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Ky-Zerbo O, Desclaux A, Kouadio AB, Rouveau N, Vautier A, Sow S, Camara SC, Boye S, Pourette D, Sidibé Y, Maheu-Giroux M, Larmarange J. 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. Front Public Health 2021; 9:653481. [PMID: 34733811 PMCID: PMC8558355 DOI: 10.3389/fpubh.2021.653481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 09/17/2021] [Indexed: 11/13/2022] Open
Abstract
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.
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Affiliation(s)
- Odette Ky-Zerbo
- TransVIHMI, Université de Montpellier, IRD, INSERM, Montpellier, France
| | - Alice Desclaux
- TransVIHMI, IRD, INSERM, University of Montpellier, Center Régional de Recherche et de Formation au VIH et Maladies Associées de Fann, Dakar, Senegal
| | - Alexis Brou Kouadio
- Département de Sociologie, Institut d'ethnosociologie (IES), Université Félix Houphouët Boigny de Cocody, Abidjan, Côte d'Ivoire
| | | | - Anthony Vautier
- Solidarité Thérapeutique et Initiatives Pour la Santé, Dakar, Senegal
| | - Souleymane Sow
- Center Régional de Recherche et de Formation à la Prise en Charge Clinique de Fann (CRCF), Dakar, Senegal
| | - Sidi Cheick Camara
- Département Santé, Institut Malien de Recherche en Sciences Sociales (IMRSS), Bamako, Mali
| | - Sokhna Boye
- Ceped, IRD, Université de Paris, Inserm, Paris, France
| | | | - Younoussa Sidibé
- Solidarité Thérapeutique et Initiatives pour la Santé, Bamako, Mali
| | - Mathieu Maheu-Giroux
- Department of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global Health, McGill University, Montréal, QC, Canada
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Jary A, Teguete I, Sidibé Y, Kodio A, Dolo O, Burrel S, Boutolleau D, Beauvais-Remigereau L, Sayon S, Kampo M, Traoré FT, Sylla M, Achenbach C, Murphy R, Berçot B, Bébéar C, Calvez V, Marcelin AG, Maiga AI. Prevalence of cervical HPV infection, sexually transmitted infections and associated antimicrobial resistance in women attending cervical cancer screening in Mali. Int J Infect Dis 2021; 108:610-616. [PMID: 34146691 DOI: 10.1016/j.ijid.2021.06.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 05/23/2021] [Accepted: 06/12/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To assess the prevalence of sexually transmitted infections (STIs), antimicrobial resistance and cervical lesions among women from Sikasso, Mali. METHODS Women infected with human immunodeficiency virus (HIV) (n=44) and HIV-negative women (n=96) attending cervical cancer screening were included. Screening for human papillomavirus (HPV), Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) was performed using polymerase chain reaction assays, and herpes simplex virus (HSV-1/2) serological status was assessed using enzyme-linked immunosorbent assays. Antibiotic resistance tests were performed for MG- and NG-positive cases. RESULTS A high prevalence of high-risk HPV (hrHPV) infection (63%) was found. This was associated with cervical lesions in 7.5% of cases. An unusual distribution was found, with HPV31, HPV56 and HPV52 being the most prevalent. The hrHPV distribution differed by HIV status, with HIV-positive cases having HPV35/31/51-52-56 and HIV-negative cases having HPV31/56/52. The seroprevalence of HSV-2 was 49%, and the prevalence of other STIs was as follows: CT, 4%; MG, 9%; NG, 1%; and TV, 7%. Five of nine MG-positive specimens and the NG strains obtained were resistant to fluoroquinolone. CONCLUSIONS These results showed high prevalence of hrHPV and fluoroquinolone resistance in several NG and MG strains. Further studies are required to confirm these data in Mali, and to improve prevention, screening and management of cervical cancer and other STIs in women.
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Affiliation(s)
- Aude Jary
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié Salpêtrière, Service de Virologie, Paris, France.
| | - Ibrahima Teguete
- CHU Gabriel Toure, Département de Gynéco-obstétrique, Bamako, Mali
| | | | - Amadou Kodio
- CHU Gabriel Toure, Département de Biologie Médicale, Bamako, Mali
| | - Oumar Dolo
- Université des Sciences Techniques et des Technologies de Bamako, USTTB, Centre de Recherche et de Formation sur le VIH et la Tuberculose SEREFO, Bamako, Mali
| | - Sonia Burrel
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié Salpêtrière, Service de Virologie, Paris, France
| | - David Boutolleau
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié Salpêtrière, Service de Virologie, Paris, France
| | | | - Sophie Sayon
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié Salpêtrière, Service de Virologie, Paris, France
| | | | - Fatoumata Tata Traoré
- Université des Sciences Techniques et des Technologies de Bamako, USTTB, Centre de Recherche et de Formation sur le VIH et la Tuberculose SEREFO, Bamako, Mali
| | - Mariam Sylla
- CHU Gabriel Toure, Département de Pédiatrie, Bamako, Mali
| | - Chad Achenbach
- Northwestern University, Institute for Global Health, Chicago, IL, USA
| | - Robert Murphy
- Northwestern University, Institute for Global Health, Chicago, IL, USA
| | - Béatrice Berçot
- University of Paris, IAME and St Louis Hospital, Department of Bacteriology, Associated Laboratory of the National Reference Centre for Bacterial STIs, Paris, France
| | - Cécile Bébéar
- CHU de Bordeaux and University of Bordeaux, Department of Bacteriology, National Reference Centre for Bacterial STIs, Bordeaux, France
| | - Vincent Calvez
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié Salpêtrière, Service de Virologie, Paris, France
| | - Anne-Geneviève Marcelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié Salpêtrière, Service de Virologie, Paris, France
| | - Almoustapha I Maiga
- CHU Gabriel Toure, Département de Biologie Médicale, Bamako, Mali; Université des Sciences Techniques et des Technologies de Bamako, USTTB, Centre de Recherche et de Formation sur le VIH et la Tuberculose SEREFO, Bamako, Mali
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