SHS (Humanities and Social Sciences) - COVID-19 et VIH. Mobilisation, reconfiguration des soins et affects des acteurs du VIH/sida face au COVID-19 à Maurice et Madagascar : patients, soignants, et acteurs associatifs. COVID-19 and HIV. Mobilization, reconfiguration of care and affects of HIV/AIDS actors in the face of COVID-19 in Mauritius and Madagascar: patients, health care and NGO-workers.

The Indian Ocean has been hit by the Covid-19 epidemic since mid-March 2020. Mauritius and Madagascar, two neighbouring countries, experience contrasting situations from the point of view of their socio-economic development, of their health system and the delivery of healthcare services. However, People Living with HIV (PLHIV) in these two countries face common difficulties in maintaining medical follow-up and antiretroviral treatment, due to the persistent stigmatization of PLHIV. The Covid-19 epidemic has led states to take exceptional measures, in particular the mobilization of health professionals and services to care for people with the disease, and the adoption of measures to limit the spread of the virus (containment, curfew, social distancing ...). Such a context is likely to jeopardise the continuum of care for people suffering from chronic diseases, as well as the organisation of health care and the activities of the teams responsible for their psychological and social support. In this research, we are particularly interested in the actors of HIV / AIDS: PLHIV, healthcare and NGO-workers. Objectives: The general objective of this project is twofold: 1/ It aims to produce knowledge concerning the effects of the Covid-19 health crisis on HIV stakeholders: PLHIV, care institutions and community associations, during and after the Covid-19 crisis, in Mauritius and Madagascar. This includes documenting in particular :  the effects of the Covid-19 health crisis on the care pathways and retention of care for PLHIV, in particular documenting the effects and management of ARV supply disruptions;  the mobilization of health workers and associations in the face of Covid-19: how is their expertise in the field of HIV mobilized in the context of Covid-19? What are the effects of these mobilizations on practices, interactions with users, with the public, between colleagues (HIV associations, social and humanitarian associations, healthcare workers and institutions), and the affects?  the way in which these mobilizations lead to a reconfiguration of care spaces and activities. 2/ The aim of this project is to transfer knowledge to decision-makers, health and association players in order to guide national strategies in terms of maintaining care for people living with HIV in an epidemic context and improving working conditions professionals involved, to support public health policies and respond adequately to needs. Methodology In each country, we will carry out individual semi-structured interviews with: - 30 PLHIV: 15 men and 15 women, of various age groups and social categories, including PLHIV who have had Covid-19 (or think they have had it) - 15 health professionals involved in the care of PLHIV - 20 members of PLHIV community organisation. The study protocol, interview templates, information notices and informed consent forms will be the same in both countries, which will allow for comparative analyses. Expected benefits In order to maximize the usefulness and use of the results by non-for-profit organisations caring for PLHIV, health professionals and decision-makers on HIV in Mauritius and Madagascar, a "knowledge transfer" component will be implemented. Through this approach, we will be able to ensure that the results of the research will help guide national strategies in terms of maintaining care for PLHIV in an epidemic context, support public health policies and respond more adequately to needs. The "knowledge transfer" will be developed within the framework of this project, in order to reduce the gap between the scientific knowledge produced and its use by associations, and decision makers in matters of HIV. The deliverables for this "knowledge transfer" objective will consist of two policy briefs, one for each country, developed with the support of an "knowledge transfer" expert who will accompany the team throughout the project.