protocole de l’enquête a été développé en mai et juin 2020 et soumis au Comité d’Éthique pour la recherche en santé du Burkina Faso en juin 2020. L’enquête a été approuvée fin août. L’enquête CAP-CoV-BF est une série de trois vagues d’enquêtes quantitatives transversales (échantillons indépendants) par téléphone réalisée auprès d’un échantillon représentatif d’environ 200 médecins sur l’ensemble du territoire burkinabè. Les trois vagues ont été réalisées à différents stades de l’épidémie burkinabé : (i) alors que le nombre de cas était relativement peu important et plutôt stable en septembre 2020 ; (ii) début décembre 2020 alors que le pays faisait face au début d’un nouveau pic épidémique ; (iii) fin février 2021 à la fin de la vague épidémique ayant démarré en décembre 2020. La base d’échantillonnage était l’annuaire de l’ordre national des médecins du Burkina Faso (3548 médecins enregistrés). Résultats. Avant chaque vague d’enquête, 750 médecins étaient tirés au sort et recevaient un SMS de préannonce de l’enquête. Ils avaient la possibilité à cette étape de répondre au SMS pour refuser d’être appelé (vague 1 : 0 refus, vague 2 : 7, vague 3 : 9). L’envoi du SMS permettait également de vérifier si les numéros étaient toujours valides. Parmi les numéros valides et sans refus, un second échantillonnage était effectué. Chaque numéro de téléphone mis en production était rappelé au moins 5 fois (5 jours à des horaires différents) avant d’être considéré comme injoignable. Les refus de participer après décrochage sont restés relativement limités (respectivement 23, 5 et 10). Au final, 166 questionnaires ont été complété en 15 jours de collecte lors de la première enquête, 190 questionnaires en 13 jours pour la seconde et 203 questionnaires en 13 jours pour la troisième. Conclusion. Le dispositif d’enquête a permis de réaliser en des temps courts et avec un budget limité une enquête nationale et représentative des médecins au Burkina Faso. La passation par téléphone a permis à la fois de couvrir l’ensemble du territoire national tout en respectant les procédures de distanciations en vigueur.

Larmarange et al. - Sondages 2023 - Diaporama.pdf 2.5 Mio (source)

Larmarange et al. - Sondages 2023 - Résumé long.pdf 842 kio

Plazy Mélanie, Becquet Valentine, Maouhoub Esther, Meertens Carla, Mouquin Remi, Youssoufa Hasna, Nouaman Marcellin N., Coffie Patrick et Larmarange Joseph (2023) « PrEP among female sex workers: where are we? A literature review identifying knowledge gaps to guide the future research agenda » (communication orale), présenté à AIDS Impact Conference, Stockholm. https://hal.science/hal-04120001.

Résumé : Objectives. In 2015, the WHO recommended HIV pre-exposure prophylaxis (PrEP) for people at substantial risk of being infected by HIV, but also highlighted the need for research projects to improve PrEP implementation and follow-up, especially among female sex workers (FSW). While many studies have been published on PrEP among men who have sex with men, the literature is far less important among FSW. We aim to summarise the overall published literature on PrEP among FSW worldwide to display the challenges and facilitators of PrEP implementation in this population and highlight the knowledge gaps. Methods. We have conducted a systematic literature review searching Pubmed, Web of Sciences, Scopus, SocINDEX, APA PsycArticles, APA PsycInfo, Psychology and Behavioral Sciences Collection, until 31 December 2022. All manuscripts on PrEP in FSW were included worldwide, regardless of the primary outcome, the type of PrEP (oral, topical or long-acting), the study design, or the type of data collection. Titles and abstracts were independently screened by three reviewers, and full texts by two reviewers. We excluded papers: not presenting specific or stratified results on FSW; study protocols; conference abstracts; not written in English or French. Two independent reviewers then reviewed each included study to extract: Unaids region, country, study type, outcomes (see description in the results), type of PrEP, and study years. The results of the included papers will be analysed in more detail by one reviewer for each type of outcome. Results. Among the 412 published references identified through the search equation after duplicate removal, 198 were excluded based on the title and abstract, and 69 were excluded after full-text reading. Among the 145 papers included, n=10 were commentaries, n=17 literature reviews on global HIV prevention or including several populations, n=3 country case studies, n=24 modelling studies and n=91 other original papers. Among the latest, n=51 studies were conducted in Eastern and Southern Africa, n=13 in Western and Central Africa, n=11 in Asia and the Pacific, n=9 in Western and Central Europe and North America, n=7 in Latin America and the Caribbean; no studies were conducted in the Middle East and North Africa or Eastern Europe and Central Asia. The majority (n=85) were about oral PrEP. Regarding outcomes, n=39 were on knowledge/awareness, n=42 on willingness/interest, n=38 on attitudes/perceptions/beliefs, n=42 on uptake/use, n=21 on retention, n=23 on adherence, n=4 on efficacy/effectiveness, n=3 on epidemiological impacts, n=18 on behavioural impacts, n=5 on social impacts, n=10 on delivery models, n=9 on costs. Specific results for each type of outcome is in progress. Preliminary results suggest high PrEP willingness among FSW, but specific challenges regarding oral PrEP uptake and retention in this population. Discussion. The overall literature on PrEP focusing on FSW is relatively scarce (compared to more than 1850 references on PrEP among men who have sex with men identified on Pubmed by the end of 2022). The final results of this literature review will be available by May 2023. They will allow to guide the future research agenda regarding the implementation of biomedical HIV prevention among FSW.

Plazy Mélanie, Diallo Adama, Hlabisa Thabile, Okesola Nonhlanhla, Iwuji Collins, Herbst Kobus, Boyer Sylvie, Lert France, McGrath Nuala, Pillay Deenan, Dabis François, Larmarange Joseph, Orne-Gliemann Joanna et for the ANRS TasP Study Group (2023) « Implementation and effectiveness of a linkage to HIV care intervention in rural South Africa (ANRS 12249 TasP trial) », PLOS ONE, 18 (1) (janvier 20), p. e0280479. DOI : 10.1371/journal.pone.0280479. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0280479.

Résumé : Background Timely linkage to care and ART initiation is critical to decrease the risks of HIV-related morbidity, mortality and HIV transmission, but is often challenging. We report on the implementation and effectiveness of a linkage-to-care intervention in rural KwaZulu-Natal, South Africa. Methods In the ANRS 12249 TasP trial on Universal Testing and Treatment (UTT) implemented between 2012–2016, resident individuals ≥16 years were offered home-based HIV testing every six months. Those ascertained to be HIV-positive were referred to trial clinics. Starting May 2013, a linkage-to-care intervention was implemented in both trial arms, consisting of tracking through phone calls and/or home visits to “re-refer” people who had not linked to care to trial clinics within three months of the first home-based referral. Fidelity in implementing the planned intervention was described using Kaplan-Meier estimation to compute conditional probabilities of being tracked and of being re-referred by the linkage-to-care team. Effect of the intervention on time to linkage-to-care was analysed using a Cox regression model censored for death, migration, and end of data follow-up. Results Among the 2,837 individuals (73.7% female) included in the analysis, 904 (32%) were tracked at least once, and 573 of them (63.4%) were re-referred. Probabilities of being re-referred was 17% within six months of first referral and 31% within twelve months. Compared to individuals not re-referred by the intervention, linkage-to-care was significantly higher among those with at least one re-referral through phone call (adjusted hazard ratio [aHR] = 1.82; 95% confidence interval [95% CI] = 1.47–2.25), and among those with re-referral through both phone call and home visit (aHR = 3.94; 95% CI = 2.07–7.48). Conclusions Phone calls and home visits following HIV testing were challenging to implement, but appeared effective in improving linkage-to-care amongst those receiving the intervention. Such patient-centred strategies should be part of UTT programs to achieve the UNAIDS 95-95-95 targets.

Mots-clés : Antiretroviral therapy, Educational attainment, HIV, HIV diagnosis and management, HIV epidemiology, Schools, Viral load, Virus testing.

Plazy et al. - 2023 - Implementation and effectiveness of a linkage to H.pdf 1.2 Mio (source)

Silhol Romain, Maheu-Giroux Mathieu, Soni Nirali, Fotso Arlette Simo, Rouveau Nicolas, Vautier Anthony, Doumenc-Aidara Clemence, Geoffroy Olivier, N'Guessan Kouassi Noel, Sidibe Younoussa, Kabemba Ode Kanku, Gueye Papa Alioune, Mukandavire Christinah, Vickerman Peter, Keita Abdelaye, Ndour Cheikh Tidiane, Ehui Eboi, Larmarange Joseph, Boily Marie-Claude et Team The ATLAS (2023) « Assessing the potential population-level impacts of HIV self-testing distribution among key populations in Cote d'Ivoire, Mali, and Senegal: a mathematical modelling analysis », medRxiv. DOI : 10.1101/2023.08.23.23294498. https://www.medrxiv.org/content/10.1101/2023.08.23.23294498v2.

Résumé : Background: A third of people living with HIV (PLHIV) in Western Africa had an undiagnosed infection in 2020. In 2019-2021, the ATLAS programme has distributed a total of 380 000 HIV self-testing (HIVST) kits to key populations (KP) including female sex workers (FSW) and men who have sex with men (MSM), and their partners in Cote d'Ivoire, Mali and Senegal. We predicted the potential impact of ATLAS and of national HIVST scale-up strategies among KP. Methods: A deterministic model of HIV transmission was calibrated to country-specific empirical HIV and intervention data over time. We simulated scenarios reflecting 1) the actual ATLAS HIVST distribution only over 2019-2021 (~2% of all tests done in countries), and 2) ATLAS followed by a scale-up of HIVST distribution to KP (total of ~570 000 kits distributed each year). Impacts on HIV diagnosis, new HIV infections and deaths were derived using counterfactual scenarios without HIVST. Findings: ATLAS was predicted to substantially increase HIV diagnosis among KP by the end of 2021, especially among MSM in Mali (94.3 percentage point [pp] increase), and a 1.0pp increase overall. ATLAS might have averted a median of 706 new HIV infections among KP over 2019-2028 in the 3 countries combined, especially among MSM, and 1794 new HIV infections (0.4-3.3% of all new HIV infections across countries) and 591 HIV-related deaths overall. HIVST scale-up increased HIV diagnosis at the end of 2028 by around 8pp among FSW and 33pp among MSM in every country. Overall increases ranged from 1.0pp (Cote d'Ivoire) to 11.0pp (Senegal). HIVST scale-up may avert 3-5% of new HIV infections among FSW, 3-10% among FSW clients, and 20-28% among MSM across countries (and 2-16% overall), and avert 13-18% of HIV-related deaths among MSM over 2019-2028. Interpretation: Scaling-up HIVST distribution among KP in Western Africa may substantially attenuate disparities in access to HIV testing and help reduce HIV infections and deaths among KP and their partners.

Silhol et al_2023_Assessing the potential population-level impacts of HIV self-testing.pdf 200.6 kio (source)

Stannah James, Soni Nirali, Lam Jin Keng Stephen, Giguère Katia, Mitchell Kate M, Kronfli Nadine, Larmarange Joseph, Moh Raoul, Nouaman Marcellin, Kouamé Gérard Menan, Boily Marie-Claude et Maheu-Giroux Mathieu (2023) « Trends in HIV testing, the treatment cascade, and HIV incidence among men who have sex with men in Africa: a systematic review and meta-analysis », The Lancet HIV, p. S235230182300111X. DOI : 10.1016/S2352-3018(23)00111-X. https://linkinghub.elsevier.com/retrieve/pii/S235230182300111X.

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