Risk perception is one of the several important factors impacting sexual health behaviours. This study investigated the evolution of HIV risk perception on pre-exposure prophylaxis adherence and condom use in men who have sex with men at high risk of HIV and associated factors. Group-based trajectory modelling helped in identifying patterns of risk perception, pre-exposure prophylaxis adherence and condom use over time. The association between the former and the latter two dimensions was then investigated. An estimated 61 per cent ( p < 0.001) of participants perceiving low risk and 100 per cent ( p < 0.001) of those perceiving high risk had systematic pre-exposure prophylaxis adherence, while an estimated 49 per cent ( p < 0.001) and 99.8 per cent ( p < 0.001), respectively, reported low-level condom use.

HAL is a multi-disciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L'archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

ObjectiveTo describe changes in pre-exposure prophylaxis (PrEP) use during and following the COVID-19 lockdown in France (March–May 2020) and identify the factors associated with PrEP discontinuation among men who have sex with men (MSM) after the lockdown.MethodsData from the, an anonymous, cross-sectional internet survey among MSM in July 2020, were analysed. Among respondents who were using PrEP prior to the lockdown, a binary logistic regression model was used to compare participants who were still taking PrEP (current PrEP users) with those who were not taking PrEP at the time of the survey (former PrEP users).ResultsAmong 8345 respondents, 946 were PrEP users before the lockdown, of whom 58.8% (n=556) reported stopping PrEP during the lockdown and 15.4% (n=146) were not using PrEP at the time of the survey. Among the 556 who stopped PrEP during lockdown, 86.5% (n=481) reported no sexual activity; 76.8% (n=427) restarted PrEP after lockdown. Former PrEP users were more likely to be younger, not living with a stable male sexual partner, report moderate anxiety, report increased psychoactive drug use during the lockdown, and report not having tested for HIV or STI since the end of the lockdown because they did not know where to go, preferred to wait or for another reason. Reporting fewer male sexual partners in the last 6 months was also significantly associated with being a former PrEP user.ConclusionsMSM adapted PrEP use to their sexual activity during and after the French lockdown. After the lockdown, discontinued PrEP occurred more often among MSM who had fewer sexual partners and had mental health vulnerabilities. These factors could also be predictive of PrEP discontinuation in a more general context. PrEP users should be informed on how to safely stop/start PrEP and on the use of other prevention tools to reduce potential risk exposure during PrEP discontinuation.

Objective: This study aimed to identify situational and behavioral factors associated with condomless anal sex without on-demand PrEP in the open-label extension (OLE) study of the ANRS-IPERGAY trial. Methods: Univariable and multivariable modified Poisson regressions with a generalized estimating equation (GEE) were used. The attributable risk percentage for each explanatory variable and for condomless anal sex without PrEP was calculated.

The ANRS-IPERGAY trial consisted in providing sexual activity-based antiretroviral prophylaxis for HIV prevention (PrEP) with a package of prevention tools (counselling, condoms, HIV and sexually transmitted infections' screening) to highly exposed HIV-negative men who have sex with men (MSM). Few data exist concerning the patient-physician relationship in the particular context of PrEP, where physicians discuss sexual behaviours with MSM who are not classic patients, in that consultation is for prevention purposes, not for illness. This study took place during the open-label extension of ANRS-IPERGAY trial when all participants received PrEP. In this qualitative study, we examined how physicians perceived their relationship with participants in the ANRS-IPERGAY trial. Of all 30 physicians involved in the trial who were contacted by email to participate in an interview about their opinions and perceptions of ANRS-IPERGAY 18 volunteered to participate in the current sub-study. We performed a vertical analysis for each interview to identify the extract in each physician's discourse concerning their relationship with MSM participants, and conducted a horizontal analysis to construct the thematic tree and subsequently investigate differences and similitudes between themes. An analysis of all physicians' discourses showed that the participant-physician relationship during the trial could be described through 4 themes: (i) personal experience of the relationship, (ii) trust and non-judgement, (iii) positive relational climate and (iv) influence of physician's characteristics (age, gender, etc.) on relationship. We found that the particular context of PrEP led some physicians to adopt a patient-as-partner approach during consultations rather than a paternalist or hierarchical approach. Indeed, the close follow-up provided by the trial and the active role of patients in their own prevention care trajectory, are more compatible with the patient-as-partner approach. The prescription of PrEP may lead to an evolution in patient-physician relationships and may even modify the professional identity of physicians.

En 2020, la crise sanitaire COVID-19 a touché toutes les régions du monde, n’épargnant pas les personnes déjà vulnérables à d’autres épidémies virales telles que le VIH ou le VHC et/ou celles en situation de précarité ou socialement marginalisées, tels que les usagers-ères de drogues ou les travailleurs-ses du sexe. Coalition PLUS, réseau d’associations de lutte contre le VIH et les hépatites virales, qui défend et promeut la démarche communautaire, et ses partenaires ont mis en place une recherche multi-pays ayant pour but de documenter l’impact de la crise sanitaire dans le domaine de la lutte contre le VIH et les hépatites virales (populations clés et acteurs-rices communautaires) ainsi que les réponses communautaires mises en place (enquête EPIC). L’objectif de ce texte est de restituer la mise en place de la démarche communautaire de ce projet pendant la crise sanitaire COVID-19 et, notamment, les difficultés et imprévus auxquels le processus de recherche communautaire a dû faire face et s’adapter. Le but étant de tirer des leçons sur ce qui a fonctionné ou non, afin de capitaliser les pratiques en recherche communautaire durant cette pandémie et, par la suite, faciliter la mise en place de nouveaux projets de recherche dans des contextes similaires.

No abstract

Background Among men who have sex with men (MSM) in France, the average time between infection and testing is too long, leading to late diagnosis. A better understanding of very infrequent HIV testing (VIT; i.e. have not tested for at least 6 years) could help reach unknowingly long-infected MSM. Thus, we aim to identify psychosocial factors associated with VIT among MSM in France. Methods We conducted a multivariate regression on the data collected via a cross-sectional survey among 315 MSM. Results 11.1% ( n = 35) had VIT. Being over 50, not knowing about the existence of HIV self-testing, having predominantly heterosexual friends, and the level of belief in the effectiveness of treatment as prevention were significantly associated with VIT. Conclusion We call for the development, at the same time, of programs that operate at the individual, institutional and societal levels. In particular, we recommend diversifying the modes of promotion and access to prevention tools, especially for MSM over 50 years old or with little or no connection to the gay community.