Community-Based Care in the ANRS-IPERGAY Trial: The Challenges of Combination Prevention

Puppo, Costanza; Mabire, Xavier; Cotte, Laurent; Castro, Daniela Rojas; Spire, Bruno; Cua, Éric; Pialoux, Gilles; Monti, Marie Suzan; Pasquet, A.; Raffi, François; Molina, Jean‐Michel; Préau, Marie

doi:10.1521/aeap.2019.31.3.259

Cited by 6 publications

(17 citation statements)

References 39 publications

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“…Therefore, they are in a good position to provide PrEP services for people who experience barriers to visit other medical providers [26,30]. Also members of the community and of key populations can be involved in the delivery of PrEP or related services [25,28,47,49]. Especially in contexts where community health workers have historically been more involved in the delivery of (HIV) services, such as sub-Saharan Africa and Thailand, task-shifting to lay providers might be more acceptable and successful for PrEP delivery alike [64,65].…”

Section: Discussionmentioning

confidence: 99%

“…Six articles had an exclusive focus on MSM as a target group [39][40][41][42][43][44]. Five articles had a focus on the combination of MSM and TGW [45][46][47][48][49]. One study focused exclusively on TGW [50], one on female sex workers (FSW) [51], one on men and women in a serodiscordant relationship [52], one on pregnant or postpartum women [53] and one study focused exclusively on youth (11-24 years old) at risk of HIV acquisition [54].…”

Section: Key Population-speci C Modelsmentioning

confidence: 99%

“…In one article, PrEP services were provided in a hospital setting by integrating PrEP in reproductive health services provided to pregnant and postpartum women in Kenya [53]. Lastly, sometimes PrEP was delivered as part of a study setting, with the clinical site of PrEP provision being referred to as 'study centres' [39,[45][46][47].…”

Section: Key Population-speci C Modelsmentioning

confidence: 99%

“…Community-based health workers (CBHW) or peers were reportedly involved in PrEP service delivery. Their role varied, and involved mostly counseling and providing adherence support for PrEP users [25,28,32,47].…”

Section: Community-based Modelsmentioning

confidence: 99%

“…Delivery channels were understood as platforms or media that were used to deliver PrEP services to the people. In most of the articles, PrEP care was provided through a 'traditional' face-to-face setting, meaning PrEP clients attended in-person to a service provider in a given physical setting [22][23][24][25][26][27][28][29][31][32][33][34][35][36][37][38]40,44,47,[49][50][51][52][53][54].…”

Section: Traditional Delivery Modelsmentioning

confidence: 99%

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The current landscape of pre-exposure prophylaxis service delivery models for HIV prevention: a scoping review

Vanhamel

Rotsaert

Reyniers

et al. 2020

Preprint

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Background: Strengthening HIV prevention is imperative given the continued high HIV incidence worldwide. The introduction of oral PrEP as a new biomedical HIV prevention tool can be a potential game changer because of its high clinical efficacy and the feasibility of its provision to different key populations. Documenting the existing experience with PrEP service delivery in a variety of real-world settings will inform how its uptake and usage can be maximised. Methods: We conducted a scoping review using the five-step framework provided by Arksey and O’Malley. We systematically searched the existing peer-reviewed international and grey literature describing the implementation of real-world PrEP service delivery models reporting on four key components: the target population of PrEP services, the setting where PrEP was delivered, PrEP providers’ professionalisation and PrEP delivery channels. We restricted our search to English language articles. No geographical or time restrictions were set.Results: This review included 33 articles for charting and analysing of the results. The identified service delivery models showed that PrEP services mainly targeted people at high risk of HIV acquisition, with some models targeting specific key populations, mainly men who have sex with men. PrEP was often delivered centralised and in a clinical or hospital setting. Yet also community-based as well as home-based PrEP delivery models were reported. Providers of PrEP were mainly clinically trained health professionals, but in some rare cases community workers and lay providers also delivered PrEP. In general, in-person visits were used to deliver PrEP. More innovative digital options using mHealth and telemedicine approaches to deliver specific parts of PrEP services are currently being applied in a minority of the service delivery models in mainly high-resource settings.Conclusions: A range of possible combinations was found between all four components of PrEP service delivery models. This reflects differentiation of care according to different contextual settings. More research is needed on how integration of services in these contexts could be expanded and optimised to respond to key populations with unmet HIV prevention needs in different settings.

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Section: Discussionmentioning

confidence: 99%

Section: Key Population-speci C Modelsmentioning

confidence: 99%

Section: Key Population-speci C Modelsmentioning

confidence: 99%

Section: Community-based Modelsmentioning

confidence: 99%

Section: Traditional Delivery Modelsmentioning

confidence: 99%

See 3 more Smart Citations

The current landscape of pre-exposure prophylaxis service delivery models for HIV prevention: a scoping review

Vanhamel

Rotsaert

Reyniers

et al. 2020

Preprint

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Population-level effectiveness of a national HIV preexposure prophylaxis programme in MSM

Estcourt

Yeung

Nandwani

et al. 2021

Aids

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Objective: The aim of this study was to evaluate Scotland's national HIV preexposure prophylaxis (PrEP) programme in relation to PrEP uptake and associated population-level impact on HIV incidence among MSM. Design: A retrospective cohort study within real-world implementation. Methods: Comparison of HIV diagnoses from national surveillance data and HIV incidence within a retrospective cohort of HIV-negative MSM attending sexual health clinics from the National Sexual Health information system between the 2-year periods pre(July 2015–June 2017) and post(July 2017–June 2019) introduction of PrEP. Results: Of 16 723 MSM attending sexual health services in the PrEP period, 3256 (19.5%) were prescribed PrEP. Between pre-PrEP and PrEP periods, new HIV diagnoses among MSM declined from 229 to 184, respectively [relative risk reduction (RRR): 19.7%, 95% confidence interval (95% CI) 2.5–33.8]; diagnosed recently acquired infections declined from an estimated 73 to 47, respectively (35.6%, 95% CI 7.1–55.4). Among MSM attending sexual health clinics, HIV incidence per 1000 person-years declined from 5.13 (95% CI 3.90–6.64) pre-PrEP to 3.25 (95% CI 2.30–4.47) in the PrEP period (adjusted IRR 0.57, 95% CI 0.37–0.87). Compared with the pre-PrEP period, incidence of HIV was lower in the PrEP period for those prescribed PrEP (aIRR 0.25, 95% CI 0.09–0.70) and for those not prescribed PrEP (aIRR 0.68, 95% CI 0.43–1.05). Conclusion: We demonstrate national population-level impact of PrEP for the first time in a real-world setting. HIV incidence reduced in MSM who had been prescribed PrEP and, to a lesser extent, in those who had not. Promotion of the benefits of PrEP needs to extend to MSM who do not access sexual health clinics.

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FOREST protocol: a qualitative study exploring health and sexuality of transmasculine individuals in France

et al. 2021

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IntroductionWhile current research on sexuality and health often explores sexual behaviours among heterosexual and gay cisgender individuals, little is known about the sexualities of transgender people, especially transmasculine people. When data are available, sexual health is often reduced to risk exposure, not considering in detail social context and determinants that could contribute to a more comprehensive approach, such as general health, class, race, exposure to violence or social representations. Recognising this gap, identified in both national (French) and international scientific literature, this study aims to explore the sexual health of transmasculine people, employing an intersectional approach and considering both positive and negative health determinants.MethodsThis 2-year research based in the disciplinary field of social psychology, with a gender perspective, and will apply qualitative methods. We adopt a community-based research approach, integrating one university and one community-based organisation in the coordination of the study. In a triangulation perspective, two rounds of semistructured interviews will be performed with key informants (medical practitioners, community-based support services workers, etc) and with people self-identifying as transmasculine. Focus groups will complement data collection.Ethics and disseminationFOREST protocol was approved by the Comité d’Évaluation Éthique (CEEI) de l’Institut National de la Santé Et de la Recherche Médicale (CEEI/International Review Board 00003888). The research adopts the principles of open science, and findings will be published assuring participants’ confidentiality. Informative flyers and videos will be elaborated to communicate study findings to participants, stakeholders and the transcommunities at large, and data will be stored in lasting archives.

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Community-Based Care in the ANRS-IPERGAY Trial: The Challenges of Combination Prevention

Cited by 6 publications

References 39 publications

The current landscape of pre-exposure prophylaxis service delivery models for HIV prevention: a scoping review

The current landscape of pre-exposure prophylaxis service delivery models for HIV prevention: a scoping review

Population-level effectiveness of a national HIV preexposure prophylaxis programme in MSM

FOREST protocol: a qualitative study exploring health and sexuality of transmasculine individuals in France

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