Missed opportunities of HIV pre-exposure prophylaxis in France: a retrospective analysis in the French DAT’AIDS cohort View Full Text


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Article Info

DATE

2019-12

AUTHORS

C. Lions, O. Cabras, L. Cotte, T. Huleux, A. Gagneux-Brugnon, A. Makinson, A. Cabié, B. Bonnet, C. Duvivier, L. Hocqueloux, E. Cua, A. Cheret, L. Hustache-Mathieu, V. Obry-Roguet, C. Jacomet, I. Poizot-Martin, the DAT’AIDS STUDY GROUP

ABSTRACT

BACKGROUND: HIV pre-exposure prophylaxis (PrEP) was implemented in France in November 2015 based on individual-level risk factors for HIV infection. We evaluated the proportion of missed opportunities for PrEP among newly HIV-diagnosed people entering the Dat'AIDS cohort in 2016. METHODS: Multicenter retrospective analysis in 15 French HIV clinical centers of patients with a new diagnosis of HIV infection. Among them we differentiated patients according to the estimated date of infection: those occurring in the PrEP area (a previous negative HIV test in the last 12 months or those with an incomplete HIV-1 western blot (WB) with no HIV-1 anti-Pol-antibody at time of HIV diagnosis) and those in the pre-PrEP area (older infections). Epidemiological, biological and clinical data at HIV diagnosis were collected. Clinicians retrospectively identified potential eligibility for PrEP based on individual-level risk factors for HIV infection among those infected in the PrEP area. RESULTS: Among 966 patients with a new HIV diagnosis, 225 (23.3%) were infected in the PrEP area and 121 (53.8%) had complete data allowing evaluation of PrEP eligibility. Among them, 110 (91%) would have been eligible for PrEP, median age 31 years, with 68 (75.6%) born in France and 10 (11.1%) in Central/West Africa, with more than one previous STI in 19 (15.7%). The main eligibility criteria for PrEP were being a man who had sex with men or transgender 91 (82.7%) with at least one of the following criteria: unprotected anal sex with ≥2 partners in the last 6 months: 67 (60.9%); bacterial sexually transmitted infection in the last 12 months: 33 (30%); Use of psychoactive substances in a sexual context (chemsex): 16 (14.5%). PrEP was indicated for other HIV risk factors in 25 (22.7%). CONCLUSION: With 91% (110/121) of patients infected in the PrEP area eligible for PrEP, this study highlights the high potential of PrEP in avoiding new infection in France but also shows a persistent delay in HIV testing. Thus, an important limit on PrEP implementation in France could be insufficient screening and care access. More... »

PAGES

278

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12879-019-3915-5

DOI

http://dx.doi.org/10.1186/s12879-019-3915-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1112989380

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30909885


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285 https://www.grid.ac/institutes/grid.5399.6 schema:alternateName Aix-Marseille University
286 schema:name APHM Hôpital Sainte-Marguerite, Service d’Immuno-hématologie clinique, Aix-Marseille University, Marseille, France
287 rdf:type schema:Organization
 




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