Doing research with people, not for people
The HIV epidemic in France is concentrated in three key populations: men who have sex with men (MSM), injecting drug users (IDUs) and sub-Saharan African migrants. These populations are actively mobilized in AIDES, the primary nationwide community-based HIV association in France, and have identified key research questions leading to research projects supported by the French agency for AIDS research (ANRS). The first such project, ANRS-DRAG, demonstrated the feasibility and public health value of task-shifting HIV testing to lay individuals. Results showed that MSM attracted by the community-based testing offer, are less often tested and more often HIV-exposed, when compared with beneficiaries of conventional HIV testing offers. The second project, ANRS-AERLI, evaluated the effectiveness of a community-based intervention which provided training and education on risk reduction of HIV and other infections, in the context of drug injection. This intervention resulted in a reduction of at-risk injection practices, and in reduced local complications related to injection. The third project, ANRS IPERGAY, showed that “on demand” oral PrEP with TDF/FTC resulted in an 86% reduction in HIV-incidence among highly exposed MSM. This same approach was also implemented by Coalition Plus, an alliance between 13 international community-based organizations including AIDES. Coalition Plus’s first large scale community-based study, PARTAGES, documented the factors associated with serostatus disclosure by PLHIV in several contexts where available data are rare. Coalition Plus played an important role in designing an interventional cohort including PrEP delivery among HIV-negative MSM in 4 Western African countries. For all these projects, community-based representatives were associated with the design, implementation and governance. In addition, specific roles were assigned to community stakeholders including outreach, enrolment, and counseling of participants. Community-based representatives were considered principal co-investigators, with equal recognition and responsibilities to their academic counterparts. These projects allowed researchers, doctors, funders and the populations concerned, to learn how to better conduct community-based research, how to overcome difficulties through collaboration, and to understand the value of working with and not for people.
The Seminar is free entry. The request of a certificate and / or declaration of attendance must be ordered on the day of the event at the ISPUP Secretariat.
Bruno Spire is a researcher living with HIV and is a senior scientist in the French National Institute for Medical Research. He is a member of AIDES since 1988, the main HIV non governmental organization in France in which he was the President between 2007 and 2015. Bruno Spire was trained as Medical Doctor in Paris. He obtained his PhD in Virology in 1990 when he was working in the Françoise Barré-Sinoussi team that was involved in HIV discovery. In 1997, he turned his research to Public Health issues, in order to reconcile the objectives of scientists and activists. He has been involved in multidisciplinary studies in order to study adherence, quality of life and sexual behaviours of PLWHAs and key populations. He is leading a research team in INSERM focused on HIV community participatory research.