HIV risk behaviour, viraemia, and transmission across HIV cascade stages including low-level viremia: Analysis of 14 cross-sectional population-based HIV Impact Assessment surveys in sub-Saharan Africa.

As antiretroviral treatment (ART) coverage for people living with HIV (PLHIV) increases, HIV programmes require up-to-date information about evolving HIV risk behaviour and transmission risk, including those with low-level viremia (LLV; >50 to ≤1000 copies/mL), to guide prevention priorities. We aimed to assess differences in sexual risk behaviours, distribution of viral load (VL) and proportion of transmission across PLHIV subgroups. We analysed data from Population-based HIV Impact Assessment surveys in 14 sub-Saharan African countries during 2015-2019.

The epidemiology of HIV population viral load in twelve sub-Saharan African countries.

Background: We examined the epidemiology and transmission potential of HIV population viral load (VL) in 12 sub-Saharan African countries.

Methods: We analyzed data from Population-based HIV Impact Assessments (PHIAs), large national household-based surveys conducted between 2015 and 2019 in Cameroon, Cote d'Ivoire, Eswatini, Kenya, Lesotho, Malawi, Namibia, Rwanda, Tanzania, Uganda, Zambia, and Zimbabwe. Blood-based biomarkers included HIV serology, recency of HIV infection, and VL.

Effects of the Coronavirus Disease 2019 Pandemic on Human Immunodeficiency Virus Services: Findings from 11 Sub-Saharan African Countries.

Background: Due to concerns about the effects of the coronavirus disease 2019 (COVID-19 pandemic on health services, we examined its effects on human immunodeficiency virus (HIV) services in sub-Saharan Africa.

Methods: Quarterly data (Q1, 10/2019-12/2019; Q2, 1/2020-3/2020; Q3, 4/2020-6/2020; Q4, 7/2020-9/2020) from 1059 health facilities in 11 countries were analyzed and categorized by stringency of pandemic measures. We conducted a difference-in-differences assessment of HIV service changes from Q1-Q2 to Q3-Q4 by higher vs lower stringency.

Financial burdens of HIV and chronic disease on people living with HIV in Côte d'Ivoire: A cross-sectional out-of-pocket expenditure study.

Background: Although people living with HIV in Côte d'Ivoire receive antiretroviral therapy (ART) at no cost, other out-of-pocket (OOP) spending related to health can still create a barrier to care.

Methods: A convenience sample of 400 adults living with HIV for at least 1 year in Côte d'Ivoire completed a survey on their health spending for HIV and chronic non-communicable diseases (NCDs). In addition to descriptive statistics, we performed simple linear regression analyses with bootstrapped 95% confidence intervals.

Task-sharing with nurses to enhance access to HIV treatment in Côte d'Ivoire.

Objective: We report the first national programme in Côte d'Ivoire to evaluate the feasibility of nurse-led HIV care as a model of task-sharing with nurses to increase coverage and decentralisation of HIV services.

Methods: Twenty-six public HIV facilities implemented either a nurse-with-onsite-physician or a nurse-with-visiting-physician model of HIV task-sharing. Routinely collected patient data were reviewed to analyse patient characteristics of those enrolling in care and initiating antiretroviral therapy (ART).

[Acceptability of HIV testing provided to infants in pediatric services in Cote d'Ivoire, meanings for pediatric diagnostic coverage].

Problem: HIV testing in children had rarely been a central concern for researchers. When pediatric tracking retained the attention, it was more to inform on the diagnosis tools' performances rather than the fact the pediatric test can be accepted or refused. This article highlights the parents' reasons which explain why pediatric HIV test is accepted or refused.

Universal HIV screening at postnatal points of care: which public health approach for early infant diagnosis in Côte d'Ivoire?

Background: Universal HIV pediatric screening offered at postnatal points of care (PPOC) is an entry point for early infant diagnosis (EID). We assessed the parents' acceptability of this approach in Abidjan, Côte d'Ivoire.

Methods: In this cross-sectional study, trained counselors offered systematic HIV screening to all children aged 6-26 weeks attending PPOC in three community health centers with existing access to HAART during 2008, as well as their parents/caregivers.

Attitudes and practices of health care workers toward routine HIV testing of infants in Côte d'Ivoire: the PEDI-TEST ANRS 12165 Project.

Objective: We assessed attitudes and practices of health care workers (HCWs) toward HIV counselling and testing (CT) routinely offered to infants in health facilities in Abidjan, Côte d'Ivoire.

Methods: We performed a cross-sectional survey inquiring on systematic HIV CT offered to children aged 6-26 weeks attending postnatal care for either immunization or pediatric care and to their parents in 4 community health centres rolling-out access to antiretroviral therapy. Data were collected using standardized anonymous self-questionnaires directed to all HCWs involved.

Couples, PMTCT programs and infant feeding decision-making in Ivory Coast.

In Sub-Saharan Africa, prevention of HIV pediatric infection due to breastfeeding requires turning to alternatives to prolonged breastfeeding: artificial feeding or exclusive breastfeeding with early weaning. Choosing a preventive option and applying it does not only depend upon the mother but also on the father and more specifically on couple interactions. To date, not enough studies have considered this question.

From prenatal HIV testing of the mother to prevention of sexual HIV transmission within the couple.

The first step in preventing mother-to-child HIV transmission (PMTCT) programmes is offering HIV counselling and testing to pregnant women. In developing countries where HIV testing remains rare, it represents a unique opportunity for many women to learn their HIV status. This prenatal HIV testing is not only the entry point to prevention of mother-to-child HIV transmission, but also an occasion for women to sensitize their male partner to sexual risks.

[Contraceptive use and incidence of pregnancy among women after HIV testing in Abidjan, Ivory Coast].

Background: Within the framework of programs for the prevention of mother-to-child HIV transmission, women who discover their HIV-infection during their pregnancy receive perinatal interventions in order to reduce the risk of HIV transmission to the child. They also receive family planning counselling and free contraceptives in order to avoid a new pregnancy. In this study, we compared contraceptive use and pregnancy incidence between HIV-positive and HIV-negative women who were offered HIV counselling and testing during a program of prevention of mother-to-child HIV transmission.

Sexual prevention of HIV within the couple after prenatal HIV-testing in West Africa.

The resumption of sexual activity after delivery is a key moment in the management of the risk of sexual HIV transmission within the couple for women who have been prenatally tested for HIV. In this study, we have investigated consistent condom use during the resumption of sexual activity and its evolution over time among women tested for HIV infection during pregnancy. We tested for HIV during pregnancy 546 HIV-infected and 393 HIV-negative women within the Ditrame Plus ANRS project in Abidjan; these women were followed-up for two years after delivery.

[Refusal of prenatal HIV-testing: a case study in Abidjan (Côte d'Ivoire)].

One of the main obstacles to HIV prevention in Africa remains the insufficient number of HIV tests performed. The low percentage of individuals aware of their serostatus is due in part to the insufficient availability of HIV testing, but also to individuals' refusal to have the HIV test. Because affordable treatment is now available, it is possible to implement on a much greater scale programs of prevention of mother-to-child HIV transmission, accompanied by the expansion of prenatal HIV testing.

When do HIV-infected women disclose their HIV status to their male partner and why? A study in a PMTCT programme, Abidjan.

Background: In Africa, women tested for HIV during antenatal care are counselled to share with their partner their HIV test result and to encourage partners to undertake HIV testing. We investigate, among women tested for HIV within a prevention of mother-to-child transmission of HIV (PMTCT) programme, the key moments for disclosure of their own HIV status to their partner and the impact on partner HIV testing.

Methods And Findings: Within the Ditrame Plus PMTCT project in Abidjan, 546 HIV-positive and 393 HIV-negative women were tested during pregnancy and followed-up for two years after delivery.

Beneficial effects of offering prenatal HIV counselling and testing on developing a HIV preventive attitude among couples. Abidjan, 2002-2005.

Prenatal HIV counselling and testing is mainly an entry-point to the prevention of mother-to-child transmission of HIV, but it may also play an important role in triggering the development of spousal communication about HIV and sexual risks and thus the adoption of a preventive attitude. In Abidjan, Côte d'Ivoire, we investigated couple communication on STIs and HIV, male partner HIV-testing and condom use at sex resumption after delivery among three groups of pregnant women who were offered prenatal counselling and HIV testing: HIV-infected women, uninfected women, and women who refused HIV-testing. The proportion of women who discussed STIs with their regular partner greatly increased after prenatal HIV counselling and testing in all three groups, irrespective of the women's serostatus and even in the case of test refusal.

[Impact of HIV counseling and testing during antenal consultation for HIV- women in Abidjan (Côte d'Ivoire): a quantitative and qualitative study (Ditrame Plus 3 project, ANRS 1253)].

This study takes place in Abidjan, Côte d'Ivoire, inside a program of reduction of the mother-to-child HIV transmission, the Ditrame Plus study, ANRS 1201-1202. In this program, HIV test is proposed to women during antenatal consultations. After the test, we have followed during twelve months after childbirth 400 women who were HIV negative.

Resumption of sexual relations following childbirth: norms, practices and reproductive health issues in Abidjan, Côte d'Ivoire.

Before modern contraceptive methods were available in developing countries, post-partum sexual abstinence formed the backbone of birth spacing. With the changes occurring in African societies, how has post-partum sexual abstinence been affected? We conducted an exploratory study in 2000-2001 in Abidjan, Côte d'Ivoire with 23 women and 19 men who were parents of small children. Breastfeeding remains widespread and prolonged.

Physicians' knowledge and attitudes toward HIV care in the context of the UNAIDS/Ministry of Health Drug Access Initiative in Côte d'Ivoire.

Objective: To evaluate the impact of the availabity of highly active antiretroviral therapies (HAART) in the context of the Drug Access Initiative (DAI) on physicians' knowledge, attitudes and practices toward HIV care in Côte d'Ivoire.

Design And Methods: Cross-sectional survey using self-administered questionnaires among all consulting physicians in the six 'referral centers' of the DAI and five additional centers in charge of HIV care.

Results: Among the 123 respondents (response rate = 82.

Prophylactic use of cotrimoxazole against opportunistic infections in HIV-positive patients: knowledge and practices of health care providers in Côte d'Ivoire.

We present here the results of a survey conducted in Côte d'Ivoire, Africa, among healthcare providers, on the knowledge of prophylactic use of cotrimoxazole to prevent opportunistic infections in HIV-infected persons. The survey was conducted in 15 health centres, involved or not in the 'initiative of access to treatment for HIV infected people'. Between December 1999 and March 2000, 145 physicians and 297 other health care providers were interviewed.