Les hommes ayant des rapports sexuels avec des hommes (HSH) sont les plus touchés par le VIH. La prévention du VIH dans cette population doit aujourd'hui se diversifier grâce à divers outils visant à réduire le risque : traitement des personnes séropositives, traitement préventif chez les personnes séronégatives, et comportements de réduction des risques sexuels. Le dépistage du VIH est alors un enjeu crucial de la prévention.La diversification de l'offre de dépistage en France, notamment grâce au dépistage rapide et communautaire, est un résultat majeur de cette thèse. D'autres problématiques sont également investiguées : le recours au dépistage du VIH chez les HSH vivant au Cameroun et l'intérêt pour la recherche en prévention chez les HSH en France.Tous ces résultats sont confrontés les uns aux autres et sont mis en perspective, en termes de recherches à mener mais aussi en termes de recommandations pour les politiques de prévention à destination des HSH. / Men who have sex with men (MSM) are the most affected by HIV. In this population, HIV prevention must be diversified, using several tools aiming to reduce risks: treatment of HIV positive persons, preventive treatment among HIV negative persons and, sexual risk reduction behaviours. HIV testing thus becomes the cornerstone of HIV prevention.Diversifying HIV testing is one of the most important results of this thesis. Other questions are also addressed: access to HIV testing among MSM living in Cameroon and interest in prevention research among MSM in France.The discussion of all these results leads to several perspectives in terms of researches that should be conducted, but also in terms of recommendations for prevention policies towards MSM.

The American Indians population in Minneapolis, Minnesota has experienced limited health care access and threefold diabetes health disparity. The purpose of this study was to measure the extent to which collaborating marketplace clinics and community-based support groups expanded diabetes care and provided self-management education for this largely urban Indian neighborhood. The marketplace clinics located in nearby CVS, Walmart, Target, and Supervalu stores committed financial support, certified educators, and pharmacy staff for the community-based support group. The study was conducted within the patient activation measure (PAM) analytical framework to assess the participants' acquired knowledge, skills, and confidence for diabetes self-management. A case-control study and 3 years retrospective analysis of secondary data were used to test whether the Minneapolis marketplace clinics and the Phillips community diabetes support group participants (n = 48) had improved diabetes health outcomes relative to the control group (n = 87). The intervention group employed motivational interviewing and PAM in coaching diabetes self-care and behavioral modification. The control group received only basic self-management education. T test and Cohen's d effect size measurements were used to quantify the size of the health outcome variables' difference between the study intervention and comparison groups. The positive effects of marketplace clinics and community-based complementation were shown through improved blood sugar control (A1C), weight loss (BMI), and healthful lifestyle changes. Social change progress could be realized by incorporating PAM with diabetes prevention programs for 33 Urban Indian Health Organizations that are located in large cities throughout the United States.

High prevalence of mental illness in South African and limited Mental Health Care (MHC) resources call for ways to supplement the overburdened system to meet the rehabilitative and supportive needs of service users as stipulated in the MHC Act no. 17 of 2002. Various psychological, social, and financial difficulties plaguing MHC users require holistic treatment intervention to help them cope with their conditions. This study explored the meaning of a Tshwane District community-based support group for MHC out-patients to help illuminate the value the group had for the members. A Social Constructionist epistemology informed the qualitative research approach. Data were collected by conducting semi-structured interviews and employing a collage-making method. The main themes illuminated by thematic analysis suggest that the group provided the members with a sense of belonging, mental and physical mobilisation and stimulation, a source of support, multiple learning experiences, and contributed to personal transformation and growth. / Psychology / M.A. (Social Science (Research Consultation))

High prevalence of mental illness in South African and limited Mental Health Care (MHC) resources call for ways to supplement the overburdened system to meet the rehabilitative and supportive needs of service users as stipulated in the MHC Act no. 17 of 2002. Various psychological, social, and financial difficulties plaguing MHC users require holistic treatment intervention to help them cope with their conditions. This study explored the meaning of a Tshwane District community-based support group for MHC out-patients to help illuminate the value the group had for the members. A Social Constructionist epistemology informed the qualitative research approach. Data were collected by conducting semi-structured interviews and employing a collage-making method. The main themes illuminated by thematic analysis suggest that the group provided the members with a sense of belonging, mental and physical mobilisation and stimulation, a source of support, multiple learning experiences, and contributed to personal transformation and growth. / Psychology / M.A. (S.S. (Research Consultation))