Éditeur(s) : UNDP Guyana UNDP Guyana ( Guyana )
Résumé : (Funding) Support for the development of the technical infrastructure and partner training provided by the United States Department of Education TICFIA program.
While the global response to HIV and AIDS has realized several successes in achieving universal access to prevention, care and treatment to date, challenges persist in ensuring equal access to these services for most at risk populations. The epidemiology of HIV reflects a stark disparity in access to prevention and treatment services for neglected most-at risk populations, such as men who have sex with men (MSM). World-wide, MSM often experience higher rates of HIV relative to the total population. The reasons for this dynamic are multi-faceted and include high risk behaviors, and cultural as well as structural barriers. For MSM in developing countries, for example, basic services for prevention and treatment of HIV infection have yet to reach the large majority of men. Homophobia and discrimination limit access of MSM to prevention services and markedly increase vulnerability, as do criminalization of same-sex behavior. Decriminalization of same-sex behavior is a structural intervention for prevention of HIV infection and has recently been embraced by a nonbinding statement from the United Nations (Beyrer C,Clin Infect Dis. 2010 May 15;50 Suppl 3:S108-13) In the Caribbean, all of the above mentioned barriers exist. In fact, recent evidence demonstrates that there is a correlation between the decriminalization of homosexuality and lower rates of HIV (UNAIDS). This correlation is attributed to improved access to services. Therefore, The United Nations Development Program (UNDP) has recently launched an initiative to address the current situation regarding men who have sex with men in Guyana where the HIV prevalence in this population is 19.4% in contrast to 1.8% in the total population. This rapid assessment has been commissioned to supplement two previous studies that were conducted in Guyana in informing the design of upcoming activities to support local capacity building to enhance access to services and respect for the human rights protections for MSM. Unfortunately, in Guyana, like much of the Caribbean, MSM tend to be a hard to reach population, perhaps due to elevated levels of stigma and discrimination and difficulty in accessing men who might participate in high risk same sex behaviors yet do not self-identify as an MSM. As a result, there is a relative paucity of data concerning the knowledge, attitudes and behaviors of this total population in Guyana. (i.e. those who self –identify and those who do not) The baseline report is organized as follows: the methodology is explained followed by the study limitations, the review (literature and desk). The report then proceeds with describing the reality of work and working with sexual and gender minorities in Guyana, the status quo and entry points. The main findings of the capacity assessment and focus groups are then discussed. Issues relating to the uniformed forces and health services providers are then presented followed by discussions and conclusions.

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Éditeur(s) : HAL CCSD SAGE Publications
Résumé : International audience
The French overseas territories in the Americas are the French territories most affected by HIV. Crack cocaine users are particularly impacted. The objective of this study was to describe sexual risk behaviors and inconsistent condom use among crack cocaine users. A total of 640 crack cocaine users were interviewed. The sampling method was non-probabilistic. An anonymous standardized questionnaire of 110 questions was used. Over a third of persons did not use condoms systematically with casual sex partners (36.2%) or commercial sex partners (32.3%), and 64% did not use condoms systematically with regular sex partners. In a context of multiple sexual partnerships, frequent forced sex, and insufficient HIV testing, the lack of systematic condom use may favor the spread of HIV. Different predictive factors of inconsistent condom use were identified, depending on the type of partner, with a log binomial regression. However, among the predictor variables identified, two predictive factors frequently occur among the different type of sex partners: high perceived risk of HIV and self-perceived capacity to persuade a sex partner to use condom. These results pointed towards interventions improving access to rights and raising perceived self-efficacy.
ISSN: 0956-4624

inserm-01566193
http://www.hal.inserm.fr/inserm-01566193
http://www.hal.inserm.fr/inserm-01566193/document
http://www.hal.inserm.fr/inserm-01566193/file/2017%2C%20Parriault%20-%20Sexual%20risk%20behaviors.pdf
DOI : 10.1097/COH.0b013e3283536ab2

Résumé : La connaissance des facteurs qui influent sur les populations de tiques et en particulier sur leurs distributions est un préalable indispensable à l’étude des maladies qu’elles transmettent. Parmi eux, l’importance des facteurs biotiques et en particulier celle de la compétition interspécifique est peu connue et souvent négligée. L’objectif de ce travail était d’évaluer le rôle de la compétition interspécifique sur la distribution de deux espèces de tiques d’importance vétérinaire, Amblyomma variegatum et A. hebraeum. Alors que seule A. variegatum favorise la transmission de la dermatophilose, une maladie de peau débilitante pour les ruminants, les deux espèces sont vectrices de la cowdriose, maladie due à une bactérie Ehrlichia ruminantium qui représente une contrainte économique majeure pour l’élevage. L’impact de l’espèce vectrice dans l’épidémiologie de la cowdriose (différences de souches circulantes, sévérité des cas,…) est inconnu bien qu’ayant potentiellement des conséquences en termes de surveillance (risque épidémiologique à l’introduction d’animaux) et de contrôle (développement de vaccin régional adapté aux souches circulantes) de la maladie. Ces deux espèces ont une distribution contiguë en Afrique australe avec peu de chevauchement (distribution parapatrique) suggérant une préférence environnementale différentielle ou une compétition exclusive entre elles. Une revue des données de la littérature a permis de mettre en évidence un chevauchement de leur niche trophique, climatique, et temporelle, et une interférence comportementale via la production de leurs phéromones. Les deux espèces pourraient donc rentrer en compétition directement par interférence communicative ou reproductive (hybridation stérile), ou indirectement via le partage de ressources, prédateurs ou pathogènes communs. Le rôle des facteurs biotiques et abiotiques sur le maintien de la parapatrie de ces deux espèces a été analysée (i) d’une part par la comparaison de leur niche environnementale réalisée en Afrique australe, et aux deux zones de contact au Zimbabwe et Mozambique, par des méthodes d’ordination et de modèles de niche (Maxent) ; (ii) et d’autre part par l’étude de leurs distributions et de leurs interactions (distribution sur les hôtes, croisements hétérospécifiques) dans la zone de contact au Mozambique. Globalement les résultats montrent qu’en Afrique Sud-Est et au Zimbabwe les deux espèces occupent des niches environnementales distinctes, celle d’A. hebraeum incluant des zones plus chaudes et plus sèches que celle d’A. variegatum. Au contraire au Mozambique les deux niches se chevauchent considérablement. L’enquête de terrain dans cette zone montre que les deux espèces y sont moins souvent trouvées en sympatrie que les données prédites, suggérant une distribution en partie déterminée par des interactions biotiques. Dans les rares sites avec présence des deux espèces, A. variegatum et A. hebraeum partagent les mêmes sites de fixation sur les animaux et forment un pourcentage relativement élevé de couples hétérospécifiques. Ce pourcentage, bien que similaire entre les femelles A. variegatum et A. hebraeum, semble impliquer des processus de discrimination spécifique propres aux deux espèces intervenant au niveau de l’agrégation, de la fixation et du contact des individus. Nos résultats suggèrent l’existence d’une compétition exclusive entre les deux espèces, due à une compétition sexuelle probablement associée à une compétition indirecte. La frontière parapatrique semble occuper une position stable le long d’un gradient environnemental au Zimbabwe mais pas au Mozambique. Les conditions entrainant la coexistence ou l’exclusion des deux espèces avec formation d’une frontière parapatrique sont discutés à l’aide de modèles théoriques de compétition.
Studying the factors that influence tick populations and their distributions is an essential pre-requisite to understanding the dynamics of the diseases they transmit. The relative importance of biotic factors such as interspecific competition is not well known and often neglected. The objective of this study was to assess the influence of interspecific competition on the distribution of two tick species of veterinary importance, Amblyomma variegatum and A. hebraeum. Whereas only A. variegatum is known to favor dermatophilosis, a debilitating skin disease of ruminants, both species are good vectors of Ehrlichia ruminantium, the bacteria causing heartwater, a fatal disease of ruminants that presents a major constraint for livestock development in Africa. The impact of vector species in heartwater epidemiology (differences of circulating strains, severity of clinical cases…) is poorly known but may have important implications for surveillance (epidemiological risk of imported animals) and control (adapting regional vaccine programs to circulating strains) of the disease. These two ticks have abutting and marginally overlapping (i.e. parapatric) distributions in southern Africa, suggesting either differential environmental preferences or exclusive competition between the two species. A review of published data highlighted an important overlap of their trophic, climatic and seasonal niche, and existence of chemical behavior interference through pheromone production. Therefore, the two species might compete either directly by communicative or reproductive interference (sterile hybridization), or indirectly by sharing the same resources, predators or pathogens. The role of biotic and abiotic factors in determining parapatry of these species was assessed by (i) comparing their realized environmental niche in southern Africa, and at contact zones in Zimbabwe and Mozambique, using ordination techniques and environmental niche modeling (Maxent); (ii) studying their distributions and their interactions (distribution on co-infested host, heterospecific mating) at the contact zone in Mozambique. Globally, the results indicated the two species occupied distinctly different environmental niches in southern Africa and at the contact zone in Zimbabwe, with the niche of A. hebraeum including both hotter and drier areas than that of A. variegatum. However, in Mozambique their niches overlapped considerably. Field studies within this zone showed that sympatry was observed less frequently than predicted by niche models, suggesting an importance of biotic interactions. At the rare sites where both species were present, A. variegatum and A. hebraeum were observed to share the same preference sites on hosts and formed a high percentage of heterospecific pairs. Though this cross-mating rate was not significantly different between A. variegatum and A. hebraeum females, our observations suggest different mechanism of species discrimination involved for the two species acting at the aggregation, fixation and partner contact level. Our results strongly suggest exclusive competition between these species may arise from sexual competition probably interacting with other indirect forms of competition. The parapatric boundary apparently occupies a stable location along an environmental gradient at the contact zone in Zimbabwe but not in Mozambique. Conditions inducing coexistence or exclusion of both species with the formation of parapatric distributions are discussed in relation to theoretical models of competition. When sexual competition is introduced in these models, the relative frequency of two species is determined by their endogenous fitness (a function of environmental conditions), density dependent effects of competitive interactions, historical distributions and dispersal rates: survival of the first prevails when the immigration rate of a fitter invading species remains lower than an invasion threshold.

http://www.theses.fr/2014AGUY0705/document