Références bibliographiques

Bottin Marie, Ludet Louise et Schantz Clémence (2023) « Cancers du sein et migrations en Ile-de-France : où sont les associations ? », Communication présenté à Colloque international Institut du Genre, Toulouse, France.

Cardoso Pablo et Chavez Henry (2023) « Booms petroleros, quimeras de transformación productiva y el retorno de Washington. Balance de un medio siglo de economía ecuatoriana (1970-2020) », Revue internationale des études du développement, 251 (avril 6), p. 203. DOI : 10.4000/ried.8179. https://hal.science/hal-04142370.

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Chabrol Fanny et David Pierre-Marie (2023) « How resilience affected public health research during COVID-19 and why we should abandon it », Global Public Health, 18 (1) (janvier 2), p. 2212750. DOI : 10.1080/17441692.2023.2212750. https://doi.org/10.1080/17441692.2023.2212750.

Résumé : Resilience has accompanied the COVID-19 pandemic as a rallying motto, with calls by governments for a resilient society, resilient families and schools, and, of course, resilient healthcare systems in the face of this unprecedented pandemic shock. Resilience had already gained traction as an analytical concept in public health research for approximately a decade. It became a key concept despite the recognition of its lack of conceptual consistency. The COVID-19 pandemic presented itself as a perfect test-case and encouraged a multiplicity of studies on resilience and health care systems. In this commentary, we add to the existing critiques of resilience in the social sciences by reflecting on the effects of resilience when used to frame empirical inquiries and to draw lessons from the crisis. Resilience as a concept is unable to address crucial structural issues that health systems already faced throughout the world, and it remains a non-neutral political notion. We argue that we need to resist a generalised view of resilience and work with alternative imaginaries.

Mots-clés : adaptation, COVID-19, public health, Resilience, social sciences.

Chabrol Fanny et David Pierre-Marie (2023) « Ce que la résilience nous aura fait », Anthropologie & Santé. Revue internationale francophone d'anthropologie de la santé, 26 (avril 12). DOI : 10.4000/anthropologiesante.12626. https://journals.openedition.org/anthropologiesante/12626.

Résumé : Nous sommes heureux d’inaugurer cette section « Anthropolémiques » de la revue Anthropologie & Santé par une réflexion sur la résilience en recherche qui nous tient à cœur au sortir de trois années de pandémie. Certains pourront penser que cette « anthropolémique » ne prend pas beaucoup de risques tant la critique de la résilience devient rétrospectivement évidente après la Covid-19. Ceci n’était cependant pas aussi évident au début de la pandémie, et encore moins au cours de l’épidémie d’Ebo...

Mots-clés : adaptation, anthropologie, Covid-19, Résilience.

Chabrol Fanny, Traverson Lola, Hou Renyou, Chotard Lisa, Peiffer-Smadja Nathan, Lucet Jean-Christophe, Bendjelloul Gisèle, Dagenais Christian et Ridde Valéry (2023) « Échanges interprofessionnels en temps de COVID-19 à l’hôpital Bichat Claude-Bernard : éclairages pour la recherche », Santé Publique, 35 (1), p. 59-64. DOI : 10.3917/spub.231.0059. https://www.cairn.info/revue-sante-publique-2023-1-page-59.htm.

Résumé : La gestion de l’épidémie de COVID-19 a bouleversé l’organisation des soins dans les hôpitaux. Dans le cadre d’un projet de recherche portant sur la résilience des hôpitaux et des professionnel·le·s de santé face à la pandémie de COVID-19 (HoSPiCOVID), nous avons documenté leurs stratégies d’adaptation dans cinq pays (France, Mali, Brésil, Canada, Japon). En France, dès la fin de la première vague (juin 2020), une équipe de chercheur·se·s et des professionnel·le·s de santé de l’hôpital Bichat Claude-Bernard ont organisé des groupes de discussion pour prendre acte de ces accomplissements et pour partager leurs expériences vécues. Un an plus tard, d’autres échanges ont permis de discuter et de valider les résultats de la recherche. L’objectif de cette contribution courte est de décrire les apports de ces temps d’échanges interprofessionnels conduits à l’hôpital Bichat Claude-Bernard. Nous montrons que ceux-ci ont permis : 1) de créer des espaces de parole pour les professionnel·le·s, 2) d’enrichir et de valider les données collectées au travers d’une (re)connaissance collective d’aspects saillants relatifs aux vécus de la crise, et 3) de rendre compte des attitudes, interactions et rapports de pouvoir de ces professionnel·le·s dans un contexte de gestion de crise.

Mots-clés : COVID-19, Groupe de discussion, Hôpital, Interprofessionnel, Recherche qualitative.

Chane-Po David, Gatina Jean-Hugues, Leruste Sébastien et Legrand Florian (2023) « Knowledge of type 2 diabetic patients followed for less than 5 years in primary care in the western region of Reunion Island: a cross-sectional pilot study », Pec Innovation, 2, p. 100122. DOI : 10.1016/j.pecinn.2023.100122. https://hal.science/hal-04149579.

Résumé : BACKGROUND: The learning needs of newly diagnosed diabetic patients followed up in medical offices in Reunion Island are unknown, although necessary for the improvement of education programmes and disease control. AIM: To assess the knowledge of type 2 diabetic patients in primary care followed for less than 5 years. METHOD: A cross-sectional study was carried out, using a self-questionnaire to assess patients’ knowledge of diabetes, complications, follow-up, diet and physical activity. Patients were recruited from medical offices in the western region of Reunion Island. RESULTS: From 23(rd) April to 31(st) July 2021, 89 patients were included. The knowledge level of the total sample was moderate (mean correct answers 65 % ± 17). The best knowledge levels were in the areas "generalities on diabetes" and "complications", while the lowest levels were in the categories "follow-up" and "diet and physical activity". Glycated haemoglobin, libido disorders, frequency of urinalysis and dental consultation, and the recommended diet for patients with diabetes which is the same as for the general population, were the least known concepts. CONCLUSION: This study revealed gaps in patients’ knowledge that could be used to improve education programmes which in turn could reduce or prevent diabetes complications.

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Combes Hélène, Ruiz De Elvira Laura, Musamba Josaphat et Dorronsoro Gilles (2023) « Faire face aux transformations des terrains : retours sur des expériences contrastées: », Critique internationale, N° 100 (3) (septembre 1), p. 177-192. DOI : 10.3917/crii.100.0177. https://www.cairn.info/revue-critique-internationale-2023-3-page-177.htm?ref=doi.

Coulibaly Abdourahmane (2023) « The complexe care pathway for women with breast cancer in Mali », Poster novembre 3, AORTIC-Africa, Dakar, Sénégal.

Coulibaly Abdourahmane, Chabrol Fanny, Touré Laurence, Hou Renyou, Dramé Boubacar Sidiki Ibrahim, Zinszer Kate et Ridde Valéry (2023) « Responses to Hospital Restrictions on Family Visits during the COVID-19 Epidemic in Mali and France », Health Systems & Reform, 9 (2) (juin 15), p. 2241188. DOI : 10.1080/23288604.2023.2241188. https://doi.org/10.1080/23288604.2023.2241188.

Résumé : Few studies have focused on the presence of families in the hospital in the context of an epidemic. The present study aims to contribute to filling this gap by answering the following question: How did professionals, patients and their families cope with more or less drastic restrictions to family visits and presence during the COVID-19 pandemic in a French and a Malian hospital during the COVID-19 pandemic? Data were collected during the first two waves of the pandemic through 111 semi-structured interviews (France = 55, Mali = 56). Most of the interviews were conducted with staff (n = 103), but also with families in the case of Mali (n = 8). The investigators also conducted 150 days of field observations, 44 in France and 106 in Mali. Thematic analysis was applied using an inductive approach. Interviews were content analyzed to identify passages in the interviews that were relevant to these different themes. The study highlighted the difficulty for the medical-clinical system to provide appropriate responses to the many emotional needs of patients in a pandemic context. Families in France benefited from a support service to reduce stress, while in Mali, no initiative was taken in this sense. In both countries, families often used the telephone as an alternative means of communicating with relatives. The results showed that in the two contexts, the presence and involvement of the families contributed to a better response to the patients’ psycho-affective demands and thus promoted resilience in this field.

Mots-clés : COVID-19, family visits, France, hospitals, Mali, resilience.

Coulibaly Abdourahmane, Touré Laurence, Chabrol Fanny, Zinszer Kate et Ridde Valéry (2023) « Quand les pratiques des soignants « calment » ou « stressent » les malades : l’accompagnement psychosocial des malades infectés par le SARS-CoV-2 à Bamako », Sciences sociales et santé, 41 (3) (septembre 1), p. 69-94. DOI : 10.1684/sss.2023.0255. https://www.jle.com/fr/revues/sss/e-docs/quand_les_pratiques_des_soignants_calment_ou_stressent_les_malades_laccompagnement_psychosocial_des_malades_infectes_par_le_sars_cov_2_a_bamako_333015/article.phtml?tab=texte.

Coulibaly Karna, Bousmah Marwân-al-Qays, Ravalihasy Andrainolo, Senne Jean-Noël, Gubert Flore, Gosselin Anne, Desgrées du Loû Annabel et for the MAKASI Study Group (2023) « Bridging the gap: the impact of an empowerment based intervention on the knowledge of biomedical HIV prevention tools among sub-Saharan African precarious immigrants in France. Results from the Makasi Project. », Poster. N°EPC0388 présenté à 12th International AIDS Society Conference (IAS), juillet 23, Brisbane, Australie. https://programme.ias2023.org/Abstract/Abstract/?abstractid=3936.

Mots-clés : Empowerment intervention, France, Immigrants, Post-exposure prophylaxis, Pre-exposure prophylaxis, Sub-saharan african, Treatment as prevention.

Coulibaly Karna, Bousmah Marwân-al-Qays, Ravalihasy Andrainolo, Taéron Corinne, Mbiribindi Romain, Senne Jean-Noël, Gubert Flore, Gosselin Anne, Desgrées du Loû Annabel et for the MAKASI Study Group (2023) « Bridging the knowledge gap of biomedical HIV prevention tools among sub-saharan african immigrants in France. Results from an empowerment-based intervention », SSM - Population Health, 23 (septembre 1), p. 101468. DOI : 10.1016/j.ssmph.2023.101468. https://www.sciencedirect.com/science/article/pii/S2352827323001337.

Résumé : Introduction Biomedical HIV prevention tools are available in France to prevent new infections. However, evidence suggests a lack of knowledge of these tools among sub-Saharan African immigrants, who are particularly affected by HIV due to social hardship, an indirect factor of HIV acquisition. We analysed the impact of an empowerment-based intervention on the knowledge of treatment as prevention (TasP), pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) in a population of precarious sub-Saharan African immigrants. Methods Data were collected throughout the MAKASI project. Following an outreach approach, participants were recruited in public places based on their precarious situations and followed for six months (0, 3, 6 months) between 2018 and 2021. Participants were randomized into two groups and received an empowerment intervention sequentially (stepped wedge design). We used random-effects logistic regression models to evaluate the intervention effect on the knowledge of biomedical HIV prevention tools. ClinicalTrials.gov Identifier: NCT04468724. Results The majority of the participants were men (77.5%), and almost half of them had arrived in France within 2 years prior to inclusion (49.3%). At baseline, 56% of participants knew about TasP, 6% knew about PEP and 4% knew about PrEP. Receiving the intervention increased the odds of knowing about PEP (aOR = 2.02 [1.09–3.75]; p < 0.026). Intervention effects were observed for TasP and PrEP only after 6 months. We found significant time effects for PEP (at 3 months, aOR = 4.26 [2.33–7.80]; p < 0.001; at 6 months, aOR = 18.28 [7.39–45.24]; p < 0.001) and PrEP (at 3 months, aOR = 4.02 [2.10–7.72]; p < 0.001; at 6 months, aOR = 28.33 [11.16–71.91]; p < 0.001). Conclusions We showed that the intervention increased the knowledge of biomedical HIV prevention tools. The effect of the intervention was coupled with an important time effect. This suggested that exposure to the intervention together with other sources of information contributed to increased knowledge of biomedical HIV prevention tools among precarious sub-Saharan African immigrants.

Mots-clés : Empowerment intervention, France, Immigrants, Post-exposure prophylaxis, Pre-exposure prophylaxis, Sub-saharan african, Treatment as prevention.

Coulibaly Karna, Gosselin Anne, Carillon Severine, Taéron Corinne, Mbiribindi Romain, Desgrées du Loû Annabel et Group on behalf of the Makasi study (2023) « Low knowledge of antiretroviral treatments for the prevention of HIV among precarious immigrants from sub-Saharan Africa living in the greater Paris area: Results from the Makasi project », PLOS ONE, 18 (6) (juin 14), p. e0287288. DOI : 10.1371/journal.pone.0287288. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0287288.

Résumé : Introduction In France, combination prevention tools, particularly antiretroviral treatment for HIV prevention has been available for several years. We described the knowledge of these antiretroviral treatments among immigrants from sub-Saharan Africa, who are particularly affected by HIV, and the factors associated with this knowledge. Methods The data come from the Makasi study, which was conducted between 2019 and 2020 among precarious immigrants from sub-Saharan Africa recruited through a community-based outreach approach in the greater Paris area (n = 601). We described levels of knowledge of HIV treatment effectiveness (HTE), treatment as prevention (TasP), post-exposure prophylaxis (PEP), and pre-exposure prophylaxis (PrEP), by sex with chi2 test. We investigated factors associated with their knowledge with logistic regressions adjusted for sociodemographic characteristics, living conditions and sexual behaviors (p≤0.2). Results Respondents were mostly men (76%), from West Africa (61%), in precarious situation: 69% were unemployed, 74% were undocumented and 46% had no health coverage. Among this population, knowledge of HIV preventive treatments was heterogeneous. While HTE was well known (84%); TasP was known by only half of the respondents (46%), and PEP and PrEP were hardly known: 6% and 5%, respectively. Multivariate regressions models showed that these antiretroviral treatments for the prevention of HIV was better known by people with a higher level of education (PEP: aOR = 3.33 [1.09–10.20], p = 0.03; HTE: aOR = 4.33 [1.87–10.04], p<0.001), those who had a social network in France (TasP: aOR = 1.90, [1.33–2.73], p<0.001), those who had access to the health system and those who were exposed to sexual risks (TasP: aOR = 3.17, [1.03–9.69], p = 0.04; PrEP: aOR = 2.60 [0.72–9.34], p = 0.14). Conclusions There is a need for specific communication on antiretroviral treatment for HIV prevention that targets sub-Saharan immigrants, particularly those who have no access to the health-care system and those who are less educated.

Mots-clés : Antiretroviral therapy, Antiretrovirals, France, HIV, HIV prevention, Medical risk factors, Post-exposure prophylaxis, Pre-exposure prophylaxis.

Dagenais C., Hot A. et Ridde Valéry (2023) « Communiquer efficacement les connaissances scientifiques permet de sauver des vies », The Conversation, 2023-02-21, p. en ligne [4 p.]. https://hal.science/hal-04010332.

Mots-clés : ⛔ No DOI found.

Dagenais C., Proulx M., Sween-Cadieux M. C., Nikiema A., Bonnet Emmanuel, Ridde Valéry et Somé P. A. (2023) « Recherche collaborative et transfert des connaissances sur les accidents de la route au Burkina Faso : le point de vue de la police 18 mois plus tard », Ed. Science et Bien Commun. https://hal.science/hal-04130581.

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David Pierre-Marie, Gabet Morgane, Duhoux Arnaud, Traverson Lola, Ridde Valéry, Zinszer Kate et Gautier Lara (2023) « Adapting Hospital Work During COVID-19 in Quebec (Canada) », Health Systems & Reform, 9 (2) (juin 15), p. 2200566. DOI : 10.1080/23288604.2023.2200566. https://www.tandfonline.com/doi/full/10.1080/23288604.2023.2200566.

Delfraissy J. F., Duée P. H. et Duault Laëtitia Atlani (2023) Les personnes âgées au risque de la pandémie, La Documentation Française. https://hal.science/hal-04144781.

Résumé : De nombreux experts considèrent à la lumière de la crise de la COVID-19, la façon dont notre société construit son rapport aux personnes âgées, concernant notamment leur prise en charge, en particulier dans les établissements d'hébergement pour personnes âgées dépendantes (EHPAD). A partir de l'étude des faits, des chiffres, des textes législatifs, les auteurs tentent ici de répondre à deux questions : avons-nous protégé nos aînés ? Le modèle de l'EPHAD est-il encore adapté ? Le taux de mortalité observé dans cette population pagée a conduit les autorités à mettre en place des mesures contraignantes, afin de la protéger. La restriction des libertés, l'altération du lien social ont entraîné nombre de souffrances pour les personnes elles-mêmes et pour leurs proches. La concentration de personnes fragiles en un même lieu s'est avérée un facteur multiplicateur des risques inhérents à une épidémie et à confronté, de façon dramatique, ces personnes, les familles et leurs proches à la question de la fin de la vie et de la mort. Ces constats appellent à questionner, à la lumière de la pandémie de COVID-19, la politique d'accompagnement du vieillissement en France, à mettre en lumière des témoignages, à s'interroger sur les enjeux éthiques de santé publique et à tenter, enfin, de poser les bases d'une reconstruction de l'accompagnement du grand âge. Avec une ambition : retrouver l'humanité à la fin la de la vie.

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Diagne Ibra, Petit Véronique, Ndiaye Ndongo Ndeye Diale et Sylla Aida (2023) « Profil des jeunes de 15 à 25 ans souffrant de problèmes de santé mentale au Sénégal : une étude au centre de santé mentale dalal xel de Thiès », Health Sciences & Diseases, 24 (6), p. 20-25.

Mots-clés : ⛔ No DOI found.

Diagne Ibrahima, Petit Véronique, Bousso Abdoulaye, Dieng Allé Baba et Sylla Aida (2023) « Pyschosocial Support and Follow-up in emergency situations, the Mobile Intervention and Psychosocial Support Team: an innovative emergency system in Senegal », International Journal of Advanced Multidisciplinary Research Studies, 3 (1), p. 613-621.

Résumé : This article reports on the process of creating an innovative emergency mechanism in Senegal, the Mobile Psychosocial Intervention and Support Team (EMIS), by recalling how in the early 2000s a tragedy shook the country and triggered reflection on psychosocial follow-up in a political context subject to the idiom of resilience. The creation of the EMIS seems paradoxical since it requires and valorizes competencies in psychology and psychiatry which in ordinary times are little supported by social and health policies.

Mots-clés : ⛔ No DOI found.

Duchesne Véronique, Langewiesche Katrin, Pilon Marc, Dasré Aurélien, Degorce Alice, Guiblehon Bony, Pérouse de Montclos Marc-Antoine et Saint-Lary Maud (2023) Quelle prise en compte de la religion dans les sources de données démographiques en Afrique ?, Working Papers du CEPED (55), Paris : Ceped, 30 p. https://www.ceped.org/wp55.

Résumé : Ce texte propose, à l’échelle de l’Afrique, un état des lieux de l’évolution de la manière dont la religion est renseignée (ou non) dans les recensements nationaux de la population et certaines enquêtes démographiques nationales, depuis les années 1960 jusqu’à la fin des années 2010. Nous nous intéressons d’abord à l’évolution de la place accordée au recueil d’informations sur la religion dans les sources de données démographiques déjà évoquées. Puis nous questionnons les catégories religieuses rete-nues par les diverses opérations de collecte. Sur la base de plus de 100 recensements étudiés (concernant 38 pays) ainsi que toutes les enquêtes EDS et MICS, il ressort une prise en compte croissante de la religion. Poser une question relative à la religion est toujours laissée à l’appréciation des pays. Les modalités retenues s’avèrent d’une très grande diversité à l’échelle du conti-nent. L’analyse de ces modalités met en évidence que celles-ci varient non pas seulement selon les pays, mais aussi selon les opérations de collecte, ainsi que dans le temps au sein d’un même pays. Dans tous les cas, les choix qui sont faits conditionnent les chiffres qui en résultent, notamment en termes de « poids démographique » de telle ou telle catégorie religieuse.

Duchesne et al. - 2023 - Quelle prise en compte de la religion dans les sou.pdf 566.9 kio (source)

d’Elbée Marc, Terris-Prestholt Fern, Briggs Andrew, Griffiths Ulla Kou, Larmarange Joseph, Medley Graham Francis et Gomez Gabriella Beatriz (2023) « Estimating health care costs at scale in low- and middle-income countries: Mathematical notations and frameworks for the application of cost functions », Health Economics, 2023 (juin 18), p. 1-18. DOI : 10.1002/hec.4722. https://onlinelibrary.wiley.com/doi/abs/10.1002/hec.4722.

Résumé : Appropriate costing and economic modeling are major factors for the successful scale-up of health interventions. Various cost functions are currently being used to estimate costs of health interventions at scale in low- and middle-income countries (LMICs) potentially resulting in disparate cost projections. The aim of this study is to gain understanding of current methods used and provide guidance to inform the use of cost functions that is fit for purpose. We reviewed seven databases covering the economic and global health literature to identify studies reporting a quantitative analysis of costs informing the projected scale-up of a health intervention in LMICs between 2003 and 2019. Of the 8725 articles identified, 40 met the inclusion criteria. We classified studies according to the type of cost functions applied—accounting or econometric—and described the intended use of cost projections. Based on these findings, we developed new mathematical notations and cost function frameworks for the analysis of healthcare costs at scale in LMICs setting. These notations estimate variable returns to scale in cost projection methods, which is currently ignored in most studies. The frameworks help to balance simplicity versus accuracy and increase the overall transparency in reporting of methods.

Mots-clés : cost functions, econometrics, health economics, low- and middle-income countries, microeconomics, production costs.

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d’Elbée et al_2023_Estimating health care costs at scale in low- and middle-income countries.pdf 2 Mio (source)

Fotso Arlette Simo, Kouassi Arsene Kra, Boily Marie-Claude, Silhol Romain, Vautier Anthony et Larmarange Joseph (2023) « Knowledge, attitude and practices towards HIV testing following the introduction of self-testing: The case of the ATLAS project in Côte d’Ivoire » (poster), présenté à AIDS Impact Conference, Stockholm. https://hal.science/hal-04120627.

Résumé : Background HIV testing is a central element of the strategy to end AIDS epidemic, as status awareness is the entry point to HIV care. In West Africa, only 68% of people living with HIV (PLHIV) were aware of their HIV status in 2019. To address the testing gap, the ATLAS project distributed a total of 400000 self-tests (HIVST) in three West African countries between 2019 and 2022, including 200 000 kits in Côte d’Ivoire. The aim of this study is to assess levels and correlates of knowledge, attitude and practice towards HIV conventional testing (tests other than HIVST) and self-testing after the introduction of HIVST in Cote d’Ivoire. Method We conducted the population-based cross-sectional in the Bas-Sassandra District of Côte d’Ivoire, 24 months after HIVST was introduced in the region by ATLAS. ATLAS Household Survey (AHS) used a three-stage stratified sampling approach – 3 of the strata are the 3 departments with ATLAS activities and 1 includes departments with almost none, each further stratified on urban and rural settings. Face-to- face interviews were conducted in a representative a sample of the population aged 15-49. One main objective of the survey was to assess the effect of the ATLAS initiative on HIV testing. Weighed proportions and chi-square tests were used to assess knowledge of, attitude towards and practice of HIV conventional and self testing, comparing male and female on the one hand and departments with and without ATLAS HIVST distribution activities on the other hand. Logistic regressions were used to identified factors associated with knowledge of, attitude towards and practice of HIV conventional and self testing (ongoing analysis). Preliminary results A total of 6274 people with median age of 29 were interviewed and completed the questionnaire (3205 males and 3069 females). Most participants were in couple (44% males and 59% females) and have attended school (63% males and 45% females). Despite most participants knowing about HIV-AIDS (97 % Males and 96% females), very few reported having heard about HIVST (11% males and 10% females). However, most participants showed a positive attitude toward HIVST and reported that they would be interested/very interested to use it if freely available for themselves (75% males and 71% females), as well as for their sexual partners. About 18% of females and 10% of males reported having performed at least 1 conventional test in the last 12 months, while 3% of participants had already used a HIVST in the past. Conclusion Although knowledge and use of HIVST remain relatively low in the region, participants show a positive attitude toward HIVST, and express willingness to use it if freely available. Next results will tell how the observed results differ between participants living in department with ATLAS HIVST distribution and others, and how significant are the differences. It will also provide an overview of associated factors. This will provide policy makers with tools for potential actions in order to improve HIV testing and advance progress towards UNAIDS targets to achieve 95 % of PLHIV who know their status by 2025.

Freyne Marvin (2023) « Un court état des lieux de la participationsociale en santé en Europe », Actualité et dossier en santé publique, 121 (mars), p. 27-29. https://www.hcsp.fr/explore.cgi/Adsp?clef=1182.

Mots-clés : ⛔ No DOI found.

Gabet M., Duhoux A., Ridde Valéry, Zinszer K., Gautier L. et David P. M. (2023) « How did an integrated health and social services center in the Quebec Province respond to the COVID-19 pandemic ? A qualitative case study », Health Systems & Reform, 9 (2), p. 2186824 [8 p.]. DOI : 10.1080/23288604.2023.2186824. https://hal.science/hal-04145236.

Résumé : D

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Gagnon-Dufresne Marie-Catherine, Gautier Lara, Beaujoin Camille, Boivin Pauline, Coulibaly Abdourahmane, Richard Zoé, Gomes DE Medeiros Stéphanie, Dutra Da Nóbrega Raylson Emanuel, DE Araujo Oliveira Sydia Rosana, Cloos Patrick, Chabrol Fanny, Ridde Valéry et Zinszer Kate (2023) « Did the design and planning of testing and contact tracing interventions for COVID-19 consider social inequalities in health? A multiple case study from Brazil, Canada, France & Mali », Social Science & Medicine (septembre 9), p. 116230. DOI : 10.1016/j.socscimed.2023.116230. https://www.sciencedirect.com/science/article/pii/S0277953623005877.

Résumé : The COVID-19 pandemic has led to an unprecedented global crisis. It has exposed and exacerbated weaknesses in public health systems worldwide, particularly with regards to reaching the most vulnerable populations, disproportionately impacted by the pandemic. The objective of our study was to examine whether and how social inequalities in health (SIH) were considered in the design and planning of public health responses to COVID-19 in jurisdictions of Brazil, Canada, France, and Mali. This article reports on a qualitative multiple case study of testing and contact tracing interventions in regions with high COVID-19 incidence in each country, namely: Manaus (Brazil), Montréal (Canada), Île-de-France (France), and Bamako (Mali). We conducted interviews with 108 key informants involved in these interventions in the four jurisdictions, focusing on the first and second waves of the pandemic. We analyzed our data thematically using a theoretical bricolage framework. Our analysis suggests that the lack of a common understanding of SIH among all actors involved and the sense of urgency brought by the pandemic eclipsed the prioritization of SIH in the initial responses. The pandemic increased intersectoral collaboration, but decision-making power was often unequal between Ministries of Health and other actors in each jurisdiction. Various adaptations to COVID-19 interventions were implemented to reach certain population groups, therefore improving the accessibility, availability, and acceptability of testing and contact tracing. Our study contributes to identifying lessons learned from the current pandemic, namely that the ways in which SIH are understood shape how interventions are planned; that having clear guidelines on how to integrate SIH into public health interventions could lead to more inclusive pandemic responses; that for intersectoral collaboration to be fruitful, there needs to be sufficient resources and equitable decision-making power between partners; and that interventions must be flexible to respond to emerging needs while considering long-standing structural inequalities.

Gautier Lara, Noda Shinichiro, Chabrol Fanny, David Pierre-Marie, Duhoux Arnaud, Hou Renyou, Rosana de Araújo Oliveira Sydia, Traverson Lola, Zinszer Kate et Ridde Valéry (2023) « Hospital Governance During the COVID-19 Pandemic: A Multiple-Country Case Study », Health Systems & Reform, 9 (2) (juin 15), p. 2173551. DOI : 10.1080/23288604.2023.2173551. https://doi.org/10.1080/23288604.2023.2173551.

Résumé : In response to the disruptions caused by COVID-19, hospitals around the world proactively or reactively developed and/or re-organized their governance structures to manage the COVID-19 response. Hospitals’ governance played a crucial role in their ability to reorganize and respond to the pressing needs of their staff. We discuss and compare six hospital cases from four countries on different continents: Brazil, Canada, France, and Japan. Our study examined how governance strategies (e.g., special task forces, communications management tools, etc.) were perceived by hospital staff. Key findings from a total of 177 qualitative interviews with diverse hospital stakeholders were analyzed using three categories drawn from the European Observatory on Health Systems and Policies framework on health systems resilience during the COVID-19 pandemic: 1) delivering a clear and timely COVID-19 response strategy; 2) coordinating effectively within (horizontally) and across (vertically) levels of decision-making; and 3) communicating clearly and transparently with the hospital’s diverse stakeholders. Our study gleaned rich accounts for these three categories, highlighting significant variations across settings. These variations were primarily determined by the hospitals’ environment prior to the COVID-19 crisis, namely whether there already existed a culture of managerial openness (including spaces for social interactions among hospital staff) and whether preparedness planning and training had been routinely integrated into their activities.

Mots-clés : Comparative health systems, hospital governance, multiple case study, resilience.

Gérard Étienne (2023) Universités privées: la fabrique des inégalités [leçons d'Afrique, d'Amérique latine et d'Asie], Paris : Éditions Karthala, 326 p. (Hommes et sociétés). ISBN : 978-2-38409-000-6.

Résumé : La marchandisation et la privatisation de l'éducation constituent, depuis plusieurs décennies, des processus en forte expansion. Les pays émergents et en développement sont particulièrement sujets à cette évolution, notamment dans l'enseignement supérieur. Dans ces pays, la création des universités privées est liée à des déterminants économiques, politiques et sociologiques, tout autant qu'historiques. Ces universités, dont la croissance ressortit principalement à l'adoption des politiques néolibérales qui ont investi le champ éducatif, sont désormais de plus en plus hétérogènes et différenciées par des modes complexes de fonctionnement et de régulation. Cette hétérogénéité des universités privées, qui se double d'une forte hiérarchie sociale, économique et politique entre elles, concerne tout autant leur offre éducative que leurs modes de financement, leurs fondateurs et dirigeants, leurs personnels académiques, enfin leurs populations étudiantes. Impliquées dans une forte concurrence – entre elles et avec leurs homologues publiques –, ces universités multiplient des stratégies offensives d'attraction et de captation des clientèles étudiantes, au rang desquelles comptent en premier lieu la sélection, le soutien ou l'accompagnement de ces étudiants. Elles favorisent certes l'élargissement de l'accès à l'enseignement supérieur, mais elles participent aussi et surtout à l'accroissement et à la diversification des inégalités sociales, spatiales ou économiques à ce niveau. Sur la base d'enquêtes conduites auprès des différentes catégories d'acteurs de très nombreuses universités privées, cet ouvrage analyse la fabrique et la reproduction de ces inégalités, dans des pays aussi divers que l'Argentine, le Mexique, le Pérou, la République Démocratique du Congo, le Sénégal et le Vietnam

Gérard Etienne et Kuri R. Grediaga (2023) « De la dérégulation du marché de l'enseignement supérieur à l'élitisme méritocratique : réflexions sur la fabrique des inégalités par les secteurs privés : introduction », Karthala. https://hal.science/hal-04143804.

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Guzmán-Rosas Susana Carolina (2023) « Strategies Used by Rural Indigenous Populations to Cope with Energy Poverty, in San Luis Potosí, Mexico », Energies, 16 (11) (juin 1), p. 4479. DOI : 10.3390/en16114479. https://www.mdpi.com/1996-1073/16/11/4479.

Résumé : At the global level, the strategies used by rural Indigenous populations to face energy poverty have not been studied. Pioneering in the field, this work contributes to filling the gaps in the literature on the subject, mobilize the debate on a problem that affects rural Indigenous populations unequally, and outline key areas for policy. With a quantitative approach and taking as a research scenario the five rural Indigenous municipalities with the highest multidimensional poverty in the State of San Luis Potosí, Mexico, this paper analyzes the strategies used by rural Indigenous households to cope with energy poverty. It finds that a considerable proportion has had difficulty paying for their energy consumption (electricity, LP gas, and firewood), using strategies to cope with energy poverty (67.7%, 73.2%, and 96.1%, respectively): reducing expenses or stopping buying other things, borrowing money, and/or failing to pay for electricity or buy fuels for lack of economic resources. Food is significantly sacrificed in the reduction of expenses or stopping buying things, followed by health and housing. The situation has normalized over time, potentially impacting development, physical health, and mental well-being, and acting as an accelerator of the cycle of risk of energy poverty, given the confirmation of additional stressors.

Texte intégral 7.1 Mio (source)

Honda Ayako, De Araujo Oliveira Sydia Rosana, Ridde Valéry, Zinszer Kate et Gautier Lara (2023) « Attributes and Organizational Factors that Enabled Innovation in Health Care Service Delivery during the COVID-19 Pandemic – Case Studies from Brazil, Canada and Japan », Health Systems & Reform, 9 (2) (juin 15), p. 2176022. DOI : 10.1080/23288604.2023.2176022. https://www.tandfonline.com/doi/full/10.1080/23288604.2023.2176022.

Hou Renyou, Traverson Lola, Chabrol Fanny, Gautier Lara, de Araújo Oliveira Sydia Rosana, David Pierre-Marie, Lucet Jean-Christophe, Zinszer Kate et Ridde Valéry (2023) « Communication and Information Strategies Implemented by Four Hospitals in Brazil, Canada, and France to Deal with COVID-19 Healthcare-Associated Infections », Health Systems & Reform, 9 (2) (juin 15), p. 2223812. DOI : 10.1080/23288604.2023.2223812. https://doi.org/10.1080/23288604.2023.2223812.

Résumé : During the COVID-19 pandemic outbreak, COVID-19 healthcare-associated infections (HAI) and risk management became major challenges facing hospitals. Using evidence from a research project, this commentary presents: 1) various communication and information strategies implemented by four hospitals and their staff in Brazil, Canada and France to reduce the risks of COVID-19 HAIs, and how they were perceived by hospital staff; 2) the flaws in communication in the hospitals; and 3) a proposed agenda for research on and action to improve institutional communications for future pandemics. By analyzing “top-down” strategies at the organizational level and spontaneous strategies initiated by and between professionals, this study shows that during the first waves of the pandemic, reliable information and clear communication about guidelines and health protocols’ changes can help alleviate fears among staff and avoid misapplication of protocols, thereby reducing infection risks. There was a lack of a “bottom-up” communication channel, while, when making decisions, it is crucial to listen to and fully take into account staff’s voices, experiences, and feelings. More balanced communication between hospital administrators and staff could strengthen team cohesion and lead to better enforcement of protocols, which in turn will reduce the risk of contamination, alleviate the potential impacts on staff health, and improve the quality of care provided to patients.

Mots-clés : Communication, COVID-19, healthcare-associated infection, hospital, information, resilience.

Joxe Ludovic et Meneghini Stéphanie (2023) « Les limites de la mansuétude. Analyse du traitement de la faute dans une organisation humanitaire internationale », Sociologies pratiques, 46 (1), p. 55-65. https://www.cairn.info/revue-sociologies-pratiques-2023-1-page-55.htm.

Résumé : La faute, forme particulière de déviance, n’a pas déserté le monde du travail. Les pratiques normatives, définissant le périmètre de l’(in)acceptable et s’employant à en gérer les conséquences, forment toujours une trame sur laquelle se déploient les organisations, les activités et les situations productives ; elles continuent d’identifier, de qualifier et de traiter des fautes. Contre les thèses soutenant sa disparition, ce numéro de Sociologies Pratiques, en explorant des mondes variés (de l’agriculture à la voyance en ligne, en passant par l’engagement humanitaire et les pratiques professionnelles de traduction), montre la vigueur de la vie sociale de la faute, des jugements de responsabilité qui la constituent et de l’administration des punitions qui la sanctionnent. Il dresse ainsi, en négatif, un portrait de la normativité au travail.

Mots-clés : Excuse, Faute, Humanitaire, Mansuétude, MSF, Sanction, Travail, ⛔ No DOI found.

Kadio Kadidiatou, Dagenais Christian et Ridde Valery (2023) « How does explicit knowledge inform policy shaping? The case of Burkina Faso’s national social protection policy », PLoS ONE, 18 (4), p. e0284950. DOI : 10.1371/journal.pone.0284950. https://hal.science/hal-04149567.

Résumé : In 2009, Burkina Faso embarked on a process leading to the development of a national social protection policy (politique nationale de protection sociale-PNPS) in 2012. The objective of this study was to analyze the circumstances under which explicit knowledge was used to inform the process of emergence and formulation PNPS. The term explicit knowledge excludes tacit and experiential knowledge, taking into account research data, grey literature, and monitoring data. Court and Young’s conceptual framework was adapted by integrating concepts from political science, such as Kingdon’s Multiple Streams framework. Discursive and documentary data were collected from 30 respondents from national and international institutions. Thematic analysis guided the data processing. Results showed that use of peer-reviewed academic research was not explicitly mentioned by respondents, in contrast to other types of knowledge, such as national statistical data, reports on government program evaluations, and reports on studies by international institutions and NGOs, also called technical and financial partners (TFPs). The emergence phase was more informed by grey literature and monitoring data. In this phase, national actors deepened and increased their knowledge (conceptual use) on the importance and challenges of social protection. The role of explicit knowledge in the formulation phase was nuanced. The actors’ thinking was little guided by the question of whether the solutions had the capacity to solve the problem in the Burkina Faso context. Choices were based very little on analysis of strategies (effectiveness, equity, unintended effects) and their applicability (cost, acceptability, feasibility). This way of working was due in part to actors’ limited knowledge on social protection and the lack of government guidance on strategic choices. Strategic use was clearly identified. It involved citing knowledge (reports on studies conducted by TFPs) to justify the utility and feasibility of a PNPS. Instrumental use consisted of drawing from workshop presentations and study reports when writing sections of the PNPS. The consideration of a recommendation based on explicit knowledge was influenced by perceived political gains, i.e., potential social and political consequences.

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PubMed entry

Kouassi Arsene Kra, Fotso Arlette Simo, Rouveau Nicolas, Maheu-Giroux Mathieu, Boily Marie-Claude, Silhol Romain, d’Elbée Marc, Vautier Anthony et Larmarange Joseph (2023) « Estimating HIV self-testing positivity rate and linkage to confirmatory testing and care: a telephone survey in Côte d’Ivoire, Mali and Senegal » (communication orale), présenté à AIDS Impact Conference, Stockholm. https://hal.science/hal-04120705.

Résumé : Background HIV self-testing (HIVST) empowers individuals and allow them to decide when/where to test and with whom to share their result. Between 2019 and 2022, the ATLAS program distributed 400 000 HIVST kits in a mixed epidemic context (Côte d’Ivoire, Mali and Senegal), prioritizing key populations, including female sex workers (FSW) and men who have sex with men (MSM), and encouraged secondary distribution of HIVST to their partners, peers and FSW clients. To preserve its confidential nature, distributed HIVST kits were not systematically tracked. An anonymous phone survey was implemented among its users to estimate test positivity rates and linkage to confirmatory testing and care. Methods We conducted a two-step survey. Between March and June 2021, participants were recruited using dedicated leaflets distributed with HIVST kits, inviting users to call a free phone number anonymously (participation was rewarded USD $3.40) and to complete a sociobehavioural questionnaire (phase 1), including the self-reported number of visible lines on their HIVST kits and their interpretation of results. In September and October 2021, participants who reported a reactive HIVST result in phase 1 and agreed to be re-contacted were recalled to complete a short questionnaire (phase 2) on linkage to confirmatory testing and care. Results During phase 1, 2 615 participants were recruited: 2 346 (89.7%) reported a consistent HIVST result (2 visible lines and result interpreted as reactive; one line and interpreted as non-reactive; or no/one line and interpreted as invalid), 48 (1.8%) reported an inconsistent result and 221 (8.5%) did not know (DK) how to interpret their result or refused to answer. HIVST positivity rates ranged from 2.4% to 4.5%, depending on different assumptions (self-interpreted result or reported number of lines, inclusion or exclusion of DK and refusals). Among men who received an HIVST through activities targeting MSM, positivity rates ranged from 3.2% to 4.8%, and from 2.2% to 4.2% for women reached through activities targeting FSW. Among 126 phase 1 participants eligible for phase 2, 120 agreed to be re-contacted, and 78 fully completed the phase 2 questionnaire. Among the 27 who reported a consistent reactive result in the phase 1 questionnaire, 15 (56%, 95%CI: 36-74%) linked to confirmatory test, including 12 (80%) confirmed HIV-positive, which all started treatment (100%). Linkage was lower among those who reported an inconsistent result in phase 1(37%, 95%CI: 24-52%). Among those confirming reactive self-tests, 53% did it in less than one week following self-testing, and 91% in less than three months. Two-thirds (65%) went to a general public facility and one-third to a facility dedicated to key populations. Conclusion Our HIVST distribution strategy successfully reached people living with HIV in West Africa. Linkage to confirmatory testing remained sub-optimal in these first years of HIVST implementation. However, if confirmed HIV-positive, almost all initiated treatment. The majority of those who linked to confirmatory testing went to a general facility, suggesting that HIVST has the potential to reach more discrete populations. HIVST constitutes a complementary tool to existing screening services.

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Kouassi Kra Djuhe Arsene, Fotso Arlette Simo, Rouveau Nicolas, Maheu-Giroux Mathieu, Boily Marie-Claude, Silhol Romain, d'Elbee Marc, Vautier Anthony et Larmarange Joseph (2023) « HIV self-testing positivity rate and linkage to confirmatory testing and care: a telephone survey in Côte d'Ivoire, Mali and Senegal ». https://hal.science/hal-04127016.

Résumé : HIV self-testing (HIVST) empowers individuals by allowing them to decide when and where to test and with whom to share their results. From 2019 to 2022, the ATLAS program distributed ≈ 400 000 HIVST kits in Côte d Ivoire, Mali, and Senegal. It prioritised key populations, including female sex workers and men who have sex with men, and encouraged secondary distribution of HIVST to their partners, peers and clients. To preserve the confidential nature of HIVST, use of kits and HIVST results were not systematically tracked. Therefore, an anonymous phone survey was conducted to estimate HIVST positivity rates and linkage to confirmatory testing and care. This two-step survey involved an initial recruitment phase from March to June 2021 where participants were encouraged via leaflets to call a free phone number and complete a sociobehavioural questionnaire. This was followed by a second phase in September and October 2021, where participants who reported a reactive HIVST result were re-contacted to complete a further questionnaire. Of the 2 615 participants recruited during the first phase, 89.7% reported consistent results (2 visible lines and result interpreted as reactive; one line and interpreted as non-reactive; or no/one line and interpreted as invalid). HIVST positivity rates varied between 2.4% to 9.1% based on calculation methods (i.e. self-interpreted result or reported number of lines, inclusion or exclusion of don t knows and refusals). The second phase saw 78 out of 126 eligible participants complete the questionnaire. Of the 27 who reported a consistent reactive result in the first phase, 15 (56%, 95%CI: 36 to 74%) underwent confirmatory HIV testing, with 12 (80%) confirmed as HIV-positive, all of whom began antiretroviral treatment. The confirmation rate of HIVST results was fast, with 53% doing so within a week and 91% within three months of self-testing. Two-thirds (65%) went to a general public facility, and one-third to a facility dedicated to key populations. The ATLAS HIVST distribution strategy reached people living with HIV in West Africa. Linkage to confirmatory testing remained sub-optimal in these first years of HIVST implementation. However, if confirmed HIV-positive, almost all initiated treatment. HIVST constitutes a relevant complementary tool to existing screening services.

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Kra Arsène Kouassi, Fosto Arlette Simo, N’guessan Kouassi Noël, Geoffroy Olivier, Younoussa Sidibé, Kabemba Odé Kanku, Gueye Papa Alioune, Ndeye Pauline Dama, Rouveau Nicolas, Boily Marie-Claude, Silhol Romain, d’Elbée Marc, Maheu-Giroux Mathieu, Vautier Anthony, Larmarange Joseph et on behalf of the ATLAS team (2023) « Can HIV self-testing reach first-time testers? A telephone survey among self-test end users in Côte d’Ivoire, Mali, and Senegal », BMC Infectious Diseases, 22 (1) (septembre 25), p. 972. DOI : 10.1186/s12879-023-08626-w. https://doi.org/10.1186/s12879-023-08626-w.

Résumé : Coverage of HIV testing remains sub-optimal in West Africa. Between 2019 and 2022, the ATLAS program distributed ~400 000 oral HIV self-tests (HIVST) in Côte d’Ivoire, Mali, and Senegal, prioritising female sex workers (FSW) and men having sex with men (MSM), and relying on secondary redistribution of HIVST to partners, peers and clients to reach individuals not tested through conventional testing. This study assesses the proportion of first-time testers among HIVST users and the associated factors.

Mots-clés : Côte d’Ivoire, HIV self-testing, Key populations, Mali, Phone‐based survey, Senegal, West Africa.

Kra et al_2023_Can HIV self-testing reach first-time testers.pdf 1.8 Mio (source)

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Kuri R. Grediaga, Gérard Etienne et López M. (2023) « L'enseignement supérieur sous le joug du marché : universités privées au Mexique et inégalités sociales », Karthala. https://hal.science/hal-04143815.

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Ky-Zerbo Odette, Desclaux Alice, Boye Sokhna, Maheu-Giroux Mathieu, Rouveau Nicolas, Vautier Anthony, Camara Cheick Sidi, Kouadio Brou Alexis, Sow Souleymane, Doumenc-Aidara Clémence, Gueye Papa Alioune, Geoffroy Olivier, Kamemba Odé Kanku, Ehui Eboi, Ndour Cheick Tidiane, Keita Abdelaye, Larmarange Joseph et for the ATLAS team (2023) « “I take it and give it to my partners who will give it to their partners”: Secondary distribution of HIV self-tests by key populations in Côte d’Ivoire, Mali, and Senegal », BMC Infectious Diseases, 22 (1) (mai 24), p. 970. DOI : 10.1186/s12879-023-08319-4. https://doi.org/10.1186/s12879-023-08319-4.

Résumé : HIV epidemics in Western and Central Africa (WCA) remain concentrated among key populations, who are often unaware of their status. HIV self-testing (HIVST) and its secondary distribution among key populations, and their partners and relatives, could reduce gaps in diagnosis coverage.

Mots-clés : ATLAS, HIVST, Key population, Secondary distribution, West and Central Africa.

Ky-Zerbo et al_2023_“I take it and give it to my partners who will give it to their partners”.pdf 1.2 Mio (source)

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Lacroix S., Moisseron Jean-Yves et Montclos Marc-Antoine Pérouse de (2023) « Un Islam sans frontières ? : le Sahel, le monde arabe et la Oumma : processus de diffusion des idées islamiques : table-ronde no 1 » (IRD ; MEAE), présenté à Rencontre Sahel-Méditerranée. https://hal.science/hal-04109571.

Résumé : Au-delà des inquiétudes sur la résurgence du djihadisme en Afrique, cette table-ronde questionnera les approches globales du rôle politique de l'Islam, entre l'Afrique subsaharienne et le monde arabe. On y analysera le rapport des acteurs religieux à l'Etat, y compris sur le plan diplomatique à partir d'exemples marocain et saoudien. On montrera également que la circulation des idées islamiques ne se fait pas à sens unique et que les mouvements de protestation islamique (violents ou non) sont très largement issus des dynamiques locales qui les façonnent.

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Lamotte Emmanuel et Larmarange Joseph (2023) « Plugin SPIP "Bibliographie HAL" » (juin 23). https://hal.science/hal-04138641.

Résumé : P

Mots-clés : ⛔ No DOI found.

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Lange Marie-France (2023) « L'impact de la pandémie de Covid-19 sur les systèmes scolaires des pays africains francophones [encadré] », Questions internationales, 115, p. 97. https://hal.science/hal-04144003.

Mots-clés : ⛔ No DOI found.

Snapshot (source)

Larmarange Joseph (2023) PrevR: Estimating Regional Trends of a Prevalence from a DHS and Similar Surveys, version 5.0.0. https://cran.r-project.org/web/packages/prevR/index.html.

Résumé : Spatial estimation of a prevalence surface or a relative risks surface, using data from a Demographic and Health Survey (DHS) or an analog survey, see Larmarange et al. (2011) <doi:10.4000/cybergeo.24606>.

Mots-clés : OfficialStatistics.

Larmarange Joseph (2023) « Recherche interventionnelle dans la lutte contre le VIH : apport des sciences sociales et des sciences de la mise en œuvre pour transformer des innovations efficaces en interventions efficientes » (communication orale), présenté à Afrique Global Health, Dakar. https://hal.science/hal-04133715.

Larmarange Joseph, Bachanas Pamela, Skalland Timothy, Balzer Laura B., Iwuji Collins, Floyd Sian, Mills Lisa A., Pillay Deenan, Havlir Diane, Kamya Moses R., Ayles Helen, Wirth Kathleen, Dabis François, Hayes Richard, Petersen Maya et UT³C consortium (2023) « Population-level viremia predicts HIV incidence at the community level across the Universal Testing and Treatment Trials in eastern and southern Africa », PLOS global public health, 3 (7), p. e0002157. DOI : 10.1371/journal.pgph.0002157.

Résumé : Universal HIV testing and treatment (UTT) strategies aim to optimize population-level benefits of antiretroviral treatment. Between 2012 and 2018, four large community randomized trials were conducted in eastern and southern Africa. While their results were broadly consistent showing decreased population-level viremia reduces HIV incidence, it remains unclear how much HIV incidence can be reduced by increasing suppression among people living with HIV (PLHIV). We conducted a pooled analysis across the four UTT trials. Leveraging data from 105 communities in five countries, we evaluated the linear relationship between i) population-level viremia (prevalence of non-suppression-defined as plasma HIV RNA >500 or >400 copies/mL-among all adults, irrespective of HIV status) and HIV incidence; and ii) prevalence of non-suppression among PLHIV and HIV incidence, using parametric g-computation. HIV prevalence, measured in 257 929 persons, varied from 2 to 41% across the communities; prevalence of non-suppression among PLHIV, measured in 31 377 persons, from 3 to 70%; population-level viremia, derived from HIV prevalence and non-suppression, from < 1% to 25%; and HIV incidence, measured over 345 844 person-years (PY), from 0.03/100PY to 3.46/100PY. Decreases in population-level viremia were strongly associated with decreased HIV incidence in all trials (between 0.45/100PY and 1.88/100PY decline in HIV incidence per 10 percentage points decline in viremia). Decreases in non-suppression among PLHIV were also associated with decreased HIV incidence in all trials (between 0.06/100PY and 0.17/100PY decline in HIV incidence per 10 percentage points decline in non-suppression). Our results support both the utility of population-level viremia as a predictor of incidence, and thus a tool for targeting prevention interventions, and the ability of UTT approaches to reduce HIV incidence by increasing viral suppression. Implementation of universal HIV testing approaches, coupled with interventions to leverage linkage to treatment, adapted to local contexts, can reduce HIV acquisition at population level.

PubMed entry

Larmarange Joseph et Broqua Christophe (2023) « Les hommes bisexuels sont moins exposés au virus de l’immunodéficience humaine que les homosexuels exclusifs en Afrique subsaharienne », Santé Publique, 34 (HS2) (mai 7), p. 123. DOI : 10.3917/spub.hs2.0123. https://hal.science/hal-04136246.

Résumé : Introduction : En Afrique subsaharienne, comme dans le reste du monde, les hommes ayant des rapports sexuels avec des hommes (HSH) sont plus exposés à l’infection par le virus de l’immunodéficience humaine (VIH) que la population générale. Les bisexuels sont souvent perçus comme plus à risque que les homosexuels exclusifs. But de l’étude : Nous proposons une synthèse des connaissances sur l’exposition au VIH des homo-bisexuels à partir d’une revue des enquêtes épidémiologiques réalisées en Afrique subsaharienne depuis 2005. Résultats : Nous avons étudié 355 publications et avons identifié 62 mesures de l’association entre bisexualité et prévalence du VIH et 8 mesures de l’association entre bisexualité et incidence. À l’exception de 4 mesures sur 62, la prévalence du VIH observée parmi les bisexuels était inférieure ou égale à celle des homosexuels exclusifs. En matière d’incidence, toutes les études identifiées sauf une observent une incidence du VIH plus faible ou égale parmi les bisexuels. Du point de vue comportemental, la majorité des études n’ont pas relevé de différence d’utilisation du préservatif. Les bisexuels ont parfois une fréquence de rapports sexuels moindre et systématiquement moins de rapports anaux réceptifs. Ils ont commencé leur vie homosexuelle plus tardivement, ont eu moins de partenaires et sont moins nombreux à connaître leur statut VIH. Conclusions : Les bisexuels sont moins exposés au VIH que les homosexuels exclusifs, notamment en raison de différences comportementales. Il importe que les programmes de prévention et de traitement à destination des HSH prennent en compte les spécificités des bisexuels et conçoivent des offres différenciées.

Larmarange Joseph, Broqua Christophe et Leslie Wendy (2023) « Bisexual men are at less risk of HIV infection than exclusive gay men in sub-Saharan Africa », Sante Publique, 34 (HS2) (septembre 25), p. 123-132. DOI : 10.3917/spub.hs2.0123. https://www.cairn-int.info/journal-sante-publique-2022-HS2-page-123.htm.

Résumé : Introduction : En Afrique subsaharienne, comme dans le reste du monde, les hommes ayant des rapports sexuels avec des hommes (HSH) sont plus exposés à l’infection par le virus de l’immunodéficience humaine (VIH) que la population générale. Les bisexuels sont souvent perçus comme plus à risque que les homosexuels exclusifs. But de l’étude : Nous proposons une synthèse des connaissances sur l’exposition au VIH des homo-bisexuels à partir d’une revue des enquêtes épidémiologiques réalisées en Afrique subsaharienne depuis 2005. Résultats : Nous avons étudié 355 publications et avons identifié 62 mesures de l’association entre bisexualité et prévalence du VIH et 8 mesures de l’association entre bisexualité et incidence. À l’exception de 4 mesures sur 62, la prévalence du VIH observée parmi les bisexuels était inférieure ou égale à celle des homosexuels exclusifs. En matière d’incidence, toutes les études identifiées sauf une observent une incidence du VIH plus faible ou égale parmi les bisexuels. Du point de vue comportemental, la majorité des études n’ont pas relevé de différence d’utilisation du préservatif. Les bisexuels ont parfois une fréquence de rapports sexuels moindre et systématiquement moins de rapports anaux réceptifs. Ils ont commencé leur vie homosexuelle plus tardivement, ont eu moins de partenaires et sont moins nombreux à connaître leur statut VIH. Conclusions : Les bisexuels sont moins exposés au VIH que les homosexuels exclusifs, notamment en raison de différences comportementales. Il importe que les programmes de prévention et de traitement à destination des HSH prennent en compte les spécificités des bisexuels et conçoivent des offres différenciées.

Larmarange et al_2022_Bisexual men are at less risk of HIV infection than exclusive gay men in.pdf 1.8 Mio (source)

Larmarange Joseph et Broqua Christophe (2023) « Orientation sexuelle et identité de genre : quelles catégories d'enquête en Afrique subsaharienne ? », in Minorités de genre et de sexualité : objectivation, catégorisations et pratiques d'enquête, éd. par Wilfried Rault et Mathieu Trachman, Ined Éditions, p. 191-207. (Méthodes et Savoirs). https://hal.science/hal-04194856.

Résumé : À l’inverse de quelques travaux pionniers en sciences humaines et sociales, la question de l’homosexualité masculine est restée inexistante dans les enquêtes quantitatives en Afrique subsaharienne jusqu’au début des années 2000, malgré les épidémies de VIH qui ravageaient le continent. C’est en 2005 qu’est publiée, pour la première fois, une étude quantitative bio-comportementale (Wade et al., 2005) sur une population d’hommes ayant des rapports sexuels avec des hommes (HSH) en Afrique – en l’occurrence au Sénégal. Le principal résultat concernait la prévalence du VIH : sur les 463 hommes interrogés, 22 % étaient infectés par le VIH, et ce dans un pays, le Sénégal, connu pour sa faible prévalence en population générale (moins de 1 %). Mais l’enquête apportait aussi d’autres informations importantes, notamment au sujet de l’orientation sexuelle : 94 % des répondants déclaraient avoir eu des relations sexuelles avec des femmes au moins une fois au cours de leur vie. Cette proportion élevée d’hommes ayant des pratiques bisexuelles est devenue un élément récurrent des enquêtes sur les HSH en Afrique, et l’un des aspects les plus discutés. Depuis le milieu des années 2000, parallèlement à une attention internationale croissante accordée aux HSH dans les pays à ressources limitées et une pression politique des bailleurs internationaux pour la prise en compte des populations dites « clés » dans la riposte aux épidémies de VIH, les enquêtes quantitatives sur les HSH se sont développées exponentiellement en Afrique subsaharienne. À partir des années 2010, une partie d’entre elles aussi exploré l’identité de genre et certaines publications ont concerné plus, spécifiquement, les personnes « transgenres ». Ce chapitre fait le point sur ces dimensions telles qu’elles apparaissent dans la littérature disponible, en examinant les connaissances dont nous disposons sur les différentes populations que recouvre la catégorie HSH. À partir d’une revue de littérature exhaustive, nous recensons les catégories que mettent en évidence les enquêtes quantitatives du point de vue de l’orientation sexuelle (articulant plusieurs dimensions, dont le pôle d’activité sexuelle, l’orientation sexuelle déclarée et l’attirance sexuelle) et de l’identité de genre. L’objectif est de savoir si les dimensions investiguées sont suffisantes pour la compréhension fine, tant des logiques sociales de la sexualité que des comportements et des identités, et de questionner la façon dont est pensée la diversité des profils au sein de la catégorie HSH. Nous faisons l’hypothèse que les catégories utilisées sont importées des pays du Nord et plaquées sur les pays africains au détriment des catégories et représentations locales, en suivant un agenda international lié à l’épidémie de VIH, qui dicte la définition des catégories à investiguer. Après de nombreuses décennies au cours desquelles s’est construite l’image d’un continent exclusivement hétérosexuel, le développement exponentiel des enquêtes épidémiologiques sur les HSH en Afrique ne témoigne-t-il pas lui aussi d’un travers, certes inverse, en dessinant des formes d’orientation sexuelle et d’identité de genre minoritaires de manière réductrice et schématique ?

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Lefort-Rieu Claire, Minfegue Calvin, Kojoué Larissa, Vidal Laurent, Mengue Marie-Thérèse et Atlani-Duault Laëtitia (2023) « Normes et modèles de santé à l’épreuve du local : réceptions et (re)négociations des normes et modèles de lutte contre la pandémie de Covid-19 au Cameroun », Suds, 288, p. 15-46. DOI : 10.4000/suds.950.

Résumé : La pandémie de Covid-19 a entraîné à l’échelle internationale le déploiement d’un ensemble de modèles thérapeutiques, de dispositifs institutionnels et d’arrangements techniques et normatifs. Ceux-ci ont circulé dans divers pays selon une trajectoire allant globalement des Nords vers les Suds. Mais loin d’être des réceptacles passifs, les contextes des Suds ont souvent soumis ces modèles et dispositifs à de fortes tensions. Cet article discute, à partir du cas camerounais, les modalités de réception et les trajectoires de (re)négociations des normes et modèles de lutte contre la pandémie. En s’intéressant tant aux échelles nationale que locale, il retrace la manière dont les modèles globaux de lutte contre le Covid-19 circulent, sont reçus, reformulés, mis en discours et en actes. Mots-clés : Covid-19, santé globale, pandémie, Cameroun, normes, modèles The Covid-19 pandemic led to the international deployment of a range of therapeutic models, institutional mechanisms and technical and normative arrangements. These circulated in various countries, following a trajectory that moved from the North to the South. But far from being passive receptacles, the contexts of the Global South have often subjected these models and devices to strong tensions. Based on the case of Cameroon, this article discusses the ways in which norms and models for combating the pandemic have been received and (re)negotiated. Looking at both national and local levels, it traces the way in which global models for combating Covid-19 circulate, are received, reformulated, and put into discourse and action. Keywords: Covid-19, global health, pandemic, Cameroon, standards, models

Lefort-Rieu Claire et Ngodji Fulbert (2023) « Aide internationale et gouvernances éducatives en situation de pandémie : la Covid-19 au Cameroun », Cahiers d’études africaines, 250 (juin 1), p. 343-362. DOI : 10.4000/etudesafricaines.41816. https://journals.openedition.org/etudesafricaines/41816.

Résumé : La crise sanitaire de la Covid-19 a eu de fortes incidences sur les formes d’action publique. Au Cameroun, les politiques éducatives liées à la pandémie montrent comment des modes de gouvernance hybrides, combinant dispositifs étatiques et issus de l’aide internationale, peuvent se trouver reconfigurés à la faveur d’une crise sanitaire. À rebours des discours sur la dépendance des États africains vis-à-vis de l’international, cet article montre comment des programmes portés par des organisations non étatiques peuvent servir à appuyer la stratégie gouvernementale. En s’intéressant aux stratégies déployées à l’échelle locale, il s’agira aussi d’étudier la façon dont ces modalités de gouvernance éducative peuvent faire l’objet d’une mise à l’épreuve et d’une co-construction dans la durée de la part des acteurs tant nationaux que locaux.

Mots-clés : aide internationale, Cameroun, Covid-19, éducation, éducation en situation d’urgence, pandémie, Unicef.

Lerosier Thomas, Touré Laurence, Diabaté Seydou, Diarra Yacouba et Ridde Valery (2023) « Minimal resilience and insurgent conflict: qualitative analysis of the resilience process in six primary health centres in central Mali », BMJ Global Health, 7 (Suppl 9) (avril), p. e010683. DOI : 10.1136/bmjgh-2022-010683. https://gh.bmj.com/lookup/doi/10.1136/bmjgh-2022-010683.

Résumé : Background In the context of universal health coverage in the Sahel, the study focuses on primary health centres and the difficulties of their implementation in the context of insurgency conflicts in central Mali. Methods This is qualitative research through a multiple case study. We selected six health centres according to a reasoned choice to bring together contrasting situations. We conducted 96 semistructured interviews and consulted secondary quantitative data on attendance. By focusing on community health centres, the conceptual approach focuses on the process of resilience that unfolds in a dual context of chronic health system dysfunctions and armed conflict. Results The resilience strategies deployed by health professionals were relatively basic and uncoordinated. In the end, it was the individuals who showed absorption. However, their room for manoeuvre was limited. In the most isolated health centres, resilience was based on subordinate, poorly trained staff, often from the locality. Degraded working conditions and fear caused a form of resignation among health workers. Conclusion The strategies and resources used showed a form of minimal resilience. This form is unfolding in a context marked by two structuring features. On the one hand, the Malian health system was relatively dysfunctional before the crisis, and on the other hand, the type of conflict was relatively low intensity that allowed health centres to remain open.

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