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     <dc:title xml:lang="fr">Barrières d’accès à la prophylaxie préexposition au VIH : point de vue de pharmaciens d’officine et d’associations communautaires dans la région Rennaise</dc:title>
     <dcterms:alternative xml:lang="en">Barriers to accessing HIV pre-exposure prophylaxis: perspectives of community pharmacists and community-based organisations in the Rennes region</dcterms:alternative>
     <dc:subject xml:lang="fr">PrEP</dc:subject><dc:subject xml:lang="fr">TPE</dc:subject><dc:subject xml:lang="fr">VIH</dc:subject><dc:subject xml:lang="fr">santé sexuelle</dc:subject><dc:subject xml:lang="fr">  accès aux soins</dc:subject><dc:subject xml:lang="fr">association communautaires</dc:subject><dc:subject xml:lang="fr">pharmaciens d’officines</dc:subject><dc:subject xml:lang="fr">prévention VIH</dc:subject><dc:subject xml:lang="fr">barrières d’accès</dc:subject><dc:subject xml:lang="fr">perceptions du risque</dc:subject><dc:subject xml:lang="fr">discriminations</dc:subject><dc:subject xml:lang="fr">représentations</dc:subject><dc:subject xml:lang="fr">travailleurs du sexe</dc:subject><dc:subject xml:lang="fr">populations clés</dc:subject><dc:subject xml:lang="fr">enquête qualitative</dc:subject><dc:subject xml:lang="fr">dispositif de prévention</dc:subject><dc:subject xml:lang="fr">HSH</dc:subject><dc:subject xml:lang="fr">services de santé sexuelle</dc:subject><dc:subject xml:lang="fr">professionnels de santé</dc:subject><dc:subject xml:lang="fr">parcours de soins</dc:subject>
     <dc:subject xml:lang="en">PrEP</dc:subject><dc:subject xml:lang="en">PEP</dc:subject><dc:subject xml:lang="en">HIV</dc:subject><dc:subject xml:lang="en">sexual health</dc:subject><dc:subject xml:lang="en">access to healthcare</dc:subject><dc:subject xml:lang="en">community-based organizations</dc:subject><dc:subject xml:lang="en">community pharmacists</dc:subject><dc:subject xml:lang="en">HIV prevention</dc:subject><dc:subject xml:lang="en">barriers to access</dc:subject><dc:subject xml:lang="en">risk perceptions</dc:subject><dc:subject xml:lang="en">discrimination</dc:subject><dc:subject xml:lang="en">social representations</dc:subject><dc:subject xml:lang="en">sex workers, key populations</dc:subject><dc:subject xml:lang="en">qualitative study</dc:subject><dc:subject xml:lang="en">prevention programs</dc:subject><dc:subject xml:lang="en">MSM, sexual health services</dc:subject><dc:subject xml:lang="en">healthcare professionals</dc:subject><dc:subject xml:lang="en">care pathways</dc:subject><tef:sujetRameau><tef:vedetteRameauNomCommun>
						<tef:elementdEntree autoriteSource="Sudoc" autoriteExterne="031700152">Infections à VIH</tef:elementdEntree><tef:subdivision autoriteSource="Sudoc" type="subdivisionDeSujet" autoriteExterne="02724525X">Prévention‎</tef:subdivision>
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						<tef:elementdEntree autoriteSource="Sudoc" autoriteExterne="267973993">Prophylaxie pré-exposition‎</tef:elementdEntree>
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						<tef:elementdEntree autoriteSource="Sudoc" autoriteExterne="027731456">Épidémiologie </tef:elementdEntree>
					</tef:vedetteRameauNomCommun><tef:vedetteRameauNomCommun>
						<tef:elementdEntree autoriteSource="Sudoc" autoriteExterne="028130499">Hygiène sexuelle</tef:elementdEntree>
					</tef:vedetteRameauNomCommun><tef:vedetteRameauNomCommun>
						<tef:elementdEntree autoriteSource="Sudoc" autoriteExterne="027681246">Droit à la santé</tef:elementdEntree>
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						<tef:elementdEntree autoriteSource="Sudoc" autoriteExterne="027338932">Pharmacies d'officine</tef:elementdEntree>
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						<tef:elementdEntree autoriteSource="Sudoc" autoriteExterne="027246639">Pharmaciens </tef:elementdEntree>
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						<tef:elementdEntree autoriteSource="Sudoc" autoriteExterne="027587487">Développement communautaire‎--Associations </tef:elementdEntree>
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     <dcterms:abstract xml:lang="fr">La prophylaxie pré-exposition au VIH (PrEP) a démontré son efficacité pour prévenir les infections et à sa place dans l’offre diversifiée de prévention du VIH. Toutefois, elle est insuffisamment utilisée par les personnes exposées pour entraîner une baisse de l’incidence du VIH au niveau populationnel. L’objectif de la thèse est d’évaluer les barrières et les leviers d’accès aux outils de prévention biomédicaux du VIH, PrEP et traitement post-exposition (TPE). Dans un premier temps, une revue de la littérature scientifique a permis d’identifier les barrières du point de vue des usagers potentiels et des médecins prescripteurs. Dans un second temps, j’ai mené une étude qualitative à Rennes auprès de pharmaciens d’officine et d’acteurs associatifs de santé communautaire pour identifier plus spécifiquement les freins rencontrés par ces professionnels lors de la dispensation et la promotion de la PrEP auprès des usagers, ainsi que les pistes envisagées pour améliorer l’accès à la PrEP et au TPE.</dcterms:abstract>
     <dcterms:abstract xml:lang="en">Pre-exposure prophylaxis for HIV (PrEP) has proven effective in preventing infections and plays an important role within the broader range of HIV prevention strategies. However, it remains underused among people at risk, which limits its impact on reducing HIV incidence at the population level. The aim of this thesis is to assess the barriers and facilitators to accessing biomedical HIV prevention tools, namely PrEP and post-exposure prophylaxis (PEP). Initially, a review of the scientific literature helped identify barriers from the perspectives of both potential users and prescribing physicians. Then, I conducted a qualitative study in Rennes with community pharmacists and public health association workers to better understand the obstacles these professionals face when dispensing and promoting PrEP, as well as the possible ways to improve access to both PrEP and PEP.</dcterms:abstract>
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