The geographical analysis of the main data on the HIV1 epidemic in Central Africa shows a frontline which has not moved significantly since 1985. The absence of a progressive increase between the countries, demonstrating a discontinuity in space, combined with the observed human and physical continuity within the areas, raises several questions. Are the low-rate areas facing only a simple delay in the diffusion, or is there a real difference between the epidemiological patterns of HIV1 in the two areas? The last hypothesis would impose a revision of the concept of an homogeneous pattern in the epidemiology of HIV1 in Africa. The need for further research is emphasized with the aim of precisely targeting preventive intervention.

The “Urban Health Workshop” [“Atelier santé ville” (Asv)] approach, created in 2000 and interfacing between urban development policies and public health, is implemented in about 250 territories. After more than fifteen years of implementation and development, it appeared useful to review experiences and analyse their effects.Conducted in 2015, this research demonstrates the benefits of Asv, which created health territorial dynamics and local strategies to reduce social and territorial health inequalities. Fifty-one Asv coordinators participated in the study, 30 by answering a survey, 28 (7 of whom had already answered the survey) by a semi-structured interview. The high flexibility of the approach, essential to adapt to a complex reality, justifies a qualitative analysis.Capitalising on these experiences defined the main lessons from implementation of the Asv approach and identified the “good practices” of some of the projects, with the objective of promotion and dissemination of the knowledge acquired. The main consequences observed are territorial dynamics, mobilization of diverse actors and transfer of people’s needs to policy-makers and elected representatives. Health promotion was a central part of all experiences: Asvs implement an approach that is inspired and guided by the five action areas for health promotion identified in the Ottawa Charter.Moreover, the majority of Local Health Contracts (“Contrats locaux de santé”) are based on existing Asvs, indicating the effectiveness of the approach..

Tobacco use is in itself a public health issue, but it also represents an identified entry point to the consumption of other toxic products. The key age group for initial consumption is that around the end of junior high school and the beginning of high school, when students' high level of autonomy is combined with a new set of educational circumstances and challenges. Intervening in a school or educational setting is not easy and often criticized. This programme involved around fifty secondary schools in the greater Paris metropolitan region, followed over several years, benefiting from substantial evaluation, including evaluation of results. The action combines a collective intervention in the classrooms coupled with the availability of a CO-testing stand to which the young people have open access. Several tools were created, including tools for evaluation. Significant preparation work and the creation and strengthening of solid partnerships were necessary, with a very strong investment in sustainability. The positive results which have been observed allow for the consideration of transfer methods for reproducing the activity combining two approaches into a repetitive and continuous process.

L’utilisation de l’art en éducation a fait l’objet d’une étude rétrospective sur trente années d’interventions auprès de publics le plus souvent en grande difficulté. Ce travail a permis de dégager un nouveau modèle appelé « pédagogie de l’interstice », qui mobilise imaginaire, croyance, affectivité, sensorialité, corporéité, émotion, appartenance, avec l’objectif de construire l’ empowerment des participants, dans un cadre éthique bien déterminé. Ces différents éléments s’articulent selon un modèle dont la pertinence éducative dépasse le seul champ de la santé, permet de comprendre comment fonctionne la « boîte noire » de l’outil artistique et d’en redéfinir les modalités d’évaluation. Certaines conditions éthiques et postures pratiques mobilisées autour de l’intervention et pendant sa mise en œuvre sont incontournables.

Résumé La prévention n’est pas une invention moderne. Elle a existé de tout temps, dès lors que l’homme a pris conscience que son avenir pouvait être modifié par son comportement présent. Plusieurs étapes dogmatiques se sont succédé au fil des siècles avec des effets dévastateurs. L’après-guerre a exigé une refonte des principes et des méthodes d’intervention en santé, permettant l’émergence de la notion d’éthique, concept non dogmatique de mise en discussion permanente. C’est grâce à cette notion qu’ont pu se développer des actions d’éducation pour la santé donnant aux populations les moyens de gérer globalement leur bien-être et de tolérer les différences. Néanmoins, cet équilibre demeure très instable et la normativité excluante peut très vite resurgir au nom d’un néodogme de la prévention.