Amsterdam 2015
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| Abstract #2275 - Biomedical prevention | ||||
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Session: 13.4: Biomedical prevention (Oral poster discussion) on Wednesday @ 13.30-14.30 in Poster room 2 Chaired by Catherine Hankins, Sara Paparini Authors: Presenting Author: Ms Rojas Castro Daniela - AIDES, France |
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| Additional Authors: | ||||
| Aim: The ANRS-IPERGAY double-blind randomised trial, initiated in 2012, focuses on the use of Pre-exposure Prophylaxis (PrEP) «on demand» among gay men, bisexuals and transgender people who do not consistently use condoms during anal sex. The involvement of community-based stakeholders in this experimental research to reduce the risks of HIV and STI aims to put in place a global support measure and to develop reflection on health and sexual well-being among participants. | ||||
| Method / Issue: The facilitator who was focal point for about one hundred volunteers was part of the medical research team in each centre. The support model chosen was taken from the community-based practices and know-how which the CBO AIDES has been using for many years now. With a confidential and non-judgemental attitude, the facilitator uses tools such as: 1) a brief counselling session which is systematically offered to the participants and also in the event of a negative test result, 2) more in-depth counselling sessions on demand (in the hospital, or outside), and 3) monthly gatherings for the trial participants. The facilitator remains available and can be reached by phone or text message. This process can partly explain why the participants adhered so strongly to the trial and it also provides an overall approach to health by offering: personalised support (issues relating to recently experienced situations, perception of risk, information on how the trial is run and knowledge on STIs), long-term support (aiming at gradual empowerment) and support which lays the foundations for a multidisciplenary health path focused on clearly identified needs (referral to other health professionals). In addition, the joint work between doctors in this preventative approach to sexual health, supplements the framework which is necessary for an overall approach to health and satisfies participants. Finally, when the placebo arm stopped in October 2014, facilitators intensified the community-based approach to help guide people in understanding the implications of this sensitive and rapid transition. It allowed facilitators to help participants talk about their needs (fear if disinhibition, explaining the first results of the trial, follow-up during the open phase etc.) It nurtured participants’ motivation to go on with their involvement in the trial and responded to their willingness to be fully involved in the implementation of PrEP in France. | ||||
| Results / Comments: The offer provided by community-based facilitators, has proven its usefulness within the framework of the trial and can inspire research protocols for future trials. It can also help initiate a global approach to health. Its scope goes beyond the simple framework of the trial and leads to questions on vulnerable populations’ support needs. The present experiment remains a major innovation. Today, it seems essential to include community-based support in therapeutic trials and in the future to integrate it in all prevention policies. | ||||
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