The Lancet Public Health
Volume 3, Issue 1, 2018, Pages e16-e23

Prevalence and circumstances of forced sex and post-migration HIV acquisition in sub-Saharan African migrant women in France: an analysis of the ANRS-PARCOURS retrospective population-based study (Article) (Open Access)

Pannetier J.* , Ravalihasy A. , Lydié N. , Lert F. , Desgrées du Loû A.
  • a CEPED, IRD, Université Paris Descartes, Inserm, équipe SAGESUD, Paris, France
  • b CEPED, IRD, Université Paris Descartes, Inserm, équipe SAGESUD, Paris, France
  • c Santé publique France, Saint-Maurice, Paris, France
  • d CEPED, IRD, Université Paris Descartes, Inserm, équipe SAGESUD, Paris, France
  • e CEPED, IRD, Université Paris Descartes, Inserm, équipe SAGESUD, Paris, France

Abstract

Background Sub-Saharan African migrant women are a key population at risk of HIV infection in Europe. Using data from the ANRS-PARCOURS study, we aimed to assess the prevalence of forced sex after migration and its association with post-migration acquisition of HIV as well as the circumstances of forced sex after migration, including housing and administrative insecurity, among sub-Saharan African migrant women living in the Paris Region, France. Methods The ANRS-PARCOURS study was a retrospective life-event survey done between February, 2012, and May, 2013, in health-care facilities in the Paris region of France. Women were eligible if they were born in sub-Saharan Africa, aged between 18 and 59 years, and had been diagnosed with HIV infection at least 3 months earlier for women receiving HIV care or not diagnosed with HIV. In this analysis, we used ANRS-PARCOURS study data to compare the incidence of forced sex after migration in three groups of sub-Saharan African migrant women: those who acquired HIV after migrating, those who acquired HIV before migrating, and those without HIV. We assessed the associations between forced sex, sexual partnerships, and living conditions after migration with mixed-effects logistic regression and generalised structural equation models. The study is registered with ClinicalTrials.gov, number NCT02566148. Findings We obtained data from 980 eligible individuals who participated in the ANRS-PARCOURS study (407 without HIV and 573 HIV-positive) from 54 randomly selected health-care facilities. We excluded 20 women whose HIV infection could not be dated and eight women with missing data from the analyses, for a total of 405 women in the reference group (without HIV) and 547 women in the HIV group (156 with post-migration HIV acquisition, 391 with pre-migration HIV). Women who acquired HIV after migration experienced forced sex after migration more frequently than women without HIV (24 [15%] vs 18 [4%]; p=0·001). Forced sex after migration was associated with being hosted by family or friends (β=0·95, 95% CI 0·19–1·72) and lack of stable housing (β=1·10, 0·17–2·03). Lack of a residence permit was also associated with forced sex after migration. Interpretation The social hardships faced by sub-Saharan African migrant women after migration, especially a lack of housing or lack of a residence permit, increases their exposure to sexual violence and to HIV infection. Funding The French National Agency for Research on AIDS and Viral Hepatitis, Santé publique France, the national public health agency. © 2018 The Authors. Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license

Author Keywords

[No Keywords available]

Index Keywords

forced sex concurrent sexual partnership HIV Infections Africa south of the Sahara Human immunodeficiency virus infection France human middle aged statistics and numerical data controlled study priority journal housing ethnology Young Adult social status Humans Adolescent female risk factor Risk Factors prevalence Article Retrospective Studies major clinical study adult migration structured interview outcome assessment cohort analysis Paris Transients and Migrants sexual violence retrospective study health care facility disease association population migration Rape

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85035026274&doi=10.1016%2fS2468-2667%2817%2930211-6&partnerID=40&md5=9ab964a161449c93fd18dca994ef7e6b

DOI: 10.1016/S2468-2667(17)30211-6
ISSN: 24682667
Cited by: 13
Original Language: English