Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
ISSN: 1935-2727

inserm-00919502
http://www.hal.inserm.fr/inserm-00919502
http://www.hal.inserm.fr/inserm-00919502/document
http://www.hal.inserm.fr/inserm-00919502/file/2013_Nacher_-_Disseminated_histo_in_hiv_in_south_america_a_neglected_killer_continues_on_its_rampage.pdf
DOI : 10.1371/journal.pntd.0002319

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
Plasmodium vivax malaria is an important public health issue in the Amazon region, and it accounts for approximately 84 % of cases of the disease. Migration across the border between Brazil and French Guiana contributes to the maintenance of the disease. The aim of this study was to evaluate the therapeutic and parasitological responses of patients with P. vivax malaria treated with chloroquine and primaquine in the socio-environmental context of cross-border interactions between Brazil and French Guiana. The factors controlled were diagnostic agreement, adherence, adjustment of primaquine doses for patient weight, and quality of the drugs used. A prospective study was conducted in 2011 with 103 individuals aged 10-60 years with a positive diagnosis of P. vivax treated with chloroquine (10 mg base/kg on the first day, followed by 7.5 mg/kg on the second and third days) and primaquine for 7 days, who were followed for 28 days. The primaquine doses were adjusted for the patients' weight. A number of factors were determined: epidemiological characteristics, origin of patients, signs and symptoms, initial parasitaemia and parasitaemia clearance time, blood concentrations of chloroquine and primaquine, quality of anti-malarial drugs and diagnostic agreement. Ninety-five patients were followed for 28 days. There was a 100 % agreement in microscopic diagnosis between field laboratory and reference centre. The adhesion to the treatment was 100 %. Of these patients, 32.6 % received a weight-adjusted dose of primaquine. The chloroquine and primaquine tablets were consistent with the optimal quality limits for human consumption. The investigated patients achieved optimal blood exposure to anti-malarial drugs. The parasitological and therapeutic response was adequate in 99.0 % of cases. In the municipality of Oiapoque, the therapeutic regime used for the treatment of P. vivax malaria using chloroquine combined with primaquine remains effective, when external factors are controlled, such as the quality of anti-malarial drugs, the adhesion to the treatment prescribed, the correct diagnostic and the adjustment of primaquine dose for patient body weight.
ISSN: 1475-2875

Droits : http://creativecommons.org/licenses/by/
pasteur-01229355
https://hal-pasteur.archives-ouvertes.fr/pasteur-01229355
https://hal-pasteur.archives-ouvertes.fr/pasteur-01229355/document
https://hal-pasteur.archives-ouvertes.fr/pasteur-01229355/file/s12936-015-0925-7.pdf
PUBMEDCENTRAL : PMC4600333

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
A retrospective cohort study was conducted on 1541 HIV-infected patients to determine variables associated with the incidence of herpes zoster. A single failure Cox model showed that herpes zoster incidence increased following the first 6 months of antiretroviral treatment adjusted hazard ratio (AHR)=5 (95%CI=2.6-9.2), P<0.001; in the >60 years age group AHR=2 (95%CI=1-4), P=0.04; in patients in the top CD8 quartile AHR=2.1 (95%CI=1.3-3.6), P<0.001; and in patients previously reported to use crack cocaine AHR=5.9, (95%CI=1.4-25), P=0.02. Herpes zoster incidence increased in patients with CD4 counts<500 per mm(3) and gradually declined since 1992-1996, with AHR=0.3 (95%CI=0.2-0.5), P<0.001 for the 1997-2002 period and AHR=0.24 (95%CI=0.14-0.4), P<0.001 for the 2002-2008 period. Contrary to what has been described elsewhere, there was no specific effect of protease inhibitors on herpes zoster incidence. The present study is the first to suggest that crack cocaine is associated with an increased incidence of herpes zoster. The neurological or immunological effects of crack are discussed.
ISSN: 1932-6203

inserm-00921158
http://www.hal.inserm.fr/inserm-00921158
http://www.hal.inserm.fr/inserm-00921158/document
http://www.hal.inserm.fr/inserm-00921158/file/2013_Nacher_-_Predictive_factorssur herpes_zoster.pdf
DOI : 10.1371/journal.pone.0080187

Éditeur(s) : HAL CCSD American Society of Tropical Medicine and Hygiene
Résumé : International audience
To study the link between climatic variables and the incidence of leishmaniasis a study was conducted in Cayenne, French Guiana. Patients infected between January 1994 and December 2010. Meteorological data were studied in relation to the incidence of leishmaniasis using an ARIMA model. In the final model, the infections were negatively correlated with rainfall (with a 2-month lag) and with the number of days with rainfall > 50 mm (lags of 4 and 7 months). The variables that were positively correlated were temperature and the Multivariate El Niño Southern Oscillation Index with lags of 8 and 4 months, respectively. Significantly greater correlations were observed in March for rainfall and in November for the Multivariate El Niño/Southern Oscillation Index. Climate thus seems to be a non-negligible explanatory variable for the fluctuations of leishmaniasis. A decrease in rainfall is linked to increased cases 2 months later. This easily perceptible point could lead to an interesting prevention message.
ISSN: 0002-9637

inserm-00913933
http://www.hal.inserm.fr/inserm-00913933
http://www.hal.inserm.fr/inserm-00913933/document
http://www.hal.inserm.fr/inserm-00913933/file/article_amaury_leishmaniose_revised2corrected.pdf
http://www.hal.inserm.fr/inserm-00913933/file/figure_2.pdf

Éditeur(s) : HAL CCSD Taylor & Francis (Routledge)
Résumé : International audience
The French Antilles (Martinique, Saint Martin and Guadeloupe) and French Guiana are the French territories most affected by the HIV epidemic. Some population groups such as men who have sex with men (MSM), especially those involved in transactional sex, are thought to be particularly vulnerable to HIV but few data exist to help characterize their health-related needs and thus implement relevant prevention interventions. To fill this knowledge gap, we used data collected from an HIV/AIDS Knowledge, Attitudes, Behaviours and Practices survey conducted in 2012 among MSM living in the French Antilles and French Guiana and recruited through snowball sampling. Our objectives were to compare social and demographic characteristics and sexual behaviours between MSM engaging in transactional sex and MSM not engaging in transactional sex and to identify factors associated with transactional sex involvement using a logistic regression model. A total of 733 MSM were interviewed, 21% of whom reported to undergo transactional sex. Their behaviour and social and demographic characteristics were different from other MSMs’ and they were more exposed to factors that are recognized to potentiate HIVvulnerability, at the individual, community, network and structural levels. The variables positively associated with sex trade involvement were having ever consumed drug (OR = 2.84 [1.23–6.52]; p = .002), having a greater number of sex partners than the median (OR = 8.31 [4.84–14.30]; p < .001), having experienced intimate partner violence (OR = 1.72 [0.99–3.00]; p = .053) and having undergone physical aggression because of sexual orientation (OR = 2.84 [1.23–6.52];p = .014). Variables negatively associated with sex trade involvement were being older (OR = 0.93 [0.90–0.97] per year; p = .001), having a stable administrative situation (OR = 0.10 [0.06–0.19]; p < .001), having a stable housing (OR = 0.29 [0.15–0.55]; p < .001) and being employed full-time (OR = 0.29 [1.23–6.52]; p = .002).
ISSN: 0954-0121

inserm-01407263
http://www.hal.inserm.fr/inserm-01407263
http://www.hal.inserm.fr/inserm-01407263/document
http://www.hal.inserm.fr/inserm-01407263/file/AIDS%20Care%20final%20version.pdf
DOI : 10.1080/09540121.2016.1234680

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
The nine countries sharing the Amazon forest accounted for 89% of all malaria cases reported in the Americas in 2008. Remote sensing can help identify the environmental determinants of malaria transmission and their temporo-spatial evolution. Seventeen studies characterizing land cover or land use features, and relating them to malaria in the Amazon subregion, were identified. These were reviewed in order to improve the understanding of the land cover/use class roles in malaria transmission. The indicators affecting the transmission risk were summarized in terms of temporal components, landscape fragmentation and anthropic pressure. This review helps to define a framework for future studies aiming to characterize and monitor malaria.
ISSN: 1475-2875

inserm-00834790
http://www.hal.inserm.fr/inserm-00834790
http://www.hal.inserm.fr/inserm-00834790/document
http://www.hal.inserm.fr/inserm-00834790/file/1475-2875-12-192.pdf
DOI : 10.1186/1475-2875-12-192

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
Resistance to artemisinin casts a shadow on the fight against malaria. The importance of illegal gold miners and of malaria in isolated regions of French Guiana constitutes a threat that endangers the fight against malaria in the Amazon. The hurdles of French laws and the remoteness of the territory from France make it impossible for the system to adapt to the problem of total inaccessibility of an important part of the malaria problem. Transmission is high in these areas and gold miners self-medicate with erratic regimens of artemisinin combinations, thus creating perfect conditions for the emergence of resistance. What needs to be done is being done, but within the limits of national law, with some results. However, facing the same difficult problem, Suriname shows more flexibility and is doing much better than French Guiana despite having lower resources. Local authorities in French Guiana cannot overrule the laws that block appropriate malaria care from reaching a third of malaria-exposed persons. Thus the health authorities in France should take immediate calibrated legislative and financial measures to avoid a predictable disaster.
ISSN: 1475-2875

inserm-00838961
http://www.hal.inserm.fr/inserm-00838961
http://www.hal.inserm.fr/inserm-00838961/document
http://www.hal.inserm.fr/inserm-00838961/file/Nacher_et_al._Malaria_J.pdf
PUBMED : 23641802

Éditeur(s) : HAL CCSD Taylor & Francis (Routledge)
Résumé : International audience
The Maroni basin, an isolated region delineating the border between Suriname and French Guiana has been affected by the human immunodeficiency virus (HIV) epidemic 10 years after coastal French Guiana. However, the rise in HIV prevalence was sharp, exceeding 1% within 10 years. The aim of the present study is to compare, using the first quantitative data from the general population in remote villages, the knowledge, attitudes, and behaviors regarding HIV between Maroon and Amerindian populations, the two most frequent populations living along the Maroni. Data were collected in 2012 using a structured questionnaire among a random sample of 896 individuals residing in the remote villages on the Maroni river. Proportions were compared between the Maroni and the coastal general population, and between Maroon and Amerindian populations. The present study shows significant differences between territories and between communities living on the Maroni river: the multiple sexual partnerships, more common among population living on the Maroni river, were more frequently reported in Maroons than in Amerindians. Condom use was more frequently reported among men on the Maroni river than on the coast, but these findings were reversed for women. Moreover, among people living on the Maroni river, condom use was more frequently reported among Maroons than among Amerindians. Regarding genital factors that may affect transmission, penile implant seemed to have no ethnic boundaries, steam baths seemed specific to Maroon women. The present results should help to improve community-based specific interventions.
ISSN: 0954-0121

hal-01260915
https://hal.archives-ouvertes.fr/hal-01260915
https://hal.archives-ouvertes.fr/hal-01260915/document
https://hal.archives-ouvertes.fr/hal-01260915/file/2015%2C%20Van%20Melle%20-%20Knowledge%2C%20attitudes%2C%20behaviors%2C%20and%20practices%20differences%20regarding%20HIV.pdf
DOI : 10.1080/09540121.2015.1032203

Éditeur(s) : HAL CCSD American Society of Tropical Medicine and Hygiene
Résumé : International audience
In South America, the presence of the Leishmania RNA virus type 1 (LRV1) was described in Leishmania guyanensis and Leishmania braziliensis strains. The aim of this study was to determine the prevalence distribution of LRV1 in Leishmania isolates in French Guiana given that, in this French overseas department, most Leishmania infections are due to these parasite species. The presence of the virus was observed in 74% of Leishmania spp. isolates, with a highest presence in the internal areas of the country.
ISSN: 0002-9637

pasteur-01583614
https://hal-riip.archives-ouvertes.fr/pasteur-01583614
https://hal-riip.archives-ouvertes.fr/pasteur-01583614/document
https://hal-riip.archives-ouvertes.fr/pasteur-01583614/file/2016%20Ginouves%20et%20al.%20ajtmh.pdf
PUBMED : 26598572

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
BACKGROUND: Dengue fever is the most important arboviral infection that affects humans, particularly in tropical and subtropical regions. Here, we provide the first comprehensive overview of the severity of dengue epidemics in French Guiana. METHODOLOGY/PRINCIPAL FINDINGS: We monitored hospitalized cases between 2008 and 2013. Detailed clinical features and biological parameters were collected on a daily basis from all cases. Among the 1,356 cases, 216 (16%) were classified according to the WHO 2009 classification as dengue without warning signs (WS), 926 (68%) were classified as dengue with WS and 214 (16%) were classified as severe dengue. The severity rates were similar between the three major epidemics that occurred during the study period, whereas the hospitalization rate was highest in 2013. Fluid accumulation, aspartate aminotransferase (ASAT) counts>193 IU/L and platelet counts<75,000 cells/mm3 were associated with dengue severity. CONCLUSIONS/SIGNIFICANCE: Our findings provide a recent epidemiological description of the severity of dengue epidemics in French Guiana. These results highlight the potential impacts and consequences of implementing the WHO 2009 classification on hospital activity. Future studies should include virological and immunological investigations of well-documented serum samples.
ISSN: 1932-6203

hal-01477201
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01477201
DOI : 10.1371/journal.pone.0172267
PUBMED : 28196111

Éditeur(s) : HAL CCSD American Society of Tropical Medicine and Hygiene
Résumé : International audience
Anti-leishmaniasis drug resistance is a common problem worldwide. The aim of this study was to inventory the general in vitro level of sensitivity of Leishmania isolates circulating in French Guiana and to highlight potential in vitro pentamidine-resistant isolates. This sensitivity study was conducted on 36 patient-promastigote isolates for seven drugs (amphotericin B, azithromycin, fluconazole, meglumine antimoniate, miltefosine, paromomycin, and pentamidine) using the Cell Counting Kit-8 viability test. The IC50 values obtained were heterogeneous. One isolate exhibited high IC50 values for almost all drugs tested. Pentamidine, which is the first-line treatment in French Guiana, showed efficacy at very low doses (mean of 0.0038 μg/mL). The concordance of the in vitro pentamidine results with the patients' clinical outcomes was 94% (K = 0.82).
ISSN: 0002-9637

inserm-01481512
http://www.hal.inserm.fr/inserm-01481512
http://www.hal.inserm.fr/inserm-01481512/document
http://www.hal.inserm.fr/inserm-01481512/file/2017%2C%20Ginouves%20-%20In%20vitro%20sensitivity%20of%20cutaneous%20leishmania.pdf
DOI : 10.4269/ajtmh.16-0373

Éditeur(s) : HAL CCSD Centers for Disease Control and Prevention
Résumé : International audience
To assess the prevalence of malaria among illegal gold miners in the ă French Guiana rainforest, we screened 205 miners during May-June 2014. ă Malaria prevalence was 48.3%; 48.5% of cases were asymptomatic. ă Patients reported self-medication with artemisinin-based combination ă therapy. Risk for emergence and spread of artemisinin resistance among ă gold miners in the rainforest is high.
ISSN: 1080-6040

hal-01467560
https://hal.archives-ouvertes.fr/hal-01467560
DOI : 10.3201/eid2205.151957

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
Background: Access to health care is a global public problem. In French Guiana, there exists social inequalities which are specially marked amongst immigrants who make up a third of the population. Health care inequalities are prevalent. The objective of this study was to determine factors associated with why health care amongst the poor population of Cayenne was renounced.Study design The study was cross sectional. It focused on knowledge, attitudes, practices and beliefs of the population living in poor neighborhoods of the Cayenne area. Methods: Populations coming at the Red Cross mobile screening unit in poor urban areas of Cayenne were surveyed from July 2013 to June 2014. Structured questionnaires consisted of 93 questions. Written informed consent was requested at the beginning of the questionnaire. The predictors for renouncing medical care were determined using logistic regression models and tree analysis. Results: Twenty percent of persons had renounced care. Logistic regression showed that renouncement of health care was negatively associated with having no regular physician Adjusted Odds Ratio (AOR)=0.43 (95%CI=0.24-0.79) and positively associated with being embarrassed to ask certain questions AOR=6.81 (95%CI=3.98-11.65) and having been previously refused health care by a doctor AOR=3.08 (95%CI=1.43-6.65) . Tree analysis also showed that three of these variables were linked to renouncement, with feeling shy to ask certain questions as the first branching.Conclusion: Although most people felt it was easy to see a doctor, one in five had renounced health care. The variables identified by the models suggest vulnerable persons generally had previous negative encounters with the health system and felt unwanted or non eligible for healthcare. Health care mediation and welcoming staff may be simple solutions to the above problems which were underscored in our observations.
ISSN: 1472-6963

hal-01288656
https://hal.archives-ouvertes.fr/hal-01288656
https://hal.archives-ouvertes.fr/hal-01288656/document
https://hal.archives-ouvertes.fr/hal-01288656/file/Predictive%20factors%20for%20renouncing%20to%20care%20in%20FG.pdf
PUBMEDCENTRAL : PMC4731954

Éditeur(s) : HAL CCSD MDPI
Résumé : International audience
Malaria remains one of the most common vector-borne diseases in the world and the definition of novel control strategies can benefit from the modeling of transmission processes. However, data-driven models are often difficult to build, as data are very often incomplete, heterogeneous in nature and in quality, and/or biased. In this context, a knowledge-based approach is proposed to build a robust and general landscape-based hazard index for malaria transmission that is tailored to the Amazonian region. A partial knowledge-based model of the risk of malaria transmission in the Amazonian region, based on landscape features and extracted from a systematic literature review, was used. Spatialization of the model was obtained by generating land use and land cover maps of the cross-border area between French Guiana and Brazil, followed by computing and combining landscape metrics to build a set of normalized landscape-based hazard indices. An empirical selection of the best index was performed by comparing the indices in terms of adequacy with the knowledge-based model, intelligibility and correlation with P. falciparum incidence rates. The selected index is easy to interpret and successfully represents the current knowledge about the role played by landscape patterns in malaria transmission within the study area. It was significantly associated with P. falciparum incidence rates, using the Pearson and Spearman correlation coefficients (up to 0.79 and 0.75, respectively; p-value < 0.001), and the linear regression coefficient of determination (reaching 0.63; p-values < 0.001). This study establishes a spatial knowledge-driven, landscape-based hazard malaria index using remote sensing that can be easily produced on a regular basis and might be useful for malaria prediction, surveillance, and control. Keywords: remote sensing; land use and land cover; landscape metric; knowledge-based hazard modeling; malaria; cross-border area between French Guiana and Brazil
ISSN: 2072-4292

hal-01355255
https://hal.archives-ouvertes.fr/hal-01355255
https://hal.archives-ouvertes.fr/hal-01355255/document
https://hal.archives-ouvertes.fr/hal-01355255/file/010066865.pdf
IRD : fdi:010066865

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
Local variation in the density of Anopheles mosquitoes and the risk of exposure to bites are essential to explain the spatial and temporal heterogeneities in the transmission of malaria. Vector distribution is driven by environmental factors. Based on variables derived from satellite imagery and meteorological observations, this study aimed to dynamically model and map the densities of Anopheles darlingi in the municipality of Saint-Georges de l’Oyapock (French Guiana). Longitudinal sampling sessions of An. darlingi densities were conducted between September 2012 and October 2014. Landscape and meteorological data were collected and processed to extract a panel of variables that were potentially related to An. darlingi ecology. Based on these data, a robust methodology was formed to estimate a statistical predictive model of the spatial-temporal variations in the densities of An. darlingi in Saint-Georges de l’Oyapock. The final cross-validated model integrated two landscape variables—dense forest surface and built surface—together with four meteorological variables related to rainfall, evapotranspiration, and the minimal and maximal temperatures. Extrapolation of the model allowed the generation of predictive weekly maps of An. darlingi densities at a resolution of 10-m. Our results supported the use of satellite imagery and meteorological data to predict malaria vector densities. Such fine-scale modeling approach might be a useful tool for health authorities to plan control strategies and social communication in a cost-effective, targeted, and timely manner.
ISSN: 1932-6203

hal-01383486
https://hal.archives-ouvertes.fr/hal-01383486
https://hal.archives-ouvertes.fr/hal-01383486/document
https://hal.archives-ouvertes.fr/hal-01383486/file/Adde_et_al_PlosONE_2016.pdf
DOI : 10.1371/journal.pone.0164685

Éditeur(s) : HAL CCSD Saint-Maurice (Val de Marne) : Institut de veille sanitaire
Résumé : National audience
Introduction – Le nombre d’accès palustres diminue globalement en Guyane, alors que les orpailleurs travaillantsur les sites illégaux semblent particulièrement touchés par cette pathologie. Les objectifs de cette étudeétaient de déterminer la prévalence du paludisme dans cette population, les comportements associés ainsi quele niveau de résistance des parasites vis-à-vis des dérivés de l’artémisinine.Matériel et méthodes – Les inclusions ont eu lieu sur les sites de repli fréquentés par les orpailleurs le long dufleuve Maroni. Ont été effectués : un test de diagnostic rapide du paludisme, un questionnaire, un prélèvementsanguin pour PCR et un génotypage du gène pfK13 pour les PCR positives à Plasmodium falciparum.Résultats – De janvier à juin 2015, 421 orpailleurs ont été inclus, majoritairement des hommes (70,6%) brésiliens(93,8%). La prévalence du portage de plasmodies déterminée par PCR était en moyenne de 22,3%(IC95%: [18,3-26,3]), à 84% asymptomatiques. Les espèces identifiées étaient principalement P. falciparum(47,9%) puis P. vivax (37,2%), plus 10,6% de co-infections. Lors du dernier accès palustre, 52,4% des orpailleursavaient eu recours à l’automédication, majoritairement avec des dérivés de l’artémisinine (93,8%) avecune mauvaise observance (37,8%). L’analyse du gène pfK13 n’a pas mis en évidence de mutations associéesà la résistance à P. falciparumDiscussion – La prévalence élevée de porteurs asymptomatiques de plasmodies constitue un réservoir importantde transmission dans la région. L’utilisation massive de dérivés de l’artémisinine associée à une mauvaise observancedes traitements sont des facteurs de risque d’émergence de résistance imposant des mesures rapides
ISSN: 0245-7466

inserm-01491193
http://www.hal.inserm.fr/inserm-01491193
http://www.hal.inserm.fr/inserm-01491193/document
http://www.hal.inserm.fr/inserm-01491193/file/2017%2C%20Douine%20-%20Paludisme%20et%20orpaillage%20ill%C3%A9gal%20en%20Guyane.pdf

Éditeur(s) : HAL CCSD
Résumé : International audience
Résumé :Introduction : Les départements Français d’Amérique sont à la fois parmi les territoiresfrançais les plus affectés par le VIH et parmi les territoires français les plus impactés par laconsommation de crack. L’épidémie de VIH en Guyane est une épidémie concentrée quitouche plus spécifiquement certains groupes vulnérables. Parmi ces groupes, les usagers decrack sont particulièrement touchés.Matériel et Méthodes : Une étude a été réalisée simultanément dans les trois départements en2012 dans le but de décrire les connaissances, les attitudes et les pratiques vis-à-vis du VIH etdes IST chez les usagers de crack. Au total 640 personnes ont été interrogées. La méthoded’échantillonnage utilisée était non probabiliste et combinait un échantillonnage deconvenance dans les associations recevant ce public (75% de l’échantillon), et unéchantillonnage en boule de neige en dehors afin d’atteindre les personnes ne fréquentant pasles structures (25% de l’échantillon).Résultats : Un tiers des personnes n’utilisait pas systématiquement le préservatif avec lespartenaires occasionnels (36,2%) ou avec les partenaires commerciaux (32,3%), et 64%n’utilisaient pas le préservatif à chaque fois avec les partenaires réguliers. Différents facteursprédictifs de la non utilisation du préservatif ont été identifiés selon le type de partenaire àl’aide d’un modèle log-binomial. Parmi les différents facteurs repérés, deux étaient communsà chaque type de partenaire : la perception élevée de son risque face au VIH et le fait de nepas se sentir à l’aise pour persuader un partenaire à utiliser le préservatif.Discussion : Dans un contexte de multipartenariat, de violences sexuelles fréquentes et dedépistage insuffisant du VIH, la non utilisation systématique du préservatif peut avoir unimpact non négligeable dans la diffusion de l’épidémie. Bien que la non utilisation dupréservatif soit sensiblement inférieure à ce que l’on retrouve dans la littérature, cesproportions traduisent un réel problème.La capacité à persuader un partenaire sexuel à utiliser un préservatif était négativementcorrélée avec la non utilisation du préservatif quel que soit le type de partenaire. Ainsi, ilsemble que lorsque les personnes se sentaient capables de négocier l'utilisation du préservatif,elles l’utilisaient de manière plus systématique. La capacité personnelle perçue est souventconsidérée comme un levier important pour adapter les comportements de santé. Or, elle peutêtre affectée dans des situations de stigmatisation, d’addiction ou de relation violente. Cesrésultats soulignent l’importance d’interventions spécifiques de prévention parmi les usagersde crack et notamment des interventions visant à améliorer le sentiment d’efficacitépersonnelle (perceived self-efficacy) et d’estime de soi.
Colloque ATHS Biarritz
Biarritz, France

inserm-01621896
http://www.hal.inserm.fr/inserm-01621896
http://www.hal.inserm.fr/inserm-01621896/document
http://www.hal.inserm.fr/inserm-01621896/file/2017%2C%20Parriault%20-%20Comportements%20sexuels%20%C3%A0%20risque%20%26%20crack.pdf

Éditeur(s) : HAL CCSD Taylor & Francis (Routledge)
Résumé : International audience
In Cayenne, French Guiana, 80% of HIV+ patients followed at the hospital are migrants. Behavioral information is crucial for optimizing HIV testing for this vulnerable group. Predictors of ignorance of the existence of free VCT centre and willingness to get tested were investigated in 2006 among 398 migrants from Haiti, Guyana, Suriname, and Brazil using a structured questionnaire. Only 27 % of migrants knew simultaneously about the existence of free VCT, its localisation and its operating hours. Factors associated with ignorance of the existence of free VCT centre were birthplace in Haiti, being in French Guiana for less than 3 years, not thinking one's birth country as strongly affected by HIV, and not thinking to be personally at risk for HIV. Factors independently associated with willingness to get tested were thinking to be at risk for HIV, birthplace in Brazil and Haiti, having a high integration level and fear of suffering if HIV test was positive. In order to improve testing among migrants, the accessibility of testing facilities and the knowledge of their whereabouts and operating hours must be improved to promote the desired behaviour among the majority of migrants which is often willing to do the test.
ISSN: 0954-0121

hal-00665442
https://hal.archives-ouvertes.fr/hal-00665442
https://hal.archives-ouvertes.fr/hal-00665442/document
https://hal.archives-ouvertes.fr/hal-00665442/file/PEER_stage2_10.1080%252F09540121.2010.525604.pdf
DOI : 10.1080/09540121.2010.525604

Éditeur(s) : HAL CCSD
Résumé : International audience
Background: The aim of this study was to identify the predictive factors of HIV disclosure to the sex partner in HIV pregnant women in Cayenne (French Guiana). Methods: A case control study was conducted including all deliveries in Cayenne from 2003 to 2010. For each case, a standardized questionnaire including epidemiological, clinical, and biological data was administered. Thirty-four women in the first group and 95 in the control group were included in the study. Results: The logistic regression showed that the variables that independently predicted HIV disclosure to the sex partner were the existence of a profession (OR=5.62, IC95% =1.3-24.26, p=0.021), disclosure to the doctor (OR=12.65, IC95% =2.87-55.8, p<0.001), the negative representations of HIV (OR=5.99, IC95% =1.17-30.69, p=0.032). The partner's HIV status was also linked to the outcome (OR=0.01, IC95% =0.001-0.07, p<0.001). Conclusion: These predictive factors should be considered in positive prevention programs and prevention of mother to child transmission.
Epidemiol

inserm-00915113
http://www.hal.inserm.fr/inserm-00915113
http://www.hal.inserm.fr/inserm-00915113/document
http://www.hal.inserm.fr/inserm-00915113/file/2012_Elenga_-_Predictive_Factorssur HIV_Status_Disclosure_to_Sex_Partner_in_Pregnant_women_in_cayenne_french_guiana.pdf
DOI : 10.4172/2161-1165.1000116

Éditeur(s) : HAL CCSD Cambridge University Press (CUP)
Résumé : International audience
Cervical cancer is the second most frequent cancer in women in French Guiana. Studies have shown that populations living in the remote areas of the interior have early sexual debut and that multiple sexual partnerships are common. The objective of the present study was thus to determine the prevalence of human papillomavirus (HPV) infection in these areas. A study was conducted in women aged 20-65 years with previous sexual activity. Women were included on a voluntary basis after using local media and leaders to inform them of the visit of the team. HPV infection was defined by the detection of HPV DNA using the Greiner Bio-One kit. In addition to HPV testing cytology was performed. The overall age-standardized prevalence rate was 35%. There was a U-shaped evolution of HPV prevalence by age with women aged >50 years at highest risk for HPV, followed by the 20-29 years group. Twenty-seven percent of women with a positive HPV test had normal cytology. Given the high incidence of cervical cancer in French Guiana and the high prevalence of HPV infections the present results re-emphasize the need for screening for cervical cancer in these remote areas. Vaccination against HPV, preferably with a nonavalent vaccine, also seems an important prevention measure. However, in this region where a large portion of the population has no health insurance, this still represents a challenge.
ISSN: 0950-2688

inserm-01476015
http://www.hal.inserm.fr/inserm-01476015
http://www.hal.inserm.fr/inserm-01476015/document
http://www.hal.inserm.fr/inserm-01476015/file/High%20prevalence%20HPV%20infection%20in%20women%20living%20in%20the%20remote%20territories%20of%20French%20Guiana%20STD.pdf
http://www.hal.inserm.fr/inserm-01476015/file/Table%203.pdf