Evidence map›Paper›PMID 30909885›Full record

ArticleBMC infectious diseases2019

Missed opportunities of HIV pre-exposure prophylaxis in France: a retrospective analysis in the French DAT'AIDS cohort.

C Lions, O Cabras, L Cotte, T Huleux, A Gagneux-Brugnon, A Makinson, A Cabié, B Bonnet, C Duvivier, L Hocqueloux and 7 more

Open access · goldAbstract readMulticenter Study
In one paragraph

Article in BMC infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.0field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Article
  3. Kaposi sarcoma among people living with HIV in the French DAT'AIDS cohort between 2010 and 2015.Journal of the European Academy of Dermatology and Venereology : JEADV · 2020
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 8 institutions in 2 countries.

C LionsAPHM Hôpital Sainte-Marguerite, Service d'Immuno-hématologie clinique, Aix-Marseille University, Marseille, France.
O CabrasService des maladies infectieuses et tropicales, CHU Bichat, Paris, France.
L CotteService des maladies infectieuses et tropicales, Hospices Civils de Lyon, Lyon, France.
T HuleuxService Universitaire des maladies infectieuses et du voyageur, CH Tourcoing, Tourcoing, France.
A Gagneux-BrugnonService d'Infectiologie, CHU Sainte-Etienne, Groupe Immunité des Muqueuses et Agents Pathogènes, Institut Presage, Université de Lyon, Lyon, France.
A MakinsonInfectious and Tropical Diseases Department, University Hospital Montpellier, Montpellier, France.
A CabiéService des maladies infectieuses et tropicales, CHU de Martinique, INSERM CIC 1425 and Université des Antilles EA 4537, La Martinique, France.
B BonnetMaladies Infectieuses et tropicales, CHU HOTEL DIEU, Nantes, France.
C DuvivierAPHP-Hôpital Necker-Enfants Malades, Service de Maladies Infectieuses et Tropicales, Centre d'infectiologie Necker-Pasteur, F-75015, Paris, France.
L HocquelouxService des maladies infectieuses et tropicales, CHR d'Orléans -La Source, Orléans, France.
E CuaService des maladies infectieuses et tropicales, CHU de Nice, Nice, France.
A CheretService de Médecine Interne, CHU Kremlin Bicêtre, AP-HP, Kremlin Bicêtre, France.
L Hustache-MathieuService des maladies infectieuses et tropicales, CHU Besançon, Besançon, France.
V Obry-RoguetAPHM Hôpital Sainte-Marguerite, Service d'Immuno-hématologie clinique, Aix-Marseille University, Marseille, France.
C JacometService des maladies infectieuses et tropicales, CHU Clermont Ferrand, Clermont Ferrand, France.
I Poizot-MartinAPHM Hôpital Sainte-Marguerite, Service d'Immuno-hématologie clinique, Aix-Marseille University, Marseille, France. isabelle.poizot@ap-hm.fr.ORCID http://orcid.org/0000-0002-5676-5411
DAT’AIDS STUDY GROUP
Aix-Marseille Université · FRInserm · FRCentre Hospitalier Universitaire de Nice · FRHospices Civils de Lyon · FRUniversité Claude Bernard Lyon 1 · FRCentre Hospitalier Universitaire de Besançon · FRDélégation Paris 5 · FRHôpital Necker-Enfants Malades · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHIV 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.

methodsMulticenter 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.

resultsAmong 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%).

conclusionWith 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.

Indexed as

Pre-Exposure ProphylaxisAdultAfrica, WesternAIDS SerodiagnosisAnti-HIV AgentsCohort StudiesDelayed DiagnosisFemaleFranceHIV-1HIV InfectionsHomosexuality, MaleHumansMaleMiddle AgedRetrospective StudiesAnti-HIV AgentsHIVHIV testingMissed opportunitiesPre-exposure prophylaxisPrEP

Identifiers

PMID30909885
PMCPMC6434788
OpenAlexW2941929032

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.