Habilitations |
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Desgrées du Loû, A. (2009). La démographie, une discipline de santé publique ? Habilitation thesis, Université Paris Descartes, Paris.
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Reports |
Desgrées du Loû, A., Brou, H., Tijou-Traoré, A., Djohan, G., Becquet, R., Leroy, V., et al. (2009). From prenatal HIV testing of the mother to prevention of sexual HIV transmission within the couple. Working Papers du CEPED, (01). Paris: CEPED. Retrieved March 10, 2010, from http://www.sciencedirect.com/science?_ob=GatewayURL&_method=citationSearch&_uoikey=B6VBF-4WKH6GY-2&_origin=SDEMFRHTML&_version=1&md5=446b148a89d491ec5442db566187ece5
Résumé: The first step of prevention of mother-to-child HIV-transmission (PMTCT) programmes is offering HIV couselling and testing to pregnant women. In developing countries where HIV-testing remains rare, it represents a unique opportunity for many women to learn their own HIV status. This prenatal HIV testing is not only the entry point to prevention of mother-to-child HIV transmission, but also an occasion for women to sensitize their male partner to sexual risks. We explore here if these women, HIV-tested as mothers, apply the prevention recommendations they also receive as women. In the Ditrame Plus PMTCT program in Abidjan, Côte d’Ivoire, two cohorts of women (475 HIV-infected women and 400 HIV-negative women) were followed-up two years after the pregnancy when they were offered prenatal HIV testing. In each cohort, we compared the proportion of women who communicated with their regular partner on sexual risks, prior to and after prenatal HIV testing. We analysed sociodemographic factors related to this communication. We measured two potential conjugal outcomes of women HIV testing: the level of condom use at sex resumption after delivery and the risk of union break-up. Prenatal HIV testing increased conjugal communication regarding sexual risks, whatever the woman serostatus. This communication was less frequent for women in polygamous union or not residing with their partner. Around 30% of women systematically used condoms at sex resumption. Among HIV infected ones, conjugal talk on sexual risks was related to improved condom use. After HIV testing, HIV-infected women separated more from their partner than HIV-uninfected women, despite very few negative reactions from the notified partners. In conclusion, offering prenatal HIV counselling and testing is an efficient tool to sensitize women and their partners to HIV prevention. But sexual prevention in a conjugal context remains difficult and need to be specifically adressed.
: CEPED
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Memmi, S., Desgrées du Loû, A., & Orne-Gliemann, J. (2010). Stratégies de prévention du VIH/Sida dans les pays à revenu faible et intermédiaire. Working Papers du CEPED, (07). Paris: CEPED.
Résumé: Au cours des deux dernières décennies, seul un petit nombre de pays est parvenu à réduire la prévalence du VIH grâce à d'importants efforts de prévention. Toutefois, le nombre global de personnes nouvellement infectées par le VIH demeure considérable dans les pays à faible et moyen revenus. L’épidémie du VIH influe de façon spectaculaire sur la structure démographique et la situation économique de ces pays. Il y a un besoin urgent de renforcer les stratégies pour prévenir la transmission du VIH. Malgré certains succès, les stratégies de prévention « traditionnelles » n'ont pas été suffisantes pour limiter de façon significative la propagation du VIH. De nouvelles stratégies de prévention ont été explorées. Si certaines se sont montrées efficaces, d'autres sont encore à l’étude. Cet article passe en revue les stratégies traditionnelles de prévention du VIH et présente les nouvelles stratégies de prévention du VIH proposées depuis le début des années 1990, à partir de la littérature scientifique. Pour plus d’efficacité, les efforts de prévention du VIH doivent être adaptés aux contextes socioculturels et économiques, aux caractéristiques de l'épidémie et aux besoins des populations locales.
On trouvera à la fin du présent document la bibliographie annotée sur les stratégies de prévention du VIH/Sida dans les PVD qui a servi de base à cet article, avec le détail des résumés pour chaque référence.
Mots-Clés: VIH/Sida, stratégie, prévention, transmission, efficacité, acceptabilité
: CEPED
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Wade, A. S., Larmarange, J., Diop, A. K., Diop, O., Gueye, K., Marra, A., et al. (2009). Reduction in risk-taking behaviors among MSM in Senegal between 2004 and 2007 and prevalence of HIV and other STIs.
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Magazine Articles |
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Desgrées du Loû, A. (2008). La santé en Afrique subsaharienne : quels enjeux, quels progrès ? Questions Internationales, (33), 18–20.
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Enel, C., Larmarange, J., Desgrées du Loû, A., & Wade, A. S. (2009). À propos des partenaires féminines des hommes ayant des pratiques homosexuelles au Sénégal. Autrepart, (49), 103–116.
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Larmarange, J., Desgrées du Loû, A., Enel, C., & Wade, A. S. (2009). Homosexualité et bisexualité au Sénégal : une réalité multiforme. Population, .
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Peer-reviewed Publications |
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Brou, H., Djohan, G., Becquet, R., Allou, G., Ekouevi, D. K., Zanou, B., et al. (2008). Sexual prevention of HIV within the couple after prenatal HIV-testing in West Africa. AIDS Care, 20(4), 413–118.
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Brou, H., Viho, I., Djohan, G., Ekouevi, D. K., Zanou, B., Leroy, V., et al. (2009). Pratiques contraceptives et incidence des grossesses chez des femmes après un dépistage VIH à Abidjan, Côte d’Ivoire. revue épidémiologique de santé publique, (57), 77–86.
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Desgrées du Loû, A., & Orne-Gliemann, J. (2008). Couple-centred testing and counselling for HIV serodiscordant heterosexual couples in sub-Saharan Africa. Reprod Health Matters, 16(32), 151–161.
Résumé: In Africa, a large proportion of HIV infections occur within stable relationships, either because of prior infection of one of the partners or because of infidelity. In five African countries at least two-thirds of couples with at least one HIV-positive partner were HIV serodiscordant; in half of them, the woman was the HIV-positive partner. Hence, there is an urgent need to define strategies to prevent HIV transmission within couple relationships. HIV counselling and testing have largely been organised on an individual and sex-specific basis, for pregnant women in programmes for prevention of mother-to-child transmission of HIV and in STI consultations and recently male circumcision for men. A couple-centred approach to HIV counselling and testing would facilitate communication about HIV status and adoption of preventive behaviours within couples. This paper reviews what is known about HIV serodiscordance in heterosexual couples in sub-Saharan Africa and what has been published about couple-centred initiatives for HIV counselling and testing since the early 1990s. Despite positive outcomes, couple-oriented programmes have not been implemented on a large scale. In order to stimulate and strengthen HIV prevention efforts, increased attention is required to promote prevention and testing and counselling for couples in stable relationships.
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Desgrées du Loû, A., Brou, H., Djohan, G., Becquet, R., Ekouevi, D. K., Zanou, B., et al. (2009). Beneficial Effects of Offering Prenatal HIV Counselling and Testing on Developing a HIV Preventive Attitude among Couples. Abidjan, 2002–2005. AIDS Behav, 13(2), 348–355.
Résumé: Prenatal HIV counselling and testing is mainly an entry-point to the prevention of mother-to-child transmission of HIV, but it may also play an important role in triggering the development of spousal communication about HIV and sexual risks and thus the adoption of a preventive attitude. In Abidjan, Côte d’Ivoire, we investigated couple communication on STIs and HIV, male partner HIV-testing and condom use at sex resumption after delivery among three groups of pregnant women who were offered prenatal counselling and HIV testing: HIV-infected women, uninfected women, and women who refused HIV-testing. The proportion of women who discussed STIs with their regular partner greatly increased after prenatal HIV counselling and testing in all three groups, irrespective of the women’s serostatus and even in the case of test refusal. Spousal communication was related to more frequent male partner HIV-testing and condom use. Prenatal HIV counselling and testing proposal appears to be an efficient tool to sensitize women and their partner to safer sexual practices.
Mots-Clés: Prenatal HIV counselling and testing; Couple; HIV/STIs; Africa; Prevention
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Desgrées-du-Loû, A., Brou, H., Tijou Traore, A., Djohan, G., Becquet, R., & Leroy, V. (2009). From prenatal HIV testing of the mother to prevention of sexual HIV transmission within the couple. Social Science & Medicine, 69(6), 892–899.
Résumé: The first step in preventing mother-to-child HIV transmission (PMTCT) programmes is offering HIV counselling and testing to pregnant women. In developing countries where HIV testing remains rare, it represents a unique opportunity for many women to learn their HIV status. This prenatal HIV testing is not only the entry point to prevention of mother-to-child HIV transmission, but also an occasion for women to sensitize their male partner to sexual risks. Here we explore if these women, HIV-tested as mothers, apply the prevention recommendations they also receive as women.
In the Ditrame Plus PMTCT program in Abidjan, Côte d'Ivoire, two cohorts of women (475 HIV-infected women and 400 HIV-negative women) were followed up two years after the pregnancy when they were offered prenatal HIV testing. In each cohort, we compared the proportion of women who communicated with their regular partner on sexual risks, prior to and after prenatal HIV testing. We analysed socio-demographic factors related to this communication. We measured two potential conjugal outcomes of women HIV testing: the level of condom use at sex resumption after delivery and the risk of union break-up.
Prenatal HIV testing increased conjugal communication regarding sexual risks, whatever the woman's serostatus. This communication was less frequent for women in a polygamous union or not residing with their partner. Around 30% of women systematically used condoms at sex resumption. Among HIV infected ones, conjugal talk on sexual risks was related to improved condom use. After HIV testing, more HIV-infected women separated from their partners than HIV-uninfected women, despite very few negative reactions from the notified partners.
In conclusion, offering prenatal HIV counselling and testing is an efficient tool for sensitizing women and their partners to HIV prevention. But sexual prevention in a conjugal context remains difficult and need to be specifically addressed.
Mots-Clés: Prenatal; HIV testing; Sexual transmission; Couple; Communication; Prevention; Mothers; Ivory coast
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Enel, C., Larmarange, J., Desgrées du Loû, A., & Wade, A. S. (2009). Bisexualité au Sénégal : qui sont les partenaires féminines des homosexuels masculins ?49, 103–116.
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Orne-Gliemann, J., & Desgrées du Loû, A. (2008). The involvment of men within prenatal HIV counselling and testing. Facts, constraints and hopes. (Correspondance.). AIDS, 22(18), 2555–2557.
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Tijou Traoré, A., Querre, M., Brou, H., Leroy, V., Desclaux, A., & Desgrées-du-Loû, A. (2009). Couples, PMTCT programs and infant feeding decision-making in Ivory Coast. Social Science & Medicine, 69(6), 830–837.
Résumé: In Sub-Saharan Africa, prevention of HIV pediatric infection due to breastfeeding requires turning to alternatives to prolonged breastfeeding: artificial feeding or exclusive breastfeeding with early weaning. Choosing a preventive option and applying it does not only depend upon the mother but also on the father and more specifically on couple interactions. To date, not enough studies have considered this question. In Abidjan, Ivory Coast, HIV-positive women and their infants were followed over two years in Ditrame Plus, a prevention of mother-to-child transmission (PMTCT) project. Using data from this project and from interviews conducted with couples and women, we analyzed the construction of decisions and practices concerning the application of preventive infant feeding options.
Differences may be found between women and men in discourses regarding their attitudes, which are in part related to their conceptions of motherhood and fatherhood. We found that when men know their wife is HIV positive and are involved in the PMTCT project, they play an active role in applying the advice received. However, women do not always need the support of their spouse to undertake preventative behaviour. The project team also plays an important role in the adoption of such by women and men. The implementation of preventive options is a complex process in which three groups of actors (women, men and the project team) interact. In order to optimize PMTCT programs for couples, it is essential that this dynamic be taken into account.
Mots-Clés: Côte d'Ivoire; Couple; HIV; Breastfeeding; Mother; Father; Infant feeding
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Conference Proceedings |
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Enel, C., Larmarange, J., Desgrées du Loû, A., & Wade, A. S. (2008). Les identités sexuelles des HSH et de leurs partenaires : une grande complexité de situations, au Sénégal. Communication au XVIIIème Congrès International des Sociologues de Langue Française, Istanbul, 7-11 juillet 2008..
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Book Contributions |
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Desgrées du Loû, A. (2009). Le couple à l’épreuve du sida en Afrique sub-saharienne. In Jacques Vallin (Ed.), Du genre et de l'Afrique. Hommage à Thérèse Locoh (pp. 519–529). Paris: INED.
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