title: What is driving the HIV epidemic in French Guiana?
abstract: Thirty years after the first HIV case in French Guiana, the drivers of the epidemic are not clearly known, but the epidemic is usually conceptualized as generalized. Cross-linking results from a study in the general population and a study in the HIV-infected population in Cayenne suggests that in the general population of HIV-positive men, 45% of HIV cases are attributable to having sex with someone they paid. Similarly, for HIV-positive women exchanging sex for presents or money, 10.7% of HIV cases are attributable to transactional sex. A surprising finding was that 16.8% of HIV patients had tried crack cocaine before. On the Maroni river, the female-biased sex ratio suggests the drivers in that remote area may be related to cultural polygyny. These observations have important consequences on communication and prevention strategies.
authors.affiliation: Centre d'Investigation Clinique, Epidémiologie Clinique Antilles Guyane (CIC EC CIE802). mathieu.nacher@ch-cayenne.fr
authors.forename: Mathieu
authors.initials: M
authors.lastname: Nacher
authors.forename: V
authors.initials: V
authors.lastname: Vantilcke
authors.forename: M C
authors.initials: MC
authors.lastname: Parriault
authors.forename: A
authors.initials: A
authors.lastname: Van Melle
authors.forename: M
authors.initials: M
authors.lastname: Hanf
authors.forename: G
authors.initials: G
authors.lastname: Labadie
authors.forename: M
authors.initials: M
authors.lastname: Romeo
authors.forename: L
authors.initials: L
authors.lastname: Adriouch
authors.forename: G
authors.initials: G
authors.lastname: Carles
authors.forename: P
authors.initials: P
authors.lastname: Couppié
mesh_terms: D019970:Cocaine-Related Disorders / Q000453:epidemiology; D016578:Crack Cocaine; D003430:Cross-Sectional Studies; D004196:Disease Outbreaks; D005260:Female; D005616:French Guiana / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008297:Male; D012309:Risk-Taking; D011477:Sex Work
chemical_list: D016578:Crack Cocaine