Bruno Spire
Biographic Data
| ID | 202197 |
|---|---|
| NAME | Bruno Spire |
| GIVEN NAMES | Bruno |
| FAMILY NAME | Spire |
| SIGNATURE | SPIRE B |
| AFFILIATIONS | Inserm |
| ORCID | 0000-0002-3546-8020 |
| VERIFIED | Yes |
| TOTAL WORKS | 100 |
| TOTAL CITATIONS | 32 |
| AUTHOR COUNT | 100 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2002 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 3 |
A qualitative study of healthcare workers’ living and working conditions in rural and urban areas of Senegal in the context of Universal Health Coverage
BACKGROUND: Healthcare delivery in Senegal is hindered by a limited, unequally distributed healthcare workforce, and by inadequate infrastructure which negatively impacts access to quality care and good health outcomes. Despite efforts to improve healthcare delivery through Universal Health Coverage (UHC), progress remains insufficient. We investigated the living and working conditions of Senegalese healthcare workers (HWs), specifically their re…
Factors Associated with Not Seeking Post-exposure Prophylaxis for HIV Among PrEP-Naive Men Who Have Sex with Men
HIV post-exposure prophylaxis (PEP) uptake is low among men who have sex with men (MSM), even among those aware of it. We examined factors associated with not seeking PEP among MSM in the ANRS-PREVENIR cohort who were PrEP-naive at enrollment, aware of PEP, and reported a potential need for it in the previous 12 months. Among 3,193 participants, 632 (19.8%) met these criteria, and 424 (67.1%) did not seek PEP. The most cited reasons were low perc…
Beyond the Individual
How structural homophobia is spreading HIV-risk sexual behaviours around the world
Although discrimination and stigma are recognised determinants of HIV-risk sexual behaviours in the LGBTI population, related data are scarce. In particular, the 'pathways' between these determinants and HIV-risk sexual behaviours are understudied. The main objective of the present study was to fill this knowledge gap by analysing - in a worldwide sample - the relationships between multiple dimensions of homophobia, general propensity to take ris…
Diversity of Chemsex Experiences among Men Who Have Sex with Men
The sociodynamics of chemsex
This study examined the intricate phenomenon of chemsex among men who have sex with men (MSM) in France, by focusing on the perspectives of different stakeholders, namely people with chemsex experience, clinicians, and community health workers . Employing a sociodynamic approach, lexical analysis was used to identify and interpret key themes in participants’ discourses on chemsex, with a view to revealing its multifaceted nature. Our findings hig…
Trajectories of Chemsex Engagement Across Time Among PrEP-Using Men Who Have Sex with Men
Objectives To identify trajectories of chemsex engagement and their evolution across time among men who have sex with men (MSM) and the associated factors.Methods Among 2518 PrEP-using MSM in the French ANRS- Prévenir cohort, a group-based trajectory model was used to identify trajectories of chemsex engagement. A multivariable model was then used to estimate time-constant factors associated with trajectory membership, and time-varying factors as…
Generational perspectives on PrEP, prevention, and sexual practices in MSM (ANRS-PREVENIR cohort)
This study explored perceptions of sexual norms and practices related to HIV prevention and PrEP use among three generations of men who have sex with men (MSM) in the ANRS-PREVENIR cohort in France in 2022. Using a qualitative approach with three focus groups, we identified key themes: societal transformations, evolving sexual norms, and changing attitudes toward PrEP. Participants (29-63 years) belonged to three distinct generational groups: tho…
Socioeconomic marginalization, social exclusion, and engagement in transactional sex among transgender women living with HIV
Gender affirmation (GAF) is a multidimensional (psychological, social, medical, administrative) social determinant of health for transgender individuals. Transactional sex (TS) is prevalent among transgender women living with HIV (TWLH), who face intersectional discrimination. GAF’s relationship with TS is understudied. ANRS-Trans&HIV(2020–2022) was a French cross-sectional, community-based, life-event study of TWLH. We used clustering analyses t…
The Effect of Sexual and Gender Minority Violence on Depression, Hazardous Drinking, Condom Use, and HIV Acquisition
A Competing Risks Duration Model to Study PrEP Discontinuation Among MSM in France
Barriers and Levers for PrEP Use by Migrant Women Sex Workers
Enhancing sexual health and empowerment among migrant women sex workers
Introduction: Given the high infection rate of sexually transmitted infections (STI) among migrant women sex workers (WSWs), it is necessary to understand how to improve prevention, information and care for this vulnerable population. Community health workers (CHWs), by linking community to health services, are positioned to improve health outcomes in migrant communities. This article aims to describe a pilot innovative intervention performed by …
Men Who Have Sex with Both Men and Women in West Africa
HIV is highly prevalent in men who have sex with men (MSM) in West Africa. Many MSM in the region also have sex with women (MSMW). Accordingly, they are a potential bridge subpopulation for HIV transmission to women. We aimed to evaluate the proportions and characteristics of West African MSMW at high behavioral risk of acquiring HIV from male partners and transmitting it to female partners (HBRMF). The cohort ANRS-12324 CohMSM Study included 630…
High PrEP acceptability and need for tailored implementation in Cambodian key populations
The HIV epidemics in Cambodia is concentrated in key populations (KPs). Pre-exposure prophylaxis (PrEP) has been officially approved in the country since 2019. However, its use may still be controversial after a PrEP clinical trial was interrupted in Cambodia after being deemed unethical in 2004. In this context, it was necessary to evaluate PrEP acceptability and administration preferences of KPs in Cambodia, with a view to increasing roll-out a…
The power for action – now
Strategies to improve PrEP uptake among West African men who have sex with men
Introduction: West African men who have sex with men (MSM) remain at substantial risk of contracting HIV. Pre-exposure prophylaxis (PrEP) can be an effective game-changer in reducing the number of HIV infections in MSM communities. To optimize the roll-out of PrEP, we need to better understand how we can increase its uptake. The objective of this study was to explore the perceptions of West African MSM toward PrEP and their proposed strategies to…
Benefits and challenges of a community-based programme for women living with HIV in Mali
Gundo-So is a community-based programme developed by and for women living with HIV (WLHIV) in Mali through the ARCAD-Santé-PLUS association. It provides support, co-constructed with WLHIV, to develop strategies on whether or not to disclose their status. The aim of the ANRS-12373 research is to evaluate the impact of this programme in the short and medium term. As part of this research, semi-structured interviews were conducted with participants …
Highly precarious general and sexual health conditions of young domestic servants
Most domestic servants (DS) in Mali are very young female migrants living in precarious conditions. We aimed to understand their living and working conditions in relation to their general and sexual health. Seven focus groups (53 participants) were conducted by the DS community-based organization ADDAD. Narratives were thematically analyzed using an inductive method. The dominant emerging theme was DS' strong dependence on their employers. Employ…
Transmission of Sars-CoV-2 during indoor clubbing events
Introduction: The SARS-CoV-2 pandemic led to the implementation of several non-pharmaceutical interventions (NPIs), from closings of bars and restaurants to curfews and lockdowns. Vaccination campaigns started hoping it could efficiently alleviate NPI. The primary objective of the "Indoor Transmission of COVID-19" (ITOC) study is to determine among a fully vaccinated population the relative risk of SARS-CoV-2 transmission during one indoor clubbi…
Impact of Covid-19 Pandemic on Men Who Have Sex With Men That Practice Chemsex in France
Chemsex—the use of drugs in a sexual context—has been associated with more at-risk sexual practices and substance-related complications in men who have sex with men (MSM). To date, no study has focused on the impact of France’s first coronavirus disease 2019 (COVID-19)-related lockdown on the mental health and drug/alcohol use of MSM who practice chemsex. We implemented a web-based survey of 9,488 MSM living in France in June 2020 (after the coun…
Socio-behavioral correlates of pre-exposure prophylaxis use and correct adherence in men who have sex with men in West Africa
Community-based clinic attendance and PE contact outside of scheduled visits were both associated with higher PrEP engagement, but some socially and economically marginalized participants struggled with adherence. As scale-up continues in West Africa, we recommend implementing community-based interventions and providing extra support for vulnerable users to ensure adequate PrEP engagement
Rate and Predictors of Ineffective HIV Protection in African Men Who Have Sex with Men Taking Pre-Exposure Prophylaxis
PrEP in the Context of Other HIV Risk Reduction Strategies Among Men Who Have Sex with Men
Adherence to quarterly HIV prevention services and its impact on HIV incidence in men who have sex with men in West Africa (CohMSM ANRS 12324 – Expertise France)
ClinicalTrials.gov, number NCT02626286 (December 10, 2015)
Adherence to highly active antiretroviral therapies (Haart) in HIV-infected patients
HIV disclosure and unsafe sex among HIV-infected women in Cameroon
Vulnerability, unsafe sex and non-adherence to Haart
Performance of HIV care decentralization from the patient's perspective
OBJECTIVE: (i) To assess HIV care decentralization in Cameroon from the patients' point of view, in terms of health-related quality of life (HRQL) and perceived quality of services; (ii) to identify patient- and hospital-related factors undermining HRQL. METHODS: Perceived quality of services was compared among 1985 HIV-infected patients treated with antiretroviral therapy (ART) for at least 6 months in 27 treatment centres at different levels of…
Adherence to highly active antiretroviral therapies (Haart) in HIV-infected patients
Health-related quality of life and patient–provider relationships in HIV-infected patients during the first three years after starting PI-containing antiretroviral treatment
The aim of this study was to investigate factors associated with better health-related quality of life (HRQL) during the first three years after starting PI-containing antiretroviral treatment. Clinical, social and behavioural data from the APROCO cohort enabled us to analyze simultaneously the association between HRQL and patients' relationships with their health care providers. A self-administered questionnaire collected information about HRQL …
Factors associated with Efavirenz discontinuation in a large community-based sample of patients
Efavirenz (EFV) is a potent antiretroviral drug; its use may be limited, however, by psychiatric symptoms that require its discontinuation. We sought to identify the characteristics that placed patients at an elevated risk of discontinuation. Data for this cross-sectional study came from a self-administered questionnaire distributed by French AIDS community associations; it collected information about sociodemographic characteristics, addictive b…
Oral contraception and unprotected sex with occasional partners of women HIV-infected through injection drug use
Among HIV-infected women, unprotected sex with the main sexual partner is common practice. Conversely, studies about condom use with sexual partners of unknown HIV sero-status are sparsely reported. We aimed to assess the impact of oral contraception on unsafe sexual behaviours with occasional partners in women HIV-infected through injection drug use. The analysis focused on 90 women, enrolled in the French cohort MANIF 2000 and reported having e…
La sexualité des personnes atteintes par le VIH
L'analyse présentée se fonde sur les résultats de l'enquête représentative VESPA (VIH : enquête sur les personnes atteintes) réalisée auprès de 2932 séropositifs en France en 2003. Cette recherche s'insère dans la tradition des travaux menés par les sciences sociales sur l'expérience de la maladie et ses conséquences selon le point de vue des personnes interrogées. Il apparaît que la sexualité des individus contaminés par le VIH — infection sexue…
Management of HIV-related stigma and adherence to Haart
This study investigated patterns of HIV disclosure to significant others (parents, siblings, children, other relatives, friends and colleagues) and describe them in terms of socio-demographic background and other characteristics, including experiences of AIDS-related discrimination. It also assessed the relationship between disclosure patterns and adherence to HAART. We used a cross-sectional survey conducted among a national representative sampl…
Vulnerability, unsafe sex and non-adherence to Haart
Time perspective and quality of life among HIV-infected patients in the context of Haart
We explored associations between time perspective (TP) and quality of life (QOL) among HIV-infected patients. With the French validated version of the Zimbardo Time Perspective Inventory, we evaluated the TP of patients. A self-administered questionnaire gathered information about QOL (WHOQOL-HIV), TP, relationship with medical staff and self-reported side effects of HAART. Six scores of QOL - physical, psychological, social relationship, environ…
Self-reported side-effects of anti-retroviral treatment among IDUs
Adherence to HIV treatment among IDUs and the role of opioid substitution treatment (OST)
Suicide attempts among people living with HIV in France
This study examined the prevalence and characteristics of attempted suicide among a representative sample of French Human Immunodeficiency virus (HIV) infected individuals. In 2003, a face-to-face survey was conducted among people living with HIV/AIDS (PLWHA) selected in a random, stratified sample of French hospital departments. Among solicited individuals, 2,932 agreed to participate and were asked if they had ever AS. Among the respondents, 23…
Disclosure and religion among people living with HIV/Aids in France
The aim of this study was to examine associations between the importance of religion and disclosure of HIV seropositivity within sero-nonconcordant couples. In 2003, a face-to-face survey was conducted among patients selected in a random stratified sample of 102 French hospital departments delivering HIV care. Respondents who reported being in a couple with a non-HIV-positive partner were asked whether they had disclosed their HIV positive status…
Sexual Difficulties in People Living with HIV in France—Results from a Large Representative Sample of Outpatients Attending French Hospitals (ANRS-EN12-Vespa)
HIV disclosure and unsafe sex among HIV-infected women in Cameroon
HIV-positive men who have sex with men
The conceptualisation of male who have sex with male (MSM) to account for male homosexual behaviour has been developed to facilitate the endorsement of prevention message since the advent of HIV infection. Population studies performed to understand and monitor sexual and preventive behaviour usually recruit respondents through gay-friendly channels such as media, sexual venues or festivals, leading to recruitment bias. Few studies question possib…
Better health-related quality of life after switching from a virologically effective regimen to a regimen containing efavirenz or nevirapine
Switching antiretroviral therapy has been shown as safe and effective, but its impact on health-related quality of life (HRQL) was rarely measured. Our objective was to assess changes in HRQL after switching to an non-nucleoside reverse transcriptase inhibitors (NNRTI) containing regimen among NNRTI-naive HIV-infected patients with viral load (VL) <500 copies/mL. In this prospective observational study, the Hospital Anxiety and Depression, Sympto…
Desire for a child among HIV-infected women receiving antiretroviral therapy in Cameroon
The majority of HIV-infected people in sub-Saharan Africa are women, many of reproductive age. Cameroon is severely hit by the AIDS epidemic and has developed a large national program for improving access to antiretroviral treatment (ART). The reproductive intentions of women living with HIV/AIDS (WLHA) who obtain access to ART in this country remain poorly documented. Our study aimed at exploring factors associated with the desire to have a chil…
Stigma, discrimination, and sexual (dis)satisfaction among people living with HIV
The effects of HIV-related stigma and discrimination have been studied in several areas, such as access to testing, quality of care quality, and access to work. Nevertheless, the effects of stigma and discrimination on the sexual life of people living with HIV/AIDS (PLWHA) have not been studied enough. AIDES, a French community-based organization, has developed a biannual survey which assesses several socioeconomical and psychosocial dimensions o…
Harmful alcohol consumption and patterns of substance use in HIV-infected patients receiving antiretrovirals (ANRS-EN12-Vespa Study)
Alcohol abuse affects secondary prevention and disease progression in HIV-infected patients, and adherence and response to treatment in those chronically treated. The objective of this study was to estimate the prevalence of harmful alcohol consumption (HAC) using various indicators and identify which groups of patients may require specific targeted interventions for HAC risk reduction. A cross-sectional survey, based on a random sample represent…
Correlates of poor perceived health among individuals living with HIV and HBV chronic infections
Chronic hepatitis B virus (HBV) infection affects up to 14% of people living with HIV and AIDS (PLWHA) and is associated with a higher risk of non-AIDS death. While great advances have been made in the therapeutic management of co-infection with HIV and HBV, nothing is known about perceived health in people living with HIV and HBV. This study aimed at characterizing individuals with poor perceived overall health among 308 HIV-HBV co-infected indi…
Determinants of benzodiazepine use in a representative population of HIV-infected individuals
HIV infection may result in stressful situations such as disclosure to others and could be a mediator between seropositivity status and psychiatric illness, depression, or anxiety. Several results have shown that anxiolytic use (mainly benzodiazepines [BDZ]) is highly prevalent in HIV-infected individuals, but few studies have highlighted to what extent this use could be associated with HIV disclosure. A national cross-sectional survey representa…
Distributive sharing among HIV–HCV co-infected injecting drug users
This study, based on data from the MANIF 2000 cohort study, investigates the relationship between the lending of injecting equipment, drug use, and experience with HIV care. The sample comprised 224 HIV-HCV co-infected patients who reported having injected drugs in the previous six months and their 538 visits to clinical services. Longitudinal data were collected for medical status, and self-reported risk behaviors. A logistic regression GEE mode…
Proximity to HIV is associated with a high rate of HIV testing among men who have sex with men living in Douala, Cameroon
In low- and middle-income countries, men who have sex with men (MSM) are 19 times more likely to be HIV positive compared with background populations. Criminalisation and social rejection of homosexuality in most sub-Saharan African countries reinforce stigma and exclude MSM from prevention activities, including HIV testing. This paper's purpose is to identify factors associated with never having been HIV tested (NHT), among a sample of Camerooni…
Barebacking and sexual health in the French setting
Barebacking has been, since its emergence in the 1990s, a very controversial issue, and has as many definitions as authors writing about it. In France, sexual risk reduction strategies have been very contentious, and the advent of the bareback phenomenon increased this conflictual situation. This state of affairs has prevented the identification of needs and development of adequate programs for people not using condoms. In December 2008, a peer s…
Acceptability of an “on-demand” pre-exposure HIV prophylaxis trial among men who have sex with men living in France
Although predictors of willingness to take daily, self-administered pre-exposure HIV prophylaxis (PrEP) for men who have sex with men (MSM) have been studied in the context of several PrEP trials internationally, little is known about MSM interested in participating in a trial on the use of PrEP on an "on -demand" basis, i.e., taking a first dose of combined tenofovir/emtricitabine a few hours before possible HIV sexual exposure and a second dose…
Medicine (90 works) · HIV/AIDS Research and Interventions (81 works) · Family medicine (68 works) · HIV, Drug Use, Sexual Risk (67 works) · Psychology (45 works) · Demography (38 works) · Environmental health (38 works) · Psychiatry (38 works) · Internal Medicine (30 works) · Men who have sex with men (29 works)