TY - JOUR 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 SP - 115 LP - 120 DO - 10.1136/sextrans-2018-053892 VL - 96 IS - 2 AU - Pierre-Julien Coulaud AU - Luis Sagaon-Teyssier AU - Mohamed Mimi AU - Gwenaëlle Maradan AU - Marion Mora AU - Michel Bourrelly AU - Bintou Dembélé Keita AU - Abdoul Aziz Keita AU - Camille Anoma AU - Stéphane-Alain Babo Yoro AU - Elias Ter Tiero Dah AU - Christian Coulibaly AU - Ephrem Mensah AU - Selom Agbomadji AU - Pamela Palvadeau AU - Adeline Bernier AU - Daniela Rojas Castro AU - Clotilde Couderc AU - Christian Laurent AU - Bruno Spire A2 - , Y1 - 2020/03/01 UR - http://sti.bmj.com/content/96/2/115.abstract N2 - 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. ER -