HIV pre-exposure prophylaxis for men who have sex with men in west Africa: a multicountry demonstration study
In: ISSN: 2405-4704, 2021
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International audience ; Background HIV pre-exposure prophylaxis (PrEP) data in men who have sex with men (MSM) in west Africa are essential to guide its large-scale implementation. We assessed the uptake of event-driven and daily PrEP, HIV incidence, and changes over time in sexual behaviours and prevalence of bacterial sexually transmitted infections (STIs) in MSM in Burkina Faso, Côte d'Ivoire, Mali, and Togo. Methods We did a prospective cohort study from Nov 20, 2017, to April 14, 2020, in four community-based clinics in Abidjan (Côte d'Ivoire), Bamako (Mali), Lomé (Togo), and Ouagadougou (Burkina Faso). Participants were MSM aged 18 years or older at substantial risk of HIV infection. Participants could choose between event-driven (2+1+1 dosing) and daily oral PrEP (tenofovir disoproxil fumarate 300 mg plus emtricitabine 200 mg), switch regimen, and discontinue or restart PrEP. We compared HIV incidence in this study with that of the same cohort before the availability of PrEP (CohMSM). Statistical analysis included the Kaplan-Meier method and mixed-effects regression models. This study is registered with ClinicalTrials.gov, NCT03459157. Findings We followed up 598 participants for a total of 743•6 person-years. At enrolment, 445 (74%) of 598 participants chose event-driven PrEP and 153 (26%) of 598 chose daily PrEP. 60 (13%) of 445 and 65 (42%) of 153 partici pants switched PrEP regimen at least once (p<0•0001). 159 participants (27%) were lost to follow-up. Overall HIV incidence was 2•3 per 100 person-years (95% CI 1•3-3•7; adjusted incidence rate ratio 0•21, 95% CI 0•12-0•36 compared with CohMSM). Adherence was optimal in 802 (41%) of 1946 measures with event-driven PrEP and in 394 (71%) of 554 measures with daily PrEP (p<0•0001). Coverage of sex acts with PrEP only and PrEP and condom decreased during follow-up (p=0•039 if PrEP only; p=0•0025 if PrEP and condom). The frequency of condomless anal sex remained stable (p=0•96). The number of male sexual partners (p<0•0001) and number of sex acts ...
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HIV pre-exposure prophylaxis for men who have sex with men in west Africa: a multicountry demonstration study
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| Autor/in / Beteiligte Person: | Laurent, Christian ; Dembélé Keita, B ; Yaya, Issifou ; Le Guicher, Gwenvael ; Sagaon-Teyssier, Luis ; Agboyibor, Mawuényégan, K ; Coulibaly, Alou ; Traoré, Issa ; Malan, Jean-Baptiste ; de Baetselier, Irith ; Eubanks, August ; Riegel, Lucas ; Castro, Daniela, Rojas ; Fayé-Ketté, Hortense ; Koné, Amadou ; Diandé, Souba ; Dagnra, Claver, A ; Serrano, Laetitia ; Diallo, Fodié ; Mensah, Ephrem ; Dah, Tiero, E ; Anoma, Camille ; Vuylsteke, Bea ; Spire, Bruno ; Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI) ; Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I (UY1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Cheikh Anta Diop de Dakar Sénégal (UCAD) ; ARCAD Santé PLUS Bamako, Mali ; Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD) ; Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM) ; Espoir Vie Togo Lomé, Togo ; Association African Solidarité Ouagadougou, Burkina Faso ; Espace Confiance Abidjan, Côte d’Ivoire ; Institute of Tropical Medicine Antwerp (ITM) ; Coalition PLUS Pantin, France ; Institut Pasteur de Côte d'Ivoire ; Réseau International des Instituts Pasteur (RIIP) ; Université des Sciences, des Techniques et des Technologies de Bamako (USTTB) ; Laboratoire National de Référence de la Tuberculose Ouagadougou, Burkina Faso (LNRT) ; Laboratoire National de Référence de la tuberculose Lomé, Togo (LNRT/CHU Lomé) ; CohMSM-PrEP Study Group: Christian Laurent, Issifou Yaya, Sayouba Ouedraogo, Bruno Granouillac, Gwenvael Le Guicher, Laetitia Serrano, Martine Peeters, Clotilde Couderc, Bruno Spire, Luis Sagaon-Teyssier, Marion Mora, Gwenaëlle Maradan, Michel Bourrelly, Mohamed Mimi, Cyril Berenger, Sylvie Boyer, Daniela Rojas Castro, Lucas Riegel, Paméla Palvadeau, Bea Vuylsteke, Irith De Baetselier, Thijs Reyniers, Bintou Dembélé Keita, Fodié Diallo, Alou Coulibaly, Alassane Kader Maïga, Drissa Camara, Mahamadou Diarra, Aly Ouologuem, Naboh Sangaré, Abdoul Aziz Keita, Oumar Cissé, Fodé Traoré, Bréhima Abdrahamane Ouary, Ibrahima Kanta, Camille Anoma, Jean-Baptiste Malan, Rachelle Kotchi, Niamkey Thomas Aka, Kpassou Julien Lokrou, Noufo Hamed Coulibaly, Ekissi Jean Armel Koffi, Dibi Frédéric N'guessan, Stéphane-Alain Babo Yoro, Adama Cissé, Ter Tiero Elias Dah, Issa Traoré, Camille Rajaonarivelo, Fayçal Rodrique Ouedraogo, Joseph Ouedraogo, Christian Coulibaly, Mamadou Ouedraogo, Ousseni Ilboudo, Abdoulazziz Traoré, Honoré Comsiambo, Ephrem Mensah, Mawuényégan Kouamivi Agboyibor, Anani Attisso, Anouwarsadat Kokouba, Aléda Mawuli Badjassim, Kouakou Kokouvi Selom Agbomadji, Messan Attiogbe, Kossi Jeff Yaka, Agbégnigan Lorette Ekon, Julien Bimba, Claver Anoumou Dagnra, Kokou Dominique Tegueni |
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| Zeitschrift: | ISSN: 2405-4704, 2021 |
| Veröffentlichung: | HAL CCSD ; Elsevier, 2021 |
| Medientyp: | academicJournal |
| DOI: | 10.1016/S2352-3018(21)00005-9 |
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