A community-based healthcare package combining testing and prevention tools, including pre-exposure prophylaxis (PrEP), immediate HIV treatment, management of hepatitis B virus, and sexual and reproductive health (SRH), targeting female sex workers (FSWs) in Côte d’Ivoire: the ANRS 12381 PRINCESSE project

BMC Public Health

Alice Montoyo¹  Mélanie Plazy²  Joseph Larmarange³  Valentine Becquet⁴  Clémence Zébago⁵  Aline Agoua⁵  Hervé Dao⁵  Patrick A. Coffie⁶  Serge Eholié⁶  Marcellin Nouaman⁷  Aude Jary⁸ 

[1] ANRS, Paris, France;Bordeaux Population Health Research Center, Université de Bordeaux, Inserm, IRD, Bordeaux, France;Ceped, IRD, Université de Paris, Inserm, Paris, France;Ined, Aubervilliers, France;Ceped, IRD, Université de Paris, Inserm, Paris, France;ONG Aprosam, San Pedro, Côte d’Ivoire;PAC-CI, Abidjan, Côte d’Ivoire;Département de Dermatologie et Infectiologie, UFR des Sciences Médicales, Université Félix Houphouet-Boigny, Abidjan, Côte d’Ivoire;PAC-CI, Abidjan, Côte d’Ivoire;Département de Santé Publique, UFR d’Odonto-Stomatologie, Université Félix Houphouet-Boigny, Abidjan, Côte d’Ivoire;Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Paris, France;

关键词: HIV prevention;    Sexual and reproductive health;    Sexually transmitted infections (STIs), hepatitis B;    Pre-exposure prophylaxis (PrEP);    Sex work;    Mixed-methods research;    Mobile clinics;    Côte d’Ivoire;   

DOI  :  10.1186/s12889-021-12235-0

来源: Springer

【 摘 要 】

BackgroundPre-exposure prophylaxis (PrEP) is recommended by the WHO for HIV prevention among female sex workers (FSWs). A study conducted in 2016–2017 in Côte d’Ivoire showed that if PrEP is acceptable, FSWs also have many uncovered sexual health needs. Based on this evidence, the ANRS 12381 PRINCESSE project was developed in collaboration with a community-based organization. The main objective is to develop, document, and analyze a comprehensive sexual and reproductive healthcare package among FSWs in Côte d’Ivoire.MethodsPRINCESSE is an open, single-arm interventional cohort of 500 FSWs in San Pedro (Côte d’Ivoire) and its surroundings. Recruitment started on November 26th, 2019 and is ongoing; the cohort is planned to last at least 30 months. The healthcare package (including HIV, hepatitis B, and sexually transmitted infection management, pregnancy screening, and contraception) is available both at mobile clinics organized for a quarterly follow-up (10 intervention sites, each site being visited every two weeks) and at a fixed clinic.Four waves of data collection were implemented: (i) clinical and safety data; (ii) socio-behavioral questionnaires; (iii) biological data; and (iv) in-depth interviews with female participants. Four additional waves of data collection are scheduled outside the cohort itself: (i) the medical and activity records of Aprosam for the PRINCESSE participants; (ii) the medical records of HIV+ FSW patients not participating in the PRINCESSE cohort, and routinely examined by Aprosam; (iii) in-depth interviews with key informants in the FSW community; and (iv) in-depth interviews with PRINCESSE follow-up actors.DiscussionThe PRINCESSE project is one of the first interventions offering HIV oral PrEP as part of a more global sexual healthcare package targeting both HIV- and HIV+ women. Second, STIs and viral hepatitis B care were offered to all participants, regardless of their willingness to use PrEP. Another innovation is the implementation of mobile clinics for chronic/quarterly care. In terms of research, PRINCESSE is a comprehensive, interdisciplinary project combining clinical, biological, epidemiological, and social specific objectives and outcomes to document the operational challenges of a multidisease program in real-life conditions.Trial registrationThe PRINCESSE project was registered on the Clinicaltrial.gov website (NCT03985085) on June 13, 2019.

【 授权许可】

CC BY