Discussing HIV Status: Is It Easier After 10 Years of Antiretroviral Treatment? The ANRS CO8 APROCO-COPILOTE Cohort.

This study's objective was to explore the factors associated with the belief (or not) by people living with HIV that it is easier to talk about their seropositivity 10 years after initiating a protease inhibitor-containing ART. All patients in the ANRS CO8 APROCO-COPILOTE cohort who completed a self-administered questionnaire at 10 years of follow-up were included in this study. Forty-four percent of patients declared that discussing their seropositivity with their family was easier 10 years later, while 28 % declared this was true for discussing their status with a new sexual partner. Having a low socioeconomic status, not receiving social support from a steady partner and declaring a low number of discomforting symptoms 12 months after PI initiation were all independently associated with less difficulty in discussing seropositivity. This study highlights the difficulties in disclosing HIV 10 years after PI initiation, and the important influence of psychosocial factors and patients' daily-life experience on disclosure.

Brief Report: Prolonged Viral Suppression Over a 12-Year Follow-up of HIV-Infected Patients: The Persistent Impact of Adherence at 4 Months After Initiation of Combined Antiretroviral Therapy in the ANRS CO8 APROCO-COPILOTE Cohort.

The effect of early adherence on long-term viral suppression was assessed among 1281 patients with HIV starting a protease inhibitor-containing regimen in 1997-1999, followed up to 12 years. Association between 4-month adherence (3-level score) and prolonged viral suppression was evaluated using a multivariate mixed logistic model in 891 eligible patients. High 4-months adherence [odds ratio (95% confidence interval): 3.72 (1.98 to 6.98)] was associated with long-term prolonged viral suppression, irrespective of maintenance adherence. This unexpected long-term virological impact of early adherence reinforces the message that, when starting antiretrovirals, all means should be mobilized to ensure optimum early adherence to achieve prolonged antiretroviral success.

[A survey about determinants of 2009 pandemic influenza A(H1N1) vaccination among French general practionners patients. Motivac study]. / Déterminants de la vaccination contre la grippe A(H1N1) 2009. Enquête auprès des patients de médecins généralistes français. Etude Motivac.

The influenza A/H1N1 2009 immunization campaign did not have the accession of the French population resulting in a very low rate of immunization coverage. We conducted a cross-sectional study in spring 2010 to identify factors that led general practitionners (GPs) and their adult patients to be vaccinated or not; 43 GPs in France, included 668 patients; 29 GPs (67%) and 108 patients (16.5%) have been vaccinated; among 238 patients under vaccine priority indication 17% were vaccinated; 48% of patients thought they could receive effective treatment for influenza, 36% felt that the vaccine protected against influenza but 27% thought it did not meet usual safety criteria. A higher level of education, the belief of an effective protection with vaccination, the positive GP's opinion and behavior (OR 4,21 IC95% [1.4-14]; p=0.012), the receipt of an invitation to immunization (OR 7, 1 IC95% [1.73-58.4] and the active seek of information (OR 8.05, IC95% [2.8-27]) were significantly associated with vaccination. Regarding this immunization campaign few patients n=87 (13.7%) did trust the state heath agency. Our study confirms the distrust of the vaccine and suggests the decisive role of the GPs to achieve adequate levels of immunization coverage.

An analysis over time (1990-2000) of the experiences of living with HIV.

Qualitative data from three research projects carried out in France are used to analyze changes in the experiences of persons living with HIV during the 10-year period 1990-2000. During this decade, 167 in-depth interviews were conducted with 118 HIV-positive people in 1990-1991, 1996-1997 and 1998-2000. A three-fold typology-"continuity with drawbacks", "discontinuity and reversal" and "withdrawn"-is proposed to account for the experiences of living with HIV in relation to changes over time and the discovery of new treatment, i.e. highly active antiretroviral therapy (HAART), in the spring of 1996.

Uma doença no espaço público: a AIDS em seis jornais franceses / A disease within a public space: AIDS in six french newspapers

Pressupondo que a AIDS coloca novamente na cena social a temática da doença como cataclismo e onde se articulou de maneira inextrincável as dimensões biológica, política e social, as autoras procuram delinear como se construiu a representação desse fenômeno inédito na tradição ocidental, no qual assistimos às múltiplas interferências e retraduções entre conhecimento científico e conhecimento comum. Para isso, a AIDS é analisada no espaço público, através da leitura crítica de jornais franceses

AIDS has placed the issue of disease as catac1ysm back on the social scneario, where the biological, political, and social dimensions are inextricably interwoven. This article is an effort to outline the construction of the representation of this phenomenon, previously unknown in the Western tradition. Through it, one can observe multiple interferences and retranslations between scientific and common knowledge . With this in mind, AIDS is analyzed as approached within a public space, that is, through a critical reading of French newspapers.

[Identification and management of hereditary predisposition to cancer of the breast and the ovary (update 2004)]. / Identification et prise en charge des prédispositions héréditaires aux cancers du sein et de l'ovaire (mise à jour 2004).

BACKGROUND: Since the last recommendations, up to 2,500 new references had been published on that topic. METHODOLOGY: On the behalf of the health Minister, the Ad Hoc Committee consisted of 13 experts carried out a first version revisited by five additional experts who critically analyzed the first version of the report. MAIN UPDATING: Breast and ovarian cancer seem to be associated with fewer deleterious mutation of BRCA12 and BRCA2 than previously thought. The screening of ovarian cancer is still not an attractive option while in contrast MRI may be soon for these young women with dense breast, the recommended option for breast cancer screening. The effectiveness of prophylactic surgeries is now well established. French position is to favor such surgeries with regard to a quality of life in line with the expected benefit, and providing precise and standardized process described in the recommendation. CONCLUSIONS: Due to methodological flaws, the low power and a short follow-up of the surveys, this statement cannot however aspire to a high stability.

The illness experience: state of knowledge and perspectives for research.

Over the last quarter of a century, research on the illness experience has thrived. Publications on this subject are reviewed in relation to three themes: subjectivity; coping actions and strategies for managing everyday life; and the social structure. Sociology of Health and Illness has contributed significantly to this field. In conclusion, research perspectives are suggested for tackling the problems in passing from a micro to a macro level of analysis.