Adherence to quarterly HIV prevention services and its impact on HIV incidence in men who have sex with men in West Africa (CohMSM ANRS 12324 - Expertise France)

Ter Tiero Elias Dah, Issifou Yaya, Luis Sagaon-Teyssier, Alou Coulibaly, Malan Jean-Baptiste Kouamé, Mawuényégan Kouamivi Agboyibor, Kader Maiga, Issa Traoré, Marion Mora, Paméla Palvadeau, Daniela Rojas-Castro, Fodié Diallo, Ephrem Mensah, Camille Anoma, Bintou Dembélé Keita, Bruno Spire, Christian Laurent, CohMSM Study Group, Christian Laurent, Issifou Yaya, Sayouba Ouedraogo, Bruno Granouillac, Laetitia Serrano, Martine Peeters, Clotilde Couderc, Bruno Spire, Luis Sagaon-Teyssier, Marion Mora, Gwenaëlle Maradan, Michel Bourrelly, Pierre-Julien Coulaud, Cyril Berenger, Daniela Rojas Castro, Adeline Bernier, Paméla Palvadeau, Bintou Dembélé Keita, Fodié Diallo, Alou Coulibaly, Kader Maïga, Drissa Camara, Mahamadou Diarra, Aly Ouologuem, Abdoul Aziz Keita, Oumar Cissé, Fodé Traoré, Bréhima Abdrahamane Ouary, Ibrahima Kanta, Camille Anoma, Malan Jean-Baptiste Kouame, Rachelle Kotchi, Niamkey Thomas Aka, Kpassou Julien Lokrou, Noufo Hamed Coulibaly, Jean Armel Ekessi Koffi, Frédéric Dibi N'guessan, Stéphane-Alain Babo Yoro, Adama Cissé, Ter Tiero Elias Dah, Issa Traoré, Camille Rajaonarivelo, Juste Rodrigue Touré, Joseph Ouedraogo, Christian Coulibaly, Mamadou Ouedraogo, Elisabeth Thio, Ousseni Ilboudo, Abdoulazziz Traoré, Honoré Comsiambo, Ephrem Mensah, Richard 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 Yaotsè Dagnra, Ter Tiero Elias Dah, Issifou Yaya, Luis Sagaon-Teyssier, Alou Coulibaly, Malan Jean-Baptiste Kouamé, Mawuényégan Kouamivi Agboyibor, Kader Maiga, Issa Traoré, Marion Mora, Paméla Palvadeau, Daniela Rojas-Castro, Fodié Diallo, Ephrem Mensah, Camille Anoma, Bintou Dembélé Keita, Bruno Spire, Christian Laurent, CohMSM Study Group, Christian Laurent, Issifou Yaya, Sayouba Ouedraogo, Bruno Granouillac, Laetitia Serrano, Martine Peeters, Clotilde Couderc, Bruno Spire, Luis Sagaon-Teyssier, Marion Mora, Gwenaëlle Maradan, Michel Bourrelly, Pierre-Julien Coulaud, Cyril Berenger, Daniela Rojas Castro, Adeline Bernier, Paméla Palvadeau, Bintou Dembélé Keita, Fodié Diallo, Alou Coulibaly, Kader Maïga, Drissa Camara, Mahamadou Diarra, Aly Ouologuem, Abdoul Aziz Keita, Oumar Cissé, Fodé Traoré, Bréhima Abdrahamane Ouary, Ibrahima Kanta, Camille Anoma, Malan Jean-Baptiste Kouame, Rachelle Kotchi, Niamkey Thomas Aka, Kpassou Julien Lokrou, Noufo Hamed Coulibaly, Jean Armel Ekessi Koffi, Frédéric Dibi N'guessan, Stéphane-Alain Babo Yoro, Adama Cissé, Ter Tiero Elias Dah, Issa Traoré, Camille Rajaonarivelo, Juste Rodrigue Touré, Joseph Ouedraogo, Christian Coulibaly, Mamadou Ouedraogo, Elisabeth Thio, Ousseni Ilboudo, Abdoulazziz Traoré, Honoré Comsiambo, Ephrem Mensah, Richard 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 Yaotsè Dagnra

Abstract

Background: Access to tailored HIV prevention services remains limited for West African MSM. We assessed adherence to quarterly HIV prevention services and its impact on HIV incidence in MSM followed up in four cities in Burkina Faso, Côte d'Ivoire, Mali, and Togo.

Methods: We performed a prospective cohort study between 2015 and 2018. HIV-negative MSM aged over 18 benefited from quarterly medical visits which included a clinical examination, HIV testing, screening and treatment for other sexually transmitted infections, peer-led counselling and support, and the provision of condoms and lubricants. Determinants of adherence to quarterly follow-up visits and incident HIV infections were identified using generalized estimating equation models and Cox proportional hazard models, respectively.

Results: 618 MSM were followed up for a median time of 20.0 months (interquartile range 15.2-26.3). Overall adherence to quarterly follow-up visits was 76.5% (95% confidence interval [CI] 75.1-77.8), ranging from 66.8% in Abidjan to 87.3% in Lomé (p < 0.001). 78 incident HIV infections occurred during a total follow-up time of 780.8 person-years, giving an overall incidence of 10.0 per 100 person-years (95% CI 8.0-12.5). Adherence to quarterly follow-up visits was not associated with the risk of incident HIV infection (adjusted hazard ratio 0.80, 95% CI 0.44-1.44, p = 0.545).

Conclusions: Strengthening HIV prevention services among MSM in West Africa, including the use of PrEP, will be critical for controlling the epidemic, not only in this key population but also in the general population. Quarterly follow-up of MSM, which is essential for PrEP delivery, appears feasible.

Trial registration: ClinicalTrials.gov, number NCT02626286 (December 10, 2015).

Keywords: Africa; HIV; Incidence; MSM; Prevention.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Adherence to quarterly follow-up visits (a) in all study cities (b) according to study city
Fig. 2
Fig. 2
Cumulative probability of incident HIV infections (a) in all study cities (b) according to study city. P-value calculated using the log-rank test

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Source: PubMed

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