AIDS
Volume 30, Issue 4, 2016, Pages 645-656

Is hardship during migration a determinant of HIV infection? Results from the ANRS PARCOURS study of sub-Saharan African migrants in France (Article)

Desgrees-Du-Lou A.* , Pannetier J. , Ravalihasy A. , Le Guen M. , Gosselin A. , Panjo H. , Bajos N. , Lydie N. , Lert F. , Dray-Spira R.
  • a IRD, 19 rue Jacob, Paris, 75006, France, CEPED, UMR 196, Université Paris Descartes-IRD, Sorbonne Paris Cités, France
  • b CEPED, UMR 196, Université Paris Descartes-IRD, Sorbonne Paris Cités, France
  • c CEPED, UMR 196, Université Paris Descartes-IRD, Sorbonne Paris Cités, France
  • d CEPED, UMR 196, Université Paris Descartes-IRD, Sorbonne Paris Cités, France, INSERM, CESP-U 1018, Villejuif, France
  • e CEPED, UMR 196, Université Paris Descartes-IRD, Sorbonne Paris Cités, France
  • f INSERM, CESP-U 1018, Villejuif, France
  • g INSERM, CESP-U 1018, Villejuif, France
  • h INPES, Saint-Denis, France
  • i INSERM, CESP-U 1018, Villejuif, France
  • j Sorbonne Universités, UPMC, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France

Abstract

Objectives: In Europe, sub-Saharan African migrants are a key population for HIV infection. We analyse how social hardships during settlement in France shape sexual partnerships and HIV risk. Design: PARCOURS is a life-event survey conducted in 2012-2013 in 74 health-care facilities in the Paris region, among three groups of sub-Saharan migrants: 926 receiving HIV care (296 acquired HIV in France), 779 with chronic hepatitis B, and 763 with neither HIV nor hepatitis B (reference group). Methods: Hardships (lack of residence permit, economic resources and housing) and sexual partnerships were documented for each year since arrival in France. For each sex, reported sexual partnerships were compared by group and their associations with hardships each year analysed with mixed-effects logistic regression models. Results: Hardships were frequent: more than 40% had lived a year or longer without a residence permit, and more than 20% without stable housing. Most of the migrants had nonstable and concurrent partnerships, more frequent among those who acquired HIV in France compared with reference group, as were casual partnerships among men (76.7 vs. 54.2%; P...=...0.004) and women (52.4 vs. 30.5%; P...=...0.02), concurrent partnerships among men (69.9 vs. 45.8%; P...=0.02), and transactional partnerships among women (8.6 vs. 2.3%; P=0.006). Hardship increased risky behaviours: in women, lacking a residence permit increased casual and transactional partnerships [resp. odds ratio (OR)=2.01(1.48-2.72) and OR=6.27(2.25-17.44)]. Same trends were observed for lacking stable housing [OR=3.71(2.75-5.00) and OR=10.58 (4.68-23.93)]. Conclusion: Hardships faced by migrants increase HIV risks. Women, especially during the period without stable housing, appear especially vulnerable. © 2016 Wolters Kluwer Health, Inc.

Author Keywords

HIV acquisition hardship Sexual risk Hepatitis B France African migrants

Index Keywords

concurrent sexual partnership HIV Infections Africa south of the Sahara transmission sexual behavior Human immunodeficiency virus infection France human social isolation sexuality middle aged economic aspect controlled study priority journal housing African Young Adult Humans psychology Adolescent male female Socioeconomic Factors socioeconomics Disease Transmission, Infectious Article high risk behavior Retrospective Studies disease transmission major clinical study adult migration infection risk chronic hepatitis B Paris Transients and Migrants retrospective study
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84957430837&doi=10.1097%2fQAD.0000000000000957&partnerID=40&md5=715faee1ea4612d0a12758c2c12bf0c1
DOI: 10.1097/QAD.0000000000000957
ISSN: 02699370
Cited by: 32
Original Language: English