[Men who have sex with men (MSM) and HIV infection in Ouagadougou, Burkina Faso: Knowledge, attitudes, practices and seroprevalence survey]. / Les hommes qui ont des rapports sexuels avec d'autres hommes (HSH) et l'infection à VIH à Ouagadougou, Burkina Faso : connaissances, attitudes, pratiques et enquête de séroprévalence.

BACKGROUND: Like many African countries, the issue of sex between men in Burkina Faso remains taboo and sometimes result in social exclusion. This population which is vulnerable to HIV/AIDS is unknown, due to lack of scientific researches. AIM: Our study aimed to characterize knowledge, attitudes and sexual practices and to estimate HIV seroprevalence among men having sex with men (MSM) living in Ouagadougou. METHODS: A cross-sectional study was conducted in order to describe and analyze MSM living in Ouagadougou. They were recruited by snowball sampling, aged at least 18 years, and accepted to participate at the study. Data were collected by qualified interviewers through administered questionnaire face to face. HIV test was systematically proposed. RESULTS: A total of 142 MSM were recruited during the study period. The sample was mostly composed of students or pupils (60.8%), single men (91%), with age range 18-30 years (96.5%). The HIV knowledge median score was 8/10. HIV seroprevalence was 8.9% (4.5-15.4). CONCLUSION: Our study confirms the vulnerability of MSM living in Ouagadougou about HIV/AIDS given the high rate of HIV seroprevalence. Targeted interventions for prevention, care and scientific research are challenges for the authorities to sustain the achievements of the national fight against HIV and AIDS.

HIV seroprevalence among inmates in Togo.

BACKGROUND: There is no data on HIV seroprevalence among prisoners in Togo. METHODS: A cross-sectional study was conducted among prisoners in Togo from November 2011 to January 2012. The study population was included by selecting the most densely populated prison in each of the six Togo regions, and by including prisoners (at least18years of age and having been in prison for more than 30days) on a voluntary basis. HIV prevalence was estimated with a 95% confidence interval (CI). RESULTS: One thousand three hundred and fourty-two prisoners were included in the study. Their median age was 28years, (IQR 25-33years) and 39 (2.9%) were women. The median time spent in the prison was 10months, interquartile range [4-24months]. HIV testing was accepted by 96.0%. HIV seroprevalence in prisons was 4.3%, 95 CI% [3.2-5.5%]. Few prisoners (2.9%) reported having had sex in prisons. The only factor associated with HIV infection was gender with an HIV seroprevalence of 14.3% for women compared to 4.0% for men (P=0.003). CONCLUSION: The prevention and the management of HIV infection should be a priority in Togolese prisons. This requires implementing healthcare facilities in prisons.

The Spectrum projection package: improvements in estimating incidence by age and sex, mother-to-child transmission, HIV progression in children and double orphans.

BACKGROUND: The Spectrum program is used to estimate key HIV indicators from the trends in incidence and prevalence estimated by the Estimation and Projection Package or the Workbook. These indicators include the number of people living with HIV, new infections, AIDS deaths, AIDS orphans, the number of adults and children needing treatment, the need for prevention of mother-to-child transmission and the impact of antiretroviral treatment on survival. The UNAIDS Reference Group on Estimates, Models and Projections regularly reviews new data and information needs, and recommends updates to the methodology and assumptions used in Spectrum. METHODS: The latest update to Spectrum was used in the 2009 round of global estimates. This update contains new procedures for estimating: the age and sex distribution of adult incidence, new child infections occurring around delivery or through breastfeeding, the survival of children by timing of infection and the number of double orphans.

Implementing family-focused HIV care and treatment: the first 2 years' experience of the mother-to-child transmission-plus program in Abidjan, Côte d'Ivoire.

OBJECTIVES: To describe a family-focused approach to HIV care and treatment and report on the first 2 years experience of implementing the mother-to-child transmission (MTCT)-plus program in Abidjan, Côte d'Ivoire. PROGRAM: The MTCT-plus initiative aims to enroll HIV-infected pregnant and postpartum women in comprehensive HIV care and treatment for themselves and their families. MAIN OUTCOMES: Between August 2003 and August 2005, 605 HIV-infected pregnant or postpartum women and 582 HIV-exposed infants enrolled. Of their 568 male partners reported alive, 52% were aware of their wife's HIV status and 30% were tested for HIV; 53% of these tested partners were found to be HIV-infected and 78% enrolled into the program. Overall only 10% of the women enrolled together with their infected partner. On the other hand, the program involved half of the seronegative men who came for voluntary counselling and testing (VCT) in the care of their families. Of 1624 children <15 years reported alive by their mothers (excluding the last newborn infants of the most recent pregnancy systematically screened for HIV), only 10.8% were brought in for HIV testing, of whom 12.3% were found to be HIV-infected. LESSONS LEARNED AND CHALLENGES: The family-focused model of HIV care pays attention to the needs of families and household members. The program was successful in enrolling HIV women, their partners and infants in continuous follow-up. However engaging partners and family members of newly enrolled women into care involves numerous challenges such as disclosure of HIV status by women to their partners and family members. Further efforts are required to understand barriers for families accessing HIV services as strategies to improve partner involvement and provide access to care for other children in the households are needed in this West African urban setting.

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. Most HIV-negative women (96.7%) disclosed their HIV-test result to their partners, whereas only 45.6% of HIV-infected women did so (p<0.001). Partners of HIV-infected women were more likely to be tested for HIV before resuming sexual activity than partners of HIV-negative women (11.7% vs. 7.4%, p=0.054). Less than one third of both HIV-infected and HIV-negative women reported having systematically used condoms during the resumption of sexual activity. The proportions of HIV-infected and HIV-negative women having consistently used condoms were respectively 26.2% and 19.8% (p=0.193) at 3 months post-partum, 12.1% and 15.9% (p=0.139) at 12 months post-partum, and 8.4% and 10.6% (p=0.302) at 18 months post-partum. In our study, although women had been prenatally tested for HIV and properly counselled on the sexual risk of HIV transmission, male partners were not tested for HIV before the resumption of sexual activity after delivery, very few couples were using condoms systematically and condom use was decreasing over time.

Breast health problems are rare in both HIV-infected and HIV-uninfected women who receive counseling and support for breast-feeding in South Africa.

BACKGROUND: Breast problems, including mastitis, can interfere with the duration and exclusivity of breast-feeding. However, there are no large prospective studies documenting the prevalence, duration, and timing of such problems in breast-feeding women, particularly those who are infected with human immunodeficiency virus (HIV). METHODS: Women enrolled prenatally underwent a breast-feeding counseling intervention until 6 months after delivery. Breast health problems were documented per breast for 180 days after delivery, with 14-day recall histories. RESULTS: Breast health problems were rare, and there were no significant differences between HIV-infected and HIV-uninfected women for any of the following conditions: engorgement, 39 HIV-infected women (3.5%) versus 33 HIV-uninfected women (2.7%; P=.30); breast thrush, 17 (1.5%) versus 12 (1.0%; P=.25); bleeding nipple, 6 (0.5%) versus 4 (0.3%; P=.45); and mastitis/abscess, 11 (1.0%) versus 6 (0.5%; P=.17). Most problems occurred during the first month after birth, with few additional mothers experiencing problems after this point: at 1 and 6 months, 13% and 17% of all mothers, respectively, had experienced a minor or major breast health problem, including sore nipples. Women who had not exclusively breast-fed their infants were more likely to experience any of the breast health problems than were women who had exclusively breast-fed their infants (time-dependent variable; adjusted odds ratio, 1.46; 95% confidence interval, 1.13-1.87; P=.003). HIV-infected women who experienced any serious breast health problem (i.e., bleeding nipple, pus oozing from a nipple or breast, or mastitis/abscess) were 3.55 times (95% confidence interval, 0.86-14.78 times; P=.08) more likely to transmit HIV postnatally to their infant. CONCLUSIONS: With encouragement to exclusively breast-feed, women experienced few breast health problems. When those problems did occur, HIV-infected women with bleeding nipple, pus oozing from a nipple or breast, or mastitis/abscess were more likely to transmit HIV to their infants.

[Autochthonous strongyloidiasis in the north of France]. / Anguillulose autochtone dans le nord de la France.

The authors discuss four cases of indigenous strongyloidiasis, which were detected in northern France during the past twenty years. In our hemisphere, the limits of this helminthiasis range between the 50th and the 53rd parallels of latitude. In two cases, indoor contamination must be suspected; in the third case, transmission has been facilitated by insalubrity and crowding; the fourth case was related to the activities of a dustman in camping sites. Nose bleedings were noticed in two cases and the haemorrhagic manifestations in strongyloidiasis are mentioned.