Spatial dynamics and epidemiology for AIDS in remote areas in French Guiana

ABSTRACT

Although AIDS care is generally improving in French Guiana, disparities among regions and certain key populations remain significant. The purpose of this study was to describe the spatial and clinical characteristics of people living with HIV (PLHIV) in remote areas in comparison to those followed in hospitals on the urban coast of French Guiana. The data presented were obtained from outpatient on primary care centers located in rural regions away from the urban coast. Data were compared with that from medical records of PLHIV treated in French Guiana's urban care. The evolution of the annual rate of discovery of HIV seropositivity indicates a lag in remote areas as compared to urban and coastal areas. In recent years, the epidemic appeared as particularly active in rural areas among Brazilian patients. The median age of PLHIV in remote areas was 43.8 years, the sex ratio (M/F) was 0.93. Nearly 37% of PLHIV were discovered with advanced disease (<200 CD4/mm3). The percentage of virological success after six months of HAART was 80% and 88% in remote areas and urban area, respectively. Efforts must be made to control and halt the spread of the HIV epidemic, as these remote sites represent strategic points.

KEYWORDS:

• HIV
• remote Amazonian area
• border
• migrants’ access health
• key population
• French Guiana

Acknowledgments

We would like to acknowledge caregivers and NGOs on a remote area of French Guiana: !Dsante, DEPAC, DAAC, AIDES and MDM associations for their works to help PLHIV in French Guiana and Brazil and Surinam border.

Mosnier and Nacher are the Principal investigators of the study and were responsible for all phases of the project, including design, data collection, analysis, and interpretation of the public health findings and issues. Epelboin, Guiraud, Huber, Adriouch, Guarmit, Brousse, Terraz, Boser, Gaillet, Djossou, Adenis provided technical expertise and contributed to interpretation of study prospects. Mosnier wrote the manuscript. All co-authors reviewed, contributed and approved the final manuscript.

Disclosure statement

The authors have no conflicts of interest to disclose.