HIV-1 DNA levels in peripheral blood mononuclear cells and cannabis use are associated with intermittent HIV shedding in semen of men who have sex with men on successful antiretroviral regimens.

Background: Few data exist on the efficacy of combined antiretroviral therapy (cART) in semen of human immunodeficiency virus type 1 (HIV-1) infected men who have sex with men (MSM) with sustained control of HIV replication in blood.

Methods: HIV-1 infected MSM on successful cART for >6 months were enrolled. HIV-RNA was quantified in seminal plasma (spVL) and in blood plasma (bpVL) from 2 paired samples collected 4 weeks apart.

Expanding access to non-medicalized community-based rapid testing to men who have sex with men: an urgent HIV prevention intervention (the ANRS-DRAG study).

Background: Little is known about the public health benefits of community-based, non-medicalized rapid HIV testing offers (CBOffer) specifically targeting men who have sex with men (MSM), compared with the standard medicalized HIV testing offer (SMOffer) in France. This study aimed to verify whether such a CBOffer, implemented in voluntary counselling and testing centres, could improve access to less recently HIV-tested MSM who present a risk behaviour profile similar to or higher than MSM tested with the SMOffer.

Method: This multisite study enrolled MSM attending voluntary counselling and testing centres' during opening hours in the SMOffer.

Impact of HIV comprehensive care and treatment on serostatus disclosure among Cameroonian patients in rural district hospitals.

This work aimed to analyze the rate of disclosure to relatives and friends over time and to identify factors affecting disclosure among seropositive adults initiating antiretroviral therapy (ART) in rural district hospitals in the context of decentralized, integrated HIV care and task-shifting to nurses in Cameroon. Stratall was a 24-month, randomized, open-label trial comparing the effectiveness of clinical monitoring alone with laboratory plus clinical monitoring on treatment outcomes. It enrolled 459 HIV-infected ART-naive adults in 9 rural district hospitals in Cameroon.

Time patterns of adherence and long-term virological response to non-nucleoside reverse transcriptase inhibitor regimens in the Stratall ANRS 12110/ESTHER trial in Cameroon.

Background: Although treatment adherence is a major challenge in sub-Saharan Africa, it is still unknown which longitudinal patterns of adherence are the most detrimental to long-term virological response to non-nucleoside reverse transcriptase inhibitor (NNRTI) regimens. This analysis aimed to study the influence of different time patterns of adherence on virological failure after 24 months of treatment in Cameroon.

Methods: Antiretroviral therapy (ART) adherence data were collected using face-to-face questionnaires administered at months 1, 3, 6, 12, 18 and 24.

Investigating Recent Testing among MSM: Results from Community-Based HIV Rapid Testing Attendees in France.

Background. We aimed to identify factors associated with recent HIV testing in MSM who attended two experimental community-based and nonmedicalized voluntary counselling and testing programmes (CB-VCT) targeting MSM in France. Methods.

Empowering HIV testing as a prevention tool: targeting interventions for high-risk men who have sex with men.

In France, HIV testing can be easily performed in free and anonymous voluntary counselling testing (VCT) centres. The recent national study among French men who have sex with men (MSM) showed that 73% of those already tested for HIV had been tested in the previous two years. Nothing is known about the risk behaviours of MSM attending VCT centres.

Does HIV services decentralization protect against the risk of catastrophic health expenditures?: some lessons from Cameroon.

Objective: Scaling up antiretroviral treatment (ART) through decentralization of HIV care is increasingly recommended as a strategy toward ensuring equitable access to treatment. However, there have been hitherto few attempts to empirically examine the performance of this policy, and particularly its role in protecting against the risk of catastrophic health expenditures (CHE). This article therefore seeks to assess whether HIV care decentralization has a protective effect against the risk of CHE associated with HIV infection.

Individual and structural factors associated with HIV status disclosure to main partner in Cameroon: ANRS 12-116 EVAL survey, 2006-2007.

Encouraging HIV-positive people to disclose their serostatus to their main partner is considered as a key component of secondary prevention. The purpose of this study was to identify individual and structural factors associated with HIV serostatus disclosure to one's steady partner in Cameroon, a country which has implemented a large program for access to antiretroviral therapy. We used data from the cross-sectional, nationally representative survey, ANRS 12-116 EVAL (Evaluation du programme camerounais d'accès aux traitements antirétroviraux--Impact sur la prise en charge et les conditions de vie de la population infectée par le VIH), conducted between 2006 and 2007 among HIV-infected outpatients attending health care facilities.

Limited access to HIV prevention in French prisons (ANRS PRI2DE): implications for public health and drug policy.

Background: Overpopulation, poor hygiene and disease prevention conditions in prisons are major structural determinants of increased infectious risk within prison settings but evidence-based national and WHO guidelines provide clear indications on how to reduce this risk. We sought to estimate the level of infectious risk by measuring how French prisons adhere to national and WHO guidelines.

Methods: A nationwide survey targeting the heads of medical (all French prisons) and psychiatric (26 French prisons) units was conducted using a postal questionnaire and a phone interview mainly focusing on access to prevention interventions, i.

The burden of HIV experience and care among MSM having an HIV-positive seroconcordant steady partner: a possible research hypothesis. Results from the French VESPA ANRS EN-12 study.

Objectives: Prevention fatigue, relapse into unsafe sex practices and sexual behaviour changes have been reported in the community of men who have sex with men (MSM) since the introduction of highly active antiretroviral therapy. Engaging in a relationship with a seroconcordant partner is perceived by some HIV-positive MSM as an alternative prevention strategy to consistent condom use. This study addresses whether underlying clinical factors exist characterising HIV-positive MSM in seroconcordant stable partnerships, enrolled in the French national cross-sectional survey VESPA ANRS EN-12.

Desire for a child among HIV-infected women receiving antiretroviral therapy in Cameroon: results from the national survey EVAL (ANRS 12-116).

The majority of HIV-infected people in sub-Saharan Africa are women, many of reproductive age. Cameroon is severely hit by the AIDS epidemic and has developed a large national program for improving access to antiretroviral treatment (ART). The reproductive intentions of women living with HIV/AIDS (WLHA) who obtain access to ART in this country remain poorly documented.

Higher risk of unsafe sex and impaired quality of life among patients not receiving antiretroviral therapy in Cameroon: results from the EVAL survey (ANRS 12-116).

Objective: Cameroon has initiated a national programme of HIV care decentralization providing access to antiretroviral therapy (ART) for patients with CD4 cell counts less than 200 cells/microl or AIDS stage. Current clinical research suggests these criteria may be too stringent. This study aimed at evaluating the effect of not receiving ART on patients' psychosocial outcomes.

HIV disclosure and unsafe sex among HIV-infected women in Cameroon: results from the ANRS-EVAL study.

Encouraging seropositive people to voluntarily disclose their serostatus has been promoted as a key component of HIV prevention. Among other reasons, HIV disclosure to one's main partner is believed to be an incentive for serodiscordant couples to practice safe sex. The present article investigated this issue by conducting a cross-sectional survey of a large sample of HIV-infected women attending HIV care centers in Cameroon (N=1014).

Delayed first consultation after diagnosis of HIV infection in Cameroon.

Objectives: To study the impact of both decentralization of HIV care and individual factors on delayed first consultation (> or =6 months) after HIV diagnosis in Cameroon, in the context of the national antiretroviral treatment scale-up program.

Design: The national cross-sectional multicenter survey EVAL (ANRS 12-116) was conducted from September 2006 to March 2007 in 27 HIV centers in Cameroon.

Methods: : Logistic regression was used to characterize patients with delayed first consultation among 3151 HIV-infected adults.

Buprenorphine in primary care: risk factors for treatment injection and implications for clinical management.

Aims: Though the introduction of office-based buprenorphine has greatly contributed to stem the HIV epidemic since 1995, concerns have been raised about the intravenous use of buprenorphine even in patients on substitution treatment. The aim of this study was to identify which factors are predictive of buprenorphine injection in patients receiving office-based buprenorphine.

Design And Setting: Subazur is a survey consisting of two longitudinal assessments of 111 stabilized patients receiving office-based buprenorphine in southeastern France.