Pre-exposure prophylaxis among men who have sex with men in Côte d’Ivoire: a quantitative study of acceptability

Background: HIV remains an important public health issue throughout the world. In Côte d’Ivoire, a high burden of HIV is observed in men who have sex with men (MSM). Objective: We assessed the acceptability of Pre-Exposure Prophylaxis (PrEP) among men who have sex with men (MSM) in Bouaké, Côte d’Ivoire. Methods: We conducted and analysed four focus groups with 31 HIV-negative MSM and eight in-depth individual interviews with participants recruited from the focus groups. Results: Four MSM (13%) were aware of PrEP before participating in the study. All the participants were interested in taking PrEP if available: 19 (61.3%) would prefer the daily regimen and 12 (38.7%) would opt for the on-demand regimen. Many advantages of PrEP were mentioned: protection in case of a condom break, protection in case of high-risk sexual behaviour, self-reliance, decreasing HIV fear and ease of use. Barriers to the use of PrEP included: it does not protect against other Sexually Transmitted Tnfections (STIs), taking a pill regularly is necessary, the size of the pill, possibility of side effects, the cost and accessibility. Six participants (19.3%) admitted that they would use condoms less if they take PrEP. Conclusion: Findings indicate that PrEP is acceptable within the MSM community. Implementation should be done rapidly, and PrEP should be part of a global prevention program which includes counselling, STI screening and promotion of safe sex practices. Health authorities should consider PrEP for all high-risk groups to avoid worsening stigmatization by targeting MSM only.

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Telephone peer recruitment and interviewing during a respondent-driven sampling (RDS) survey: feasibility and field experience from the first phone-based RDS survey among men who have sex with men in Côte d’Ivoire

BMC Medical Research Methodology ◽

10.1186/s12874-021-01208-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Maxime Inghels ◽

◽

Arsène Kra Kouassi ◽

Serge Niangoran ◽

Anne Bekelynck ◽

...

Keyword(s):

Cote D'ivoire ◽

Côte D’Ivoire ◽

Network Size ◽

Sub Saharan Africa ◽

Convergence To Equilibrium ◽

Respondent Driven Sampling ◽

Size Estimation ◽

Cote D’Ivoire ◽

Côte D'ivoire ◽

Sex With Men

Abstract Background Many respondent-driven sampling (RDS) methodologies have been employed to investigate hard-to-reach populations; however, these methodologies present some limits. We describe a minimally investigated RDS methodology in which peer recruitment and interviewing are phone-based. The feasibility of the methodology, field experiences, validity of RDS assumptions and characteristics of the sample obtained are discussed. Methods We conducted a phone-based RDS survey among men who have sex with men (MSM) aged 18 or above and living in Côte d’Ivoire. Eight initial MSM across Côte d’Ivoire were selected. Participants were asked to call a hotline to be registered and interviewed by phone. After the participants completed the questionnaire, they were asked to recruit a maximum of 3 MSM from their acquaintances. Results During the 9 months of the survey, 576 individuals called the hotline, and 518 MSM completed the questionnaire. The median delay between the invitation to participate and the completion of the questionnaire by peer-recruited MSM was 4 days [IQR: 1–12]. The recruitment process was not constant, with high variation in the number of people who called the hotline during the survey period. RDS chain convergence to equilibrium was reached within 6 waves for most of the selected variables. For the network size estimation assumption, participants who incorrectly estimated their network size were observed. Regarding the sample obtained, MSM were recruited from all the regions of Côte d’Ivoire with frequent interregional recruitment; 23.5% of MSM were recruited by someone who does not live in the same region. Compared to the MSM who participated in two other surveys in Côte d’Ivoire, the MSM in our sample were less likely to know about an MSM non-governmental organisation. However, MSM aged 30 years old and above and those with a low level of education were underrepresented in our sample. Conclusion We show that phone-based RDS surveys among MSM are feasible in the context of sub-Saharan Africa. Compared to other classical RDS survey methodologies, the phone-based RDS methodology seems to reduce selection bias based on geography and proximity with the MSM community. However, similar to other methodologies, phone-based RDS fails to reach older and less-educated MSM.

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The Epidemiology of HIV and Prevention Needs of Men Who Have Sex with Men in Abidjan, Cote d’Ivoire

PLoS ONE ◽

10.1371/journal.pone.0125218 ◽

2015 ◽

Vol 10 (4) ◽

pp. e0125218 ◽

Cited By ~ 23

Author(s):

Avi J Hakim ◽

Josephine Aho ◽

Gisele Semde ◽

Mamadou Diarrassouba ◽

Konan Ehoussou ◽

...

Keyword(s):

Cote D'ivoire ◽

Côte D’Ivoire ◽

Cote D’Ivoire ◽

Côte D'ivoire ◽

Sex With Men

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Sexual health needs of female sex workers in Côte d’Ivoire: a mixed-methods study to prepare the future implementation of pre-exposure prophylaxis (PrEP) for HIV prevention

BMJ Open ◽

10.1136/bmjopen-2018-028508 ◽

2020 ◽

Vol 10 (1) ◽

pp. e028508 ◽

Cited By ~ 1

Author(s):

Valentine Becquet ◽

Marcellin Nouaman ◽

Mélanie Plazy ◽

Jean-Marie Masumbuko ◽

Camille Anoma ◽

...

Keyword(s):

Hiv Prevention ◽

Condom Use ◽

Cote D'ivoire ◽

Sex Workers ◽

Female Sex Workers ◽

Côte D’Ivoire ◽

Mixed Methods Study ◽

Cote D’Ivoire ◽

Côte D'ivoire ◽

Exposure Prophylaxis

ObjectiveTo describe sexual and reproductive health (SRH) needs of female sex workers (FSWs) to inform the future implementation of pre-exposure prophylaxis (PrEP) for HIV prevention in this population.Design and settingThe ANRS 12361 PrEP-CI cross-sectional and mixed-methods study was designed and implemented with two community-based organisations in Côte d’Ivoire.ParticipantsA convenience sample of 1000 FSWs aged ≥18, not known as HIV-positive, completed a standardised questionnaire assessing sociodemographic characteristics, sexual practices, use of community health services and a priori acceptability of PrEP. Twenty-two indepth interviews and eight focus group discussions were also conducted to document FSWs’ risky practices and sexual behaviours, experiences with violence and discrimination, attitudes regarding HIV and sexually transmitted infections (STIs), and barriers to SRH services.ResultsAlthough 87% described consistent condom use with clients, more than 22% declared accepting condomless sexual intercourse for a large sum of money. Furthermore, condom use with their steady partner and knowledge of their partner’s HIV status were low despite their acknowledged concurrent sexual partnerships. While inconsistent condom use exposed FSWs to STIs and undesired pregnancies, the prevalence of contraceptive strategies other than condoms was low (39%) due to fear of contraception causing sterility. FSWs faced obstacles to accessing SRH care and preferred advice from their peers or self-medication.ConclusionsDespite adoption of preventive behaviour in most cases, FSWs are still highly exposed to HIV. Furthermore, FSWs seem to face several barriers to accessing SRH. Implementing PrEP among FSWs in West Africa, such as in Côte d’Ivoire, constitutes an opportunity to consider the regular follow-up of HIV-negative FSWs. PrEP initiation should not condition access to SRH services; conversely, SRH services could be a way to attract FSWs into HIV prevention. Our results highlight the importance of developing a people-focused approach that integrates all SRH needs when transitioning from PrEP efficacy trials to implementation.

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Sexual behavior stigma and depression among transgender women and cisgender men who have sex with men in Côte d'Ivoire

Annals of Epidemiology ◽

10.1016/j.annepidem.2019.03.002 ◽

2019 ◽

Vol 33 ◽

pp. 79-83.e1 ◽

Cited By ~ 3

Author(s):

Ayden Scheim ◽

Carrie Lyons ◽

Rebecca Ezouatchi ◽

Benjamin Liestman ◽

Fatou Drame ◽

...

Keyword(s):

Sexual Behavior ◽

Cote D'ivoire ◽

Côte D’Ivoire ◽

Transgender Women ◽

Cote D’Ivoire ◽

Côte D'ivoire ◽

Sex With Men

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Characterizing social cohesion and gender identity as risk determinants of HIV among cisgender men who have sex with men and transgender women in Côte d’Ivoire

Annals of Epidemiology ◽

10.1016/j.annepidem.2019.11.003 ◽

2020 ◽

Vol 42 ◽

pp. 25-32

Author(s):

Alexander Moran ◽

Ayden Scheim ◽

Carrie Lyons ◽

Benjamin Liestman ◽

Fatou Drame ◽

...

Keyword(s):

Gender Identity ◽

Social Cohesion ◽

Cote D'ivoire ◽

Côte D’Ivoire ◽

Transgender Women ◽

Cote D’Ivoire ◽

Côte D'ivoire ◽

And Gender ◽

Sex With Men ◽

Risk Determinants

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A community-based healthcare package combining testing and prevention tools, including pre-exposure prophylaxis (PrEP), immediate HIV treatment, management of hepatitis B virus, and sexual and reproductive health (SRH), targeting female sex workers (FSWs) in Côte d’Ivoire: the ANRS 12381 PRINCESSE project

BMC Public Health ◽

10.1186/s12889-021-12235-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Valentine Becquet ◽

Marcellin Nouaman ◽

Mélanie Plazy ◽

Aline Agoua ◽

Clémence Zébago ◽

...

Keyword(s):

Hepatitis B ◽

Cote D'ivoire ◽

Sex Workers ◽

Côte D’Ivoire ◽

Community Based ◽

Cote D’Ivoire ◽

Côte D'ivoire ◽

Exposure Prophylaxis ◽

Depth Interviews

Abstract Background Pre-exposure prophylaxis (PrEP) is recommended by the WHO for HIV prevention among female sex workers (FSWs). A study conducted in 2016–2017 in Côte d’Ivoire showed that if PrEP is acceptable, FSWs also have many uncovered sexual health needs. Based on this evidence, the ANRS 12381 PRINCESSE project was developed in collaboration with a community-based organization. The main objective is to develop, document, and analyze a comprehensive sexual and reproductive healthcare package among FSWs in Côte d’Ivoire. Methods PRINCESSE is an open, single-arm interventional cohort of 500 FSWs in San Pedro (Côte d’Ivoire) and its surroundings. Recruitment started on November 26th, 2019 and is ongoing; the cohort is planned to last at least 30 months. The healthcare package (including HIV, hepatitis B, and sexually transmitted infection management, pregnancy screening, and contraception) is available both at mobile clinics organized for a quarterly follow-up (10 intervention sites, each site being visited every two weeks) and at a fixed clinic. Four waves of data collection were implemented: (i) clinical and safety data; (ii) socio-behavioral questionnaires; (iii) biological data; and (iv) in-depth interviews with female participants. Four additional waves of data collection are scheduled outside the cohort itself: (i) the medical and activity records of Aprosam for the PRINCESSE participants; (ii) the medical records of HIV+ FSW patients not participating in the PRINCESSE cohort, and routinely examined by Aprosam; (iii) in-depth interviews with key informants in the FSW community; and (iv) in-depth interviews with PRINCESSE follow-up actors. Discussion The PRINCESSE project is one of the first interventions offering HIV oral PrEP as part of a more global sexual healthcare package targeting both HIV- and HIV+ women. Second, STIs and viral hepatitis B care were offered to all participants, regardless of their willingness to use PrEP. Another innovation is the implementation of mobile clinics for chronic/quarterly care. In terms of research, PRINCESSE is a comprehensive, interdisciplinary project combining clinical, biological, epidemiological, and social specific objectives and outcomes to document the operational challenges of a multidisease program in real-life conditions. Trial registration The PRINCESSE project was registered on the Clinicaltrial.gov website (NCT03985085) on June 13, 2019.

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