RT Journal Article
SR Electronic
T1 Changes in risky sexual behaviours among West African MSM enrolled in a quarterly HIV testing and counselling prevention programme (CohMSM ANRS 12324 – Expertise France)
JF Sexually Transmitted Infections
JO Sex Transm Infect
FD BMJ Publishing Group Ltd
SP 115
OP 120
DO 10.1136/sextrans-2018-053892
VO 96
IS 2
A1 Pierre-Julien Coulaud
A1 Luis Sagaon-Teyssier
A1 Mohamed Mimi
A1 Gwenaëlle Maradan
A1 Marion Mora
A1 Michel Bourrelly
A1 Bintou Dembélé Keita
A1 Abdoul Aziz Keita
A1 Camille Anoma
A1 Stéphane-Alain Babo Yoro
A1 Elias Ter Tiero Dah
A1 Christian Coulibaly
A1 Ephrem Mensah
A1 Selom Agbomadji
A1 Pamela Palvadeau
A1 Adeline Bernier
A1 Daniela Rojas Castro
A1 Clotilde Couderc
A1 Christian Laurent
A1 Bruno Spire
A1 ,
YR 2020
UL http://sti.bmj.com/content/96/2/115.abstract
AB 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.