AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume 31, Issue 7, 2019, Pages 897-907

Social and structural factors and engagement in HIV care of sub-Saharan African migrants diagnosed with HIV in the Paris region (Article)

Vignier N.* , Desgrees Du Lou A. , Pannetier J. , Ravalihasy A. , Gosselin A. , Lert F. , Lydie N. , Bouchaud O. , Dray Spira R. , Chauvin P. , the PARCOURS Study Group
  • a Department of Social Epidemiology, INSERM, Sorbonne Université, Institut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP), Paris, France, Department of Infectious and Tropical Diseases, Groupe hospitalier Sud Ile-de-France, Melun, France
  • b IRD, INSERM, Université Paris Descartes, CEPED, SAGESUD team, Paris, France
  • c IRD, INSERM, Université Paris Descartes, CEPED, SAGESUD team, Paris, France
  • d IRD, INSERM, Université Paris Descartes, CEPED, SAGESUD team, Paris, France
  • e IRD, INSERM, Université Paris Descartes, CEPED, SAGESUD team, Paris, France
  • f INSERM, Center for Research in Epidemiology and Population Health (CESP-U 1018), Villejuif, France
  • g Santé Publique France, French National Agency of Public Health, Saint-Maurice, France
  • h Department of Infectious and Tropical diseases, and Laboratoire Educations et Pratiques de Santé (LEPS EA 3412), Paris 13 University, Assistance Publique-Hôpitaux de Paris (AP-HP), Avicenne Hospital, Bobigny, France
  • i Department of Social Epidemiology, INSERM, Sorbonne Université, Institut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP), Paris, France
  • j Department of Social Epidemiology, INSERM, Sorbonne Université, Institut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP), Paris, France
  • k [Affiliation not available]

Abstract

Migrants from sub-Saharan Africa (SSA) are often diagnosed at an advanced stage of HIV, and many of them have harsh living conditions. We aimed to evaluate the entry into care after HIV diagnosis and examine the related social determinants. The ANRS PARCOURS study is a life-event survey conducted in 2012–2013 in the Paris region among. Time between HIV diagnosis of SSA migrants living diagnosed HIV positive in France and HIV care and the determinants was assessed yearly by using mixed-effects logistic regression models. Among a total of 792 participants, 94.2% engaged in HIV care within the year of HIV diagnosis, 4.3% in the following year and 2.5% beyond the second year after diagnosis. The participants were more likely to engage in HIV care during years when they were effectively covered by health insurance and if the HIV test was carried out at the initiative of the doctor. Immigration for economic reasons or owing to threats in his/her country of origin was associated with delayed engagement in HIV care. Additionally, 4.3% of treated participants discontinued HIV care at least once at the time of the survey and more often if diagnosed at an advanced HIV disease stage and financially dependent. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.

Author Keywords

Health insurance and Evaluation Access Undocumented migrants HIV Healthcare quality African migrants

Index Keywords

hospitalization Africa south of the Sahara Human immunodeficiency virus infection France health insurance immigration human health service social determinants of health priority journal Human immunodeficiency virus infected patient controlled study blood donor asylum seeker migrant male female Article major clinical study adult disease association
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85060948679&doi=10.1080%2f09540121.2019.1576842&partnerID=40&md5=46ae59d831ea5702cf57a70fd066819e
DOI: 10.1080/09540121.2019.1576842
ISSN: 09540121
Original Language: English