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Master Thesis

Acceptation du suivi alterné médecin généraliste / médecin spécialiste hospitalier chez les patients sous PrEP (prophylaxie pré-exposition au VIH) : enquête dans 3 centres en Gironde

Abstract : Introduction - The reduction or even disappearance of HIV infection in France and worldwide remains a major public health issue. The means of prevention are increasing, with in particular since 2015 the introduction in France of PrEP or prophylaxis preexposure to HIV. This prevention tool, a treatment targeting HIV, can be renewed by the attending physician (MT), after initiation in a specialized environment (hospital or CeGIDD). We wanted to explore the quality of the relationship of patients taking PrEP with their own treating doctor, and to consider the possibility of alternate monitoring. We therefore wanted to determine the main obstacles and reluctance regarding the application of this alternating monitoring. Material and method - Our multicenter study, carried out from April to July 2019, was based on a paper questionnaire distributed in 3 PrEP consultation centers in Gironde, targeting the population on PrEP and exploring the concept of acceptability of alternating PrEP monitoring with their attending physician, as well as various aspects of their relationship (especially whether or not mention of their sexual orientation). Results - The 142 participants had TM in 90.8% of the cases, and for 79.2% of them, the MT was informed of their sexual orientation. Among the 130 participants with TM, 55.4% would accept alternate PrEP follow-up, including 50.8% with their treating physician, and 4.6% with another general practitioner. Patients who used their TM for a problem related to their sexual health were more favorable to alternating follow-up than the others (79.2% and 56.9% respectively, p <0.01). The main obstacles found were the desire to be followed by specialists in STIs and HIV, the practical aspect of the centers, combining consultations and screenings, and the fact of seeing their TM only too rarely. Conclusion - A majority of patients requesting PrEP seem to be in favor of alternate monitoring, which would satisfy the high demand for PrEP treatment in hospitals and CeGIDD, which has been constantly increasing since its introduction in late 2015.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02484428
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Mathieu Sacal. Acceptation du suivi alterné médecin généraliste / médecin spécialiste hospitalier chez les patients sous PrEP (prophylaxie pré-exposition au VIH) : enquête dans 3 centres en Gironde. Médecine humaine et pathologie. 2019. ⟨dumas-02484428⟩

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