scholarly journals Enthusiasm for Introducing and Integrating HIV Self-Testing but Doubts About Users: A Baseline Qualitative Analysis of Key Stakeholders' Attitudes and Perceptions in Côte d'Ivoire, Mali and Senegal

2021 ◽  
Vol 9 ◽  
Author(s):  
Odette Ky-Zerbo ◽  
Alice Desclaux ◽  
Alexis Brou Kouadio ◽  
Nicolas Rouveau ◽  
Anthony Vautier ◽  
...  
Keyword(s):  
Cote D'ivoire ◽  
Sex Workers ◽  
Côte D’Ivoire ◽  
Key Populations ◽  
Structured Interviews ◽  
Cote D’Ivoire ◽  
Côte D'ivoire ◽  
Perceptions And Attitudes ◽  
Key Stakeholders ◽  
Self Testing

Since 2019, the ATLAS project, coordinated by Solthis in collaboration with national AIDS programs, has introduced, promoted and delivered HIV self-testing (HIVST) in Côte d'Ivoire, Mali and Senegal. Several delivery channels have been defined, including key populations: men who have sex with men, female sex workers and people who use injectable drugs. At project initiation, a qualitative study analyzing the perceptions and attitudes of key stakeholders regarding the introduction of HIVST in their countries and its integration with other testing strategies for key populations was conducted. The study was conducted from September to November 2019 within 3 months of the initiation of HIVST distribution. Individual interviews were conducted with 60 key informants involved in the project or in providing support and care to key populations: members of health ministries, national AIDS councils, international organizations, national and international non-governmental organizations, and peer educators. Semi structured interviews were recorded, translated when necessary, and transcribed. Data were coded using Dedoose© software for thematic analyses. We found that stakeholders' perceptions and attitudes are favorable to the introduction and integration of HIVST for several reasons. Some of these reasons are held in common, and some are specific to each key population and country. Overall, HIVST is considered able to reduce stigma; preserve anonymity and confidentiality; reach key populations that do not access testing via the usual strategies; remove spatial barriers; save time for users and providers; and empower users with autonomy and responsibility. It is non-invasive and easy to use. However, participants also fear, question and doubt users' autonomy regarding their ability to use HIVST kits correctly; to ensure quality secondary distribution; to accept a reactive test result; and to use confirmation testing and care services. For stakeholders, HIVST is considered an attractive strategy to improve access to HIV testing for key populations. Their doubts about users' capacities could be a matter for reflective communication with stakeholders and local adaptation before the implementation of HIVST in new countries. Those perceptions may reflect the West African HIV situation through the emphasis they place on the roles of HIV stigma and disclosure in HIVST efficiency.

scholarly journals Peer Recruitment Strategies for Female Sex Workers Not Engaged in HIV Prevention and Treatment Services in Côte d’Ivoire: Program Data Analysis

10.2196/18000 ◽  
2020 ◽  
Vol 6 (4) ◽  
pp. e18000
Author(s):  
Oluwasolape Olawore ◽  
Hibist Astatke ◽  
Tiffany Lillie ◽  
Navindra Persaud ◽  
Carrie Lyons ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Cote D'ivoire ◽  
Sex Workers ◽  
Côte D’Ivoire ◽  
Key Populations ◽  
Cote D’Ivoire ◽  
Female Sex ◽  
Côte D'ivoire ◽  
Prevention And Treatment ◽  
Peer Outreach

Background In the context of the mostly generalized HIV epidemic in Côte d’Ivoire, key populations bear a higher burden of HIV than that borne by the general reproductive-aged population. Mathematical models have demonstrated the significant potential impact and cost-effectiveness of improving the coverage of HIV prevention and treatment services for key populations in Côte d’Ivoire. However, in 2019, coverage of these services remained limited by multiple intersecting stigmas affecting key populations, necessitating the study of innovative implementation strategies to better meet the needs of those most marginalized. Here, we leverage programmatic data to compare the effectiveness of the enhanced and traditional peer outreach approaches in reaching and providing community HIV testing to female sex workers not readily engaged in HIV prevention and treatment services in Côte d’Ivoire. Objective The aim of this study was to describe the characteristics of female sex workers reached by the LINKAGES project in Côte d’Ivoire with enhanced peer outreach and traditional peer outreach and to compare HIV-related outcomes between the women reached by both strategies. Methods Deidentified routine programmatic data collected as part of LINKAGES Côte d’Ivoire between October 2017 and April 2018 were used in these analyses. Demographic characteristics and HIV indicators including HIV testing history, HIV case-finding, linkage to HIV treatment, and treatment initiation were assessed using descriptive statistics. Differences in these indicators were compared by outreach strategy using Pearson chi-square tests. Results There were 9761 women reached with enhanced peer outreach and routine peer outreach included in these analyses. The overall case-finding rate in the sample was 7.8% (698/8851). Compared with women reached by routine outreach, those reached by enhanced peer outreach were more likely to have previously been tested for HIV (enhanced: 1695/2509, 67.6%; routine: 4302/7252, 60.0%; χ21=43.8; P=.001). The enhanced peer outreach approach was associated with a higher HIV case-finding rate (enhanced: 269/2507 10.7%; routine: 429/6344, 6.8%; χ21=32.3; P=.001), higher proportion of linkage to treatment (enhanced: 258/269, 95.9%; routine: 306/429, 71.3%; χ21=64.4; P=.001), and higher proportion of treatment initiation (enhanced: 212/269, 78.8%; routine: 315/429, 73.3%; χ21=2.6; P=.11). Women reached by both approaches were categorized as high risk for HIV-related behaviors such as condomless sex and number of sex acts in the previous week. Conclusions These analyses suggest that the novel peer-referral strategy, the enhanced peer outreach approach, was effective in reaching female sex workeres in Côte d’Ivoire with demonstrated acquisition risks for HIV and who had not been effectively engaged by routine outreach approaches. Scaling up novel strategies such as enhanced peer outreach in the context of differentiated service models may be needed to optimize HIV prevention and treatment outcomes for key populations in Côte d’Ivoire.

scholarly journals Peer Recruitment Strategies for Female Sex Workers Not Engaged in HIV Prevention and Treatment Services in Côte d’Ivoire: Program Data Analysis (Preprint)

2020 ◽  
Author(s):  
Oluwasolape Olawore ◽  
Hibist Astatke ◽  
Tiffany Lillie ◽  
Navindra Persaud ◽  
Carrie Lyons ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Cote D'ivoire ◽  
Sex Workers ◽  
Côte D’Ivoire ◽  
Key Populations ◽  
Cote D’Ivoire ◽  
Female Sex ◽  
Côte D'ivoire ◽  
Prevention And Treatment ◽  
Peer Outreach

BACKGROUND In the context of the mostly generalized HIV epidemic in Côte d’Ivoire, key populations bear a higher burden of HIV than that borne by the general reproductive-aged population. Mathematical models have demonstrated the significant potential impact and cost-effectiveness of improving the coverage of HIV prevention and treatment services for key populations in Côte d’Ivoire. However, in 2019, coverage of these services remained limited by multiple intersecting stigmas affecting key populations, necessitating the study of innovative implementation strategies to better meet the needs of those most marginalized. Here, we leverage programmatic data to compare the effectiveness of the enhanced and traditional peer outreach approaches in reaching and providing community HIV testing to female sex workers not readily engaged in HIV prevention and treatment services in Côte d’Ivoire. OBJECTIVE The aim of this study was to describe the characteristics of female sex workers reached by the LINKAGES project in Côte d’Ivoire with enhanced peer outreach and traditional peer outreach and to compare HIV-related outcomes between the women reached by both strategies. METHODS Deidentified routine programmatic data collected as part of LINKAGES Côte d’Ivoire between October 2017 and April 2018 were used in these analyses. Demographic characteristics and HIV indicators including HIV testing history, HIV case-finding, linkage to HIV treatment, and treatment initiation were assessed using descriptive statistics. Differences in these indicators were compared by outreach strategy using Pearson chi-square tests. RESULTS There were 9761 women reached with enhanced peer outreach and routine peer outreach included in these analyses. The overall case-finding rate in the sample was 7.8% (698/8851). Compared with women reached by routine outreach, those reached by enhanced peer outreach were more likely to have previously been tested for HIV (enhanced: 1695/2509, 67.6%; routine: 4302/7252, 60.0%; χ<sup>2</sup><sub>1</sub>=43.8; <i>P</i>=.001). The enhanced peer outreach approach was associated with a higher HIV case-finding rate (enhanced: 269/2507 10.7%; routine: 429/6344, 6.8%; χ<sup>2</sup><sub>1</sub>=32.3; <i>P</i>=.001), higher proportion of linkage to treatment (enhanced: 258/269, 95.9%; routine: 306/429, 71.3%; χ<sup>2</sup><sub>1</sub>=64.4; <i>P</i>=.001), and higher proportion of treatment initiation (enhanced: 212/269, 78.8%; routine: 315/429, 73.3%; χ<sup>2</sup><sub>1</sub>=2.6; <i>P</i>=.11). Women reached by both approaches were categorized as high risk for HIV-related behaviors such as condomless sex and number of sex acts in the previous week. CONCLUSIONS These analyses suggest that the novel peer-referral strategy, the enhanced peer outreach approach, was effective in reaching female sex workeres in Côte d’Ivoire with demonstrated acquisition risks for HIV and who had not been effectively engaged by routine outreach approaches. Scaling up novel strategies such as enhanced peer outreach in the context of differentiated service models may be needed to optimize HIV prevention and treatment outcomes for key populations in Côte d’Ivoire.

scholarly journals Describing, analysing and understanding the effects of the introduction of HIV self-testing in West Africa through the ATLAS programme in Côte d’Ivoire, Mali and Senegal

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nicolas Rouveau ◽  
◽  
Odette Ky-Zerbo ◽  
Sokhna Boye ◽  
Arlette Simo Fotso ◽  
...  
Keyword(s):  
West Africa ◽  
Cote D'ivoire ◽  
Côte D’Ivoire ◽  
West African ◽  
Hiv Care ◽  
Key Populations ◽  
Cote D’Ivoire ◽  
Côte D'ivoire ◽  
Self Testing ◽  
Secondary Distribution

Abstract Background The ATLAS programme aims to promote and implement HIV self-testing (HIVST) in three West African countries: Côte d’Ivoire, Mali, and Senegal. During 2019–2021, in close collaboration with the national AIDS implementing partners and communities, ATLAS plans to distribute 500,000 HIVST kits through eight delivery channels, combining facility-based, community-based strategies, primary and secondary distribution of HIVST. Considering the characteristics of West African HIV epidemics, the targets of the ATLAS programme are hard-to-reach populations: key populations (female sex workers, men who have sex with men, and drug users), their clients or sexual partners, partners of people living with HIV and patients diagnosed with sexually transmitted infections and their partners. The ATLAS programme includes research support implementation to generate evidence for HIVST scale-up in West Africa. The main objective is to describe, analyse and understand the social, health, epidemiological effects and cost-effectiveness of HIVST introduction in Côte d’Ivoire, Mali and Senegal to improve the overall HIV testing strategy (accessibility, efficacy, ethics). Methods ATLAS research is organised into five multidisciplinary workpackages (WPs): Key Populations WP: qualitative surveys (individual in-depth interviews, focus group discussions) conducted with key actors, key populations, and HIVST users. Index testing WP: ethnographic observation of three HIV care services introducing HIVST for partner testing. Coupons survey WP: an anonymous telephone survey of HIVST users. Cost study WP: incremental economic cost analysis of each delivery model using a top-down costing with programmatic data, complemented by a bottom-up costing of a representative sample of HIVST distribution sites, and a time-motion study for health professionals providing HIVST. Modelling WP: Adaptation, parameterisation and calibration of a dynamic compartmental model that considers the varied populations targeted by the ATLAS programme and the different testing modalities and strategies. Discussion ATLAS is the first comprehensive study on HIV self-testing in West Africa. The ATLAS programme focuses particularly on the secondary distribution of HIVST. This protocol was approved by three national ethic committees and the WHO’s Ethical Research Committee.

scholarly journals Costs and Scale-Up Costs of Integrating HIV Self-Testing Into Civil Society Organisation-Led Programmes for Key Populations in Côte d'Ivoire, Senegal, and Mali

2021 ◽  
Vol 9 ◽  
Author(s):  
Marc d'Elbée ◽  
Métogara Mohamed Traore ◽  
Kéba Badiane ◽  
Anthony Vautier ◽  
Arlette Simo Fotso ◽  
...  
Keyword(s):  
Civil Society ◽  
Cote D'ivoire ◽  
Economies Of Scale ◽  
Côte D’Ivoire ◽  
Scale Up ◽  
Vulnerable Groups ◽  
Key Populations ◽  
Cote D’Ivoire ◽  
Côte D'ivoire ◽  
Self Testing

Despite significant progress on the proportion of individuals who know their HIV status in 2020, Côte d'Ivoire (76%), Senegal (78%), and Mali (48%) remain far below, and key populations (KP) including female sex workers (FSW), men who have sex with men (MSM), and people who use drugs (PWUD) are the most vulnerable groups with a HIV prevalence at 5–30%. HIV self-testing (HIVST), a process where a person collects his/her own specimen, performs a test, and interprets the result, was introduced in 2019 as a new testing modality through the ATLAS project coordinated by the international partner organisation Solthis (IPO). We estimate the costs of implementing HIVST through 23 civil society organisations (CSO)-led models for KP in Côte d'Ivoire (N = 7), Senegal (N = 11), and Mali (N = 5). We modelled costs for programme transition (2021) and early scale-up (2022–2023). Between July 2019 and September 2020, a total of 51,028, 14,472, and 34,353 HIVST kits were distributed in Côte d'Ivoire, Senegal, and Mali, respectively. Across countries, 64–80% of HIVST kits were distributed to FSW, 20–31% to MSM, and 5–8% to PWUD. Average costs per HIVST kit distributed were $15 for FSW (Côte d'Ivoire: $13, Senegal: $17, Mali: $16), $23 for MSM (Côte d'Ivoire: $15, Senegal: $27, Mali: $28), and $80 for PWUD (Côte d'Ivoire: $16, Senegal: $144), driven by personnel costs (47–78% of total costs), and HIVST kits costs (2–20%). Average costs at scale-up were $11 for FSW (Côte d'Ivoire: $9, Senegal: $13, Mali: $10), $16 for MSM (Côte d'Ivoire: $9, Senegal: $23, Mali: $17), and $32 for PWUD (Côte d'Ivoire: $14, Senegal: $50). Cost reductions were mainly explained by the spreading of IPO costs over higher HIVST distribution volumes and progressive IPO withdrawal at scale-up. In all countries, CSO-led HIVST kit provision to KP showed relatively high costs during the study period related to the progressive integration of the programme to CSO activities and contextual challenges (COVID-19 pandemic, country safety concerns). In transition to scale-up and integration of the HIVST programme into CSO activities, this model shows large potential for substantial economies of scale. Further research will assess the overall cost-effectiveness of this model.

scholarly journals Ethnopharmacological Study of Plants Used against Malaria by Traditional Healers in the Department of Bouna, North-Eastern Côte d'Ivoire

2020 ◽  
pp. 11-22
Author(s):  
Koffi Akissi Jeanne ◽  
Tano Konan Dominique ◽  
Kangah Orphée Michelle Alerte ◽  
Rasmane Na Ahou Kaddy ◽  
Ehoulé Kroa ◽  
...  
Keyword(s):  
Medicinal Plants ◽  
Cote D'ivoire ◽  
Côte D’Ivoire ◽  
Traditional Healers ◽  
Oral Route ◽  
Structured Interviews ◽  
Ethnobotanical Survey ◽  
Cote D’Ivoire ◽  
Côte D'ivoire ◽  
Therapeutic Alternatives

Mosquitoes have developed resistance, hence the need for anti-malarial medicines. This resistance calls for therapeutic an interest to therapeutic alternatives, including the medicinal plants. An ethnopharmacological survey was conducted amongst 15 Traditional Healers, recommended by the National Program for the Promotion of Traditional Medicine using semi-structured interviews in the city of Bouna. The ethnobotanical survey conducted in 2019 has enabled the identification of 32 plant species belonging to 30 genera and grouped into 19 families. The most represented families were Fabaceae (5 species) Anacardiaceae (4 species), Annonaceae (3 species), Rubiaceae, Zingiberaceae, Asteraceae, and Combretaceae with 2 species each. The species were mostly trees (63.63%). Leaves were the most frequently used parts of the plants (44.4%). The results of our investigations show that the most used mode is the decoction (42.22%). The oral route (60%) is the most used mode of administration. These species complete the non-exhaustive list of medicinal plants that the populations of Cote d'Ivoire use. It was found out that, people in this area commonly use medicinal plants with trust they have built on the curative outcome witnessed. However, this creates a further work to test for the antiplasmodial activity and to develop of Traditional Improved Medicines (MTAs).

HIV prevalence and risk behavior among clients of female sex workers in Abidjan, Côte d'Ivoire

AIDS ◽  
2003 ◽  
Vol 17 (11) ◽  
pp. 1691-1694 ◽  
Author(s):  
Bea L Vuylsteke ◽  
Peter D Ghys ◽  
Moussa Traoré ◽  
Yao Konan ◽  
Guessan Mah-Bi ◽  
...  
Keyword(s):  
Risk Behavior ◽  
Cote D'ivoire ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Côte D’Ivoire ◽  
Hiv Prevalence ◽  
Cote D’Ivoire ◽  
Female Sex ◽  
Côte D'ivoire

scholarly journals Ethnobotanical knowledge of medicinal values of Loranthaceae used to treat human diseases by local ethnic Agni Sanwi from Aboisso and Maferé in Côte d'Ivoire

2020 ◽  
Vol 4 (1) ◽  
pp. 039-050
Author(s):  
Amon Anoh Denis-Esdras ◽  
Ahoulou Assoum Stanislas ◽  
Achah Jacques Auguste Alfred Bognan ◽  
Sebe Fiba Doriane ◽  
Soro Dodiomon ◽  
...  
Keyword(s):  
Cote D'ivoire ◽  
Vascular Plants ◽  
Côte D’Ivoire ◽  
Woody Species ◽  
Traditional Healers ◽  
Ethnobotanical Knowledge ◽  
Structured Interviews ◽  
Informant Agreement ◽  
Cote D’Ivoire ◽  
Côte D'ivoire

Loranthaceae are hemiparasitic vascular plants that develop on other woody species. They are used in traditional medicine to treat various pathologies. The present study is a contribution to the knowledge of the medicinal potential of Loranthaceae used in care by Agni Sanwi of Aboisso and Maferé, in the South-East of Côte d'Ivoire. Ethnobotanical surveys were conducted with 50 herbalists and 17 traditional healers using semi-structured interviews. Three (3) species (Globimetula braunii, Phragmanthera capitata and Tapinanthus bangwensis) divided into 3 genera used to treat 35 diseases were identified. They have been cited in the formulation of several remedies. Malaria, typhoid fever, diarrhea and fontanelle were the most commonly reported conditions. Leaves and leafy twigs are the main organs used. The decoction has been predominant in the acquisition of remedies. The drink was the most cited as a method of administering treatments. The Frequency of Citations (FC) of the Loranthaceae employed in the care and medicinal Informant Agreement Ratio (med.IARs) of the respondents were determined. T. bangwensis had the highest FC (95.52%) and med.IARs (0.73). The therapeutic potentials of Loranthaceae have been highlighted and deserve to be popularized through complementary phytochemical investigations.

scholarly journals Lutte Contre Le Tabagisme Et Les Maladies Non Transmissibles En Côte d’Ivoire

2018 ◽  
Vol 14 (17) ◽  
pp. 235
Author(s):  
Aloko-N’guessan Kouadio Joël-Henri Gilles
Keyword(s):  
Cote D'ivoire ◽  
Côte D’Ivoire ◽  
Legal Framework ◽  
Point Of View ◽  
Financial Resources ◽  
Structured Interviews ◽  
Cote D’Ivoire ◽  
Thematic Content Analysis ◽  
Côte D'ivoire ◽  
The World

WHO is in charge of the fight against smoking and its consequences in the world. This institution makes recommendations to its member states in order to help them contain the scourge of smoking. The present study therefore evaluates the level of integration of these various recommendations of the WHO in the context of the fight against smoking in Côte d’Ivoire. It starts from the observation that the fight against smoking in Ivory Coast has produced for several years mixed results. From a methodological point of view, the approach adopted in this study is essentially qualitative. It consisted of conducting semi-structured interviews, a quantitative thematic content analysis and a bibliographic synthesis. Through this approach, we have achieved results that highlight the inadequacy of the legal framework and tobacco control tools in Côte d’Ivoire and the weakness of financial resources allocated to the fight against smoking in this country.

scholarly journals Introducing and Implementing HIV Self-Testing in Côte d'Ivoire, Mali, and Senegal: What Can We Learn From ATLAS Project Activity Reports in the Context of the COVID-19 Crisis?

2021 ◽  
Vol 9 ◽  
Author(s):  
Arsène Kouassi Kra ◽  
Géraldine Colin ◽  
Papa Moussa Diop ◽  
Arlette Simo Fotso ◽  
Nicolas Rouveau ◽  
...  
Keyword(s):  
Cote D'ivoire ◽  
Côte D’Ivoire ◽  
Key Populations ◽  
Peer Educators ◽  
Cote D’Ivoire ◽  
Health Crisis ◽  
Côte D'ivoire ◽  
Hygiene Measures ◽  
The Impact ◽  
Program Data

Background: The ATLAS program promotes and implements HIVST in Côte d'Ivoire, Mali, and Senegal. Priority groups include members of key populations—female sex workers (FSW), men having sex with men (MSM), and people who use drugs (PWUD)—and their partners and relatives. HIVST distribution activities, which began in mid-2019, were impacted in early 2020 by the COVID-19 pandemic.Methods: This article, focusing only on outreach activities among key populations, analyzes quantitative, and qualitative program data collected during implementation to examine temporal trends in HIVST distribution and their evolution in the context of the COVID-19 health crisis. Specifically, we investigated the impact on, the adaptation of and the disruption of field activities.Results: In all three countries, the pre-COVID-19 period was marked by a gradual increase in HIVST distribution. The period corresponding to the initial emergency response (March-May 2020) witnessed an important disruption of activities: a total suspension in Senegal, a significant decline in Côte d'Ivoire, and a less pronounced decrease in Mali. Secondary distribution was also negatively impacted. Peer educators showed resilience and adapted by relocating from public to private areas, reducing group sizes, moving night activities to the daytime, increasing the use of social networks, integrating hygiene measures, and promoting assisted HIVST as an alternative to conventional rapid testing. From June 2020 onward, with the routine management of the COVID-19 pandemic, a catch-up phenomenon was observed with the resumption of activities in Senegal, the opening of new distribution sites, a rebound in the number of distributed HIVST kits, a resurgence in larger group activities, and a rebound in the average number of distributed HIVST kits per primary contact.Conclusions: Although imperfect, the program data provide useful information to describe changes in the implementation of HIVST outreach activities over time. The impact of the COVID-19 pandemic on HIVST distribution among key populations was visible in the monthly activity reports. Focus groups and individual interviews allowed us to document the adaptations made by peer educators, with variations across countries and populations. These adaptations demonstrate the resilience and learning capacities of peer educators and key populations.

scholarly journals Les Déterminants Des Conflits De Compétences Dans Le Processus De Décentralisation En Cote d’Ivoire

2016 ◽  
Vol 12 (17) ◽  
pp. 334 ◽  
Author(s):  
Guiriobe Paumahoulou Jean-Arsene
Keyword(s):  
Cote D'ivoire ◽  
Côte D’Ivoire ◽  
Structured Interviews ◽  
Local Authorities ◽  
Political Factors ◽  
Cote D’Ivoire ◽  
Côte D'ivoire ◽  
Conflicts Of Jurisdiction

This study identifies and analyses the factors that determine jurisdictional conflicts prevailing in the decentralization process in Côte d’Ivoire. To achieve these objectives, we interviewed, using semi-structured interviews, resource persons in the departments of Alépé, Grand-Bassam, Guiglo and the District of Abidjan. From these interviews, it appears that conflicts of jurisdiction are classified into two categories: vertical conflicts and horizontal conflicts. The vertical conflicts arise between central structures of Government and local authorities. Horizontal conflicts occur between local authorities. Usually caused by structural realities, these conflicts are fueled and poisoned by economic and especially political factors.

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