Changes in risky sexual behaviours among West African MSM enrolled in a quarterly HIV testing and counselling prevention programme (CohMSM ANRS 12324 - Expertise France). - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Sexually Transmitted Infections Année : 2020

Changes in risky sexual behaviours among West African MSM enrolled in a quarterly HIV testing and counselling prevention programme (CohMSM ANRS 12324 - Expertise France).

Bintou Dembélé Keita
  • Fonction : Auteur
Abdoul Aziz Keita
  • Fonction : Auteur
Camille Anoma
  • Fonction : Auteur
Stéphane-Alain Babo Yoro
  • Fonction : Auteur
Christian Coulibaly
  • Fonction : Auteur
Ephrem Mensah
  • Fonction : Auteur
Selom Agbomadji
  • Fonction : Auteur
Pamela Palvadeau
  • Fonction : Auteur
Adeline Bernier
  • Fonction : Auteur

Résumé

OBJECTIVES: Whether regular HIV testing and counselling reduce risky sexual behaviours in African men who have sex with men (MSM) is still a matter for debate. We aimed to identify behavioural trajectories based on HIV risk exposure (HRE) and factors affecting their evolution. METHODS: Data were collected from 621 HIV-negative West African MSM (Mali, Cote d'Ivoire, Burkina Faso and Togo) included in a community-based cohort providing quarterly HIV testing and counselling. Sociobehavioural data were collected every 6 months. HRE was defined as reporting inconsistent condom use during receptive anal sex with male partners of unknown HIV status in the previous 6 months. Using 18-month follow-up data, group-based trajectory modelling helped identify behavioural trajectories and determine the factors associated with their evolution. HIV seroconversions (n=67) were specified in each group trajectory. RESULTS: Two distinct group trajectories were identified: medium-risk exposure MSM (ME-MSM) (61%, 6.4% of whom having seroconverted) and high-risk exposure MSM (HE-MSM) (39%, 17.5% of whom having seroconverted). A significant declining trend in the probability of reporting HRE over time ((95% CI)) was observed for HE-MSM (from 0.59 (0.48 to 0.70) at M0 to 0.31 (0.22 to 0.41) at M18), while it remained constant for ME-MSM (0.034 (0.0 to 0.079)). This can be explained by a progressive use of risk reduction strategies (less receptive anal sex, better knowledge of their partners' status and increasing condom use). Being younger, living in Burkina Faso, self-considering both a man and a woman and reporting a higher level of depression were all associated with HE membership. Among HE-MSM, HRE was higher in those practising transactional or group sex and those experiencing psychological harassment. CONCLUSIONS: Quarterly HIV testing and counselling seem to reduce risky sexual behaviours in HIV-negative MSM at greatest risk of infection. Specific support for young MSM, focusing on identity and mental health, is needed to strengthen HIV prevention in West African MSM.
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hal-02511753 , version 1 (18-05-2021)

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Pierre-Julien Coulaud, Luis Sagaon-Teyssier, Mohamed Mimi, Gwenaelle Maradan, Marion Mora, et al.. Changes in risky sexual behaviours among West African MSM enrolled in a quarterly HIV testing and counselling prevention programme (CohMSM ANRS 12324 - Expertise France).. Sexually Transmitted Infections, 2020, 96 (2), pp.115-120. ⟨10.1136/sextrans-2018-053892⟩. ⟨hal-02511753⟩
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