Personne : Alary, Michel
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Alary
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Michel
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Université Laval. Département de médecine sociale et préventive
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ncf10209331
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Publication Accès libre Acceptability of pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) in Benin : a qualitative study(Taylor & Francis, 2019-05-25) Gning, Ndeye Ndiagna; Guédou, Fernand Aimé; Diabate, Souleymane; Hessou, Septime; Batona, Georges; Béhanzin, Luc; Alary, Michel; Ahouada, Carin; Zannou, Marcel D.In Benin, consistent condom use among men who have sex with men (MSM) is relatively low and providing them with Pre-exposure prophylaxis (PrEP) could be of great relevance. We aimed to describe PrEP knowledge and intention to use it; identify key facilitators and barriers to PrEP; and describe the perceived impact of PrEP on unsafe sexual behavior. MSM, 18 years or older, HIV-negative or of unknown status, were enrolled in five cities of Benin. Intention to use PrEP was assessed through five focus groups (FG). Data were analyzed using manual thematic sorting. Thirty MSM (six per city) participated in the FG. Mean age (standard deviation) was 27.1 (5.0) years. All participants expressed the intention to use PrEP if made available. Facilitators of PrEP use were: availability of medication, safety, absence of constraints as well as freedom to have multiple sex partners and sex with HIV-positive friends. Barriers were: complex procedures for obtaining medication, size and taste of medication, cost of medication, poor PrEP awareness.. Eighteen men admitted that PrEP could lead to decrease in or even abandonment of condom use. In conclusion, MSM showed openness to use PrEP if available, although they recognized that it could lead to risk compensation.Publication Accès libre Structural determinants of health : a qualitative study on female sex workers in Benin(Taylor & Francis Online, 2019-03-20) Dugas, Marylène; Guédou, Fernand Aimé; Bédard, Emmanuelle; Kpatchavi, Codjo Adolphe; Béhanzin, Luc; Alary, MichelThe objective of this paper is to expose those socio-structural contexts revealing the social injustice and human rights violations that sub-Saharan women face every day when forced into sex work by unemployment or sickness. Results of a qualitative study highlighting some key structural determinants of sex work and HIV infection among FSWs will be presented and examined through the lens of the WHO conceptual framework for action on the social determinants of health. The results showed that most FSWs had lacked the necessary financial support at some point in their lives. Also, both the socioeconomic and political context failed to provide proper support to prevent involvement in sex work and the consequent risks of HIV. The cultural and societal values placed on the health and well-being of FSWs in Benin appear to depend on the degree to which sexual violence and adultery are perceived as a collective social concern. This portrait of FSWs calls for both long-term interventions through a structural determinant approach to HIV prevention, targeting all the women who could face such a financial situation well before their entry into sex work, while maintaining short and medium-term interventions on the intermediary determinants.