Publications des membres du Ceped

2023

  • Aubry Régis, Desgrées du Loû Annabel et Guimier Lucie (2023) « Repenser le système de soins sur un fondement éthique : leçons de la crise hospitalière, diagnostic et perspectives », Adsp, 121 (mars), p. 6-9.
    Résumé : Face à la crise du système de soins, le Comité consultatif national d’éthique (CCNE) s’est penché sur les causes du malaise constaté. Il propose que du temps puisse être consacré à la réflexion éthique sur le sens du soin, ainsi que d’améliorer les conditions de travail et de revaloriser la relation entre soignants et personnes soignées.
    Mots-clés : ⛔ No DOI found.
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  • Coulaud Pierre-julien, Salway Travis, Jesson Julie, Bolduc Naseeb, Ferlatte Olivier, Bertrand Karine, Desgrées Du Loû Annabel, Jenkins Emily, Jauffret-Roustide Marie et Knight Rod (2023) « Moderation of the association between COVID-19-related income loss and depression by receipt of financial support: Repeated cross-sectional surveys of young adults in Canada and France (2020–2021) », SSM - Population Health, 21 (mars), p. 101340. DOI : 10.1016/j.ssmph.2023.101340. https://linkinghub.elsevier.com/retrieve/pii/S2352827323000058.

  • Coulibaly Karna, Bousmah Marwân-al-Qays, Ravalihasy Andrainolo, Senne Jean-Noël, Gubert Flore, Gosselin Anne, Desgrées du Loû Annabel et for the MAKASI Study Group (2023) « Bridging the gap: the impact of an empowerment based intervention on the knowledge of biomedical HIV prevention tools among sub-Saharan African precarious immigrants in France. Results from the Makasi Project. », Poster. N°EPC0388 présenté à 12th International AIDS Society Conference (IAS), juillet 23, Brisbane, Australie. https://programme.ias2023.org/Abstract/Abstract/?abstractid=3936.
    Mots-clés : Empowerment intervention, France, Immigrants, Post-exposure prophylaxis, Pre-exposure prophylaxis, Sub-saharan african, Treatment as prevention.
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  • Coulibaly Karna, Bousmah Marwân-al-Qays, Ravalihasy Andrainolo, Taéron Corinne, Mbiribindi Romain, Senne Jean-Noël, Gubert Flore, Gosselin Anne, Desgrées du Loû Annabel et for the MAKASI Study Group (2023) « Bridging the knowledge gap of biomedical HIV prevention tools among sub-saharan african immigrants in France. Results from an empowerment-based intervention », SSM - Population Health, 23 (septembre 1), p. 101468. DOI : 10.1016/j.ssmph.2023.101468. https://www.sciencedirect.com/science/article/pii/S2352827323001337.
    Résumé : Introduction Biomedical HIV prevention tools are available in France to prevent new infections. However, evidence suggests a lack of knowledge of these tools among sub-Saharan African immigrants, who are particularly affected by HIV due to social hardship, an indirect factor of HIV acquisition. We analysed the impact of an empowerment-based intervention on the knowledge of treatment as prevention (TasP), pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) in a population of precarious sub-Saharan African immigrants. Methods Data were collected throughout the MAKASI project. Following an outreach approach, participants were recruited in public places based on their precarious situations and followed for six months (0, 3, 6 months) between 2018 and 2021. Participants were randomized into two groups and received an empowerment intervention sequentially (stepped wedge design). We used random-effects logistic regression models to evaluate the intervention effect on the knowledge of biomedical HIV prevention tools. ClinicalTrials.gov Identifier: NCT04468724. Results The majority of the participants were men (77.5%), and almost half of them had arrived in France within 2 years prior to inclusion (49.3%). At baseline, 56% of participants knew about TasP, 6% knew about PEP and 4% knew about PrEP. Receiving the intervention increased the odds of knowing about PEP (aOR = 2.02 [1.09–3.75]; p < 0.026). Intervention effects were observed for TasP and PrEP only after 6 months. We found significant time effects for PEP (at 3 months, aOR = 4.26 [2.33–7.80]; p < 0.001; at 6 months, aOR = 18.28 [7.39–45.24]; p < 0.001) and PrEP (at 3 months, aOR = 4.02 [2.10–7.72]; p < 0.001; at 6 months, aOR = 28.33 [11.16–71.91]; p < 0.001). Conclusions We showed that the intervention increased the knowledge of biomedical HIV prevention tools. The effect of the intervention was coupled with an important time effect. This suggested that exposure to the intervention together with other sources of information contributed to increased knowledge of biomedical HIV prevention tools among precarious sub-Saharan African immigrants.
    Mots-clés : Empowerment intervention, France, Immigrants, Post-exposure prophylaxis, Pre-exposure prophylaxis, Sub-saharan african, Treatment as prevention.
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  • Coulibaly Karna, Gosselin Anne, Carillon Severine, Taéron Corinne, Mbiribindi Romain, Desgrées du Loû Annabel et Group on behalf of the Makasi study (2023) « Low knowledge of antiretroviral treatments for the prevention of HIV among precarious immigrants from sub-Saharan Africa living in the greater Paris area: Results from the Makasi project », PLOS ONE, 18 (6) (juin 14), p. e0287288. DOI : 10.1371/journal.pone.0287288. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0287288.
    Résumé : Introduction In France, combination prevention tools, particularly antiretroviral treatment for HIV prevention has been available for several years. We described the knowledge of these antiretroviral treatments among immigrants from sub-Saharan Africa, who are particularly affected by HIV, and the factors associated with this knowledge. Methods The data come from the Makasi study, which was conducted between 2019 and 2020 among precarious immigrants from sub-Saharan Africa recruited through a community-based outreach approach in the greater Paris area (n = 601). We described levels of knowledge of HIV treatment effectiveness (HTE), treatment as prevention (TasP), post-exposure prophylaxis (PEP), and pre-exposure prophylaxis (PrEP), by sex with chi2 test. We investigated factors associated with their knowledge with logistic regressions adjusted for sociodemographic characteristics, living conditions and sexual behaviors (p≤0.2). Results Respondents were mostly men (76%), from West Africa (61%), in precarious situation: 69% were unemployed, 74% were undocumented and 46% had no health coverage. Among this population, knowledge of HIV preventive treatments was heterogeneous. While HTE was well known (84%); TasP was known by only half of the respondents (46%), and PEP and PrEP were hardly known: 6% and 5%, respectively. Multivariate regressions models showed that these antiretroviral treatments for the prevention of HIV was better known by people with a higher level of education (PEP: aOR = 3.33 [1.09–10.20], p = 0.03; HTE: aOR = 4.33 [1.87–10.04], p<0.001), those who had a social network in France (TasP: aOR = 1.90, [1.33–2.73], p<0.001), those who had access to the health system and those who were exposed to sexual risks (TasP: aOR = 3.17, [1.03–9.69], p = 0.04; PrEP: aOR = 2.60 [0.72–9.34], p = 0.14). Conclusions There is a need for specific communication on antiretroviral treatment for HIV prevention that targets sub-Saharan immigrants, particularly those who have no access to the health-care system and those who are less educated.
    Mots-clés : Antiretroviral therapy, Antiretrovirals, France, HIV, HIV prevention, Medical risk factors, Post-exposure prophylaxis, Pre-exposure prophylaxis.
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  • Gosselin Anne, Longchamps Cecile, Oulahal Rachid, Derluyn Ilse, Ducarroz Simon, Skovdal Morten, Verelst An, Sturm Gesine, Desgrées du Loû Annabel et Melchior Maria (2023) « Social and mental health risks faced by undocumented migrants during the COVID-19 pandemic: Evidence from three surveys in France ». https://hal-univ-tlse2.archives-ouvertes.fr/hal-03999743.
    Résumé : The often-precarious life circumstances of undocumented migrants are likely to heighten the detrimental impact of the COVID-19 pandemic on their lives. Given the paucity of research exploring how undocumented migrants are affected by the COVID-19 pandemic, we set out to explore the association between being an undocumented migrant and a range of social and mental health measures. Methods Our study draws on three complementary surveys conducted among migrants in France between April 1st and June 7th 2020 (APART TOGETHER, MAKASI, ECHO; n = 716). We tested associations between eight outcome measures, covering health literacy, prevention behaviours, perceptions of government responses, livelihoods and mental health (PHQ-9 score), and the participants' legal status as either undocumented or documented. We modelled the probability of food insecurity increase, job loss, depression, and responses to SARS-COV-2 symptoms with logistic regression models, adjusted for age, gender and legal status. Results Undocumented migrants had a higher probability of experiencing food insecurity increase (aORs=10.40 [3.59, 30.16], and 2.19 [1.39, 3.50] in APART TOGETHER and ECHO), a higher probability of depression (aOR=2.65 [1.01, 6.97] in MAKASI). In all three surveys, undocumented migrants were more likely to lose their job (aORs=6.51 [1.18, 36.00], 8.36 [1.08, 64.70] and 3.96 [1.79, 9.16] in APART TOGETHER, MAKASI and ECHO respectively). Conclusion Our results suggest that the lives of undocumented migrants have been dramatically worsened by the COVID-19 pandemic, exposing and amplifying the inequalities facing this group. There is an urgent need for action to address these inequalities.
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2022



  • Bousmah Marwân-al-Qays, Gosselin Anne, Coulibaly Karna, Ravalihasy Andrainolo et Desgrées du Loû Annabel (2022) « Health empowerment and access to health coverage among immigrants in France: the Makasi intervention », European Journal of Public Health, 32 (Supplement_3) (octobre 1), p. ckac129.457. DOI : 10.1093/eurpub/ckac129.457. https://doi.org/10.1093/eurpub/ckac129.457.
    Résumé : The Makasi community-based research project offered an innovative health-related empowerment intervention to immigrants from sub-Saharan Africa living in precarious situations in the greater Paris area, to reduce their social vulnerability and their exposure to HIV. Our objective is to evaluate the impact of the intervention on access to health coverage in this population.Participants were recruited based on precariousness criteria in public places in Ile-de-France (squares, railway stations, markets, etc.) by mobile teams of social workers and health mediators. Following a stepped-wedge design, participants were randomised into two groups receiving the intervention sequentially (immediately in one group and 3 months later in the other). We evaluated the impact of the Makasi intervention on access to health coverage among 821 individuals observed at 0, 3, and 6 months, between 2018 and 2021. We implemented random-effects panel models - allowing for unobserved heterogeneity - using a Heckman selection approach to correct for attrition. Finally, we used seemingly unrelated regressions (SUR) to examine the extent to which the effect of the intervention was mediated by health-related empowerment.Participants - 77% of which were men - had been living in France for 4 years on average. 44% of them had no health coverage at the time of inclusion. Our results provided evidence for a significant impact of the Makasi intervention on participants’ access to health coverage, with an 18 percentage-point increase in the probability of accessing health coverage 6 months after having received the intervention (p &lt; 0.01). The mediation analysis revealed that this effect operated partly through an empowerment process in terms of knowledge of social and health resources.We showed that a health empowerment intervention provided by social workers and health mediators largely favours access to health rights for immigrants in precarious situations.• A health empowerment intervention improved access to health coverage among immigrants from sub-Saharan Africa living in precarious situations in France.• Improvement in access to health coverage was found to be partly mediated by reinforcement of participants’ health literacy in terms of social and health resources.
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  • Coulibaly Karna, Gosselin Anne, Carillon Séverine, Ravalihasy Andrainolo, Bousmah Marwân-al-Qays, Taéron Corinne, Mbiribindi Romain et Desgrées du Loû Annabel (2022) « Knowledge of HIV prevention biomedical tools among African immigrants in France: the Makasi project », European Journal of Public Health, 32 (Supplement_3) (octobre 1), p. ckac130.173. DOI : 10.1093/eurpub/ckac130.173. https://doi.org/10.1093/eurpub/ckac130.173.
    Résumé : In France, post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP) have been available for several years. However, there is still no evidence on the level of knowledge of these HIV prevention tools among immigrants from sub-Saharan Africa living in precarious situations, a population particularly affected by HIV. The aim of this study is to describe the knowledge of these tools in this population and analyse the factors associated with this knowledge.The data mobilized are from the Makasi interventional research that was conducted between 2018 and 2020 among immigrants from sub-Saharan Africa in precarious situations in the greater Paris area. Using data collected from 601 participants, we described levels of knowledge of HIV treatment effectiveness, treatment as prevention (TasP), post-exposure prophylaxis (PEP), and pre-exposure prophylaxis (PrEP), by sex with a chi2 test. We investigated factors associated with their knowledge with logistic regressions adjusted for sociodemographic characteristics, living conditions and sexual behaviors (p ≤ 0.2).The population surveyed was predominantly men (76%), from West Africa (61%) and in a precarious situation: 69% were unemployed, 74% were undocumented, 46% had no health coverage and 13% were homeless. In this population, knowledge of antiretroviral treatments for HIV prevention was heterogeneous: the effectiveness of HIV treatment was well known (84%), but only half of the respondents (46%) were aware of TasP and very few knew about PEP and PrEP: 6% and 5% respectively. Multivariable-adjusted models showed that these tools was better known by educated people, those who had a social network in France, those who have had access to the health system and those who were exposed to sexual risks.While sub-Saharan African immigrants know the effectiveness of HIV treatment and use certain prevention tools such as HIV testing, they are not aware of PEP and PrEP.PEP and PrEP are two HIV prevention tools that are not well known by sub-Saharan African immigrants.There is an urgent need to disseminate information about these prevention tools to immigrants.
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  • Coulibaly Karna, Gosselin Anne, Carillon Séverine, Ravalihasy Andrainolo, Melchior Maria, Ridde Valéry, Desgrées du Loû Annabel et On Behalf of the MAKASI Study Group (2022) « Is empowerment in sexual health measurable? A scoping review of definitions and measurement indicators », Health Promotion International, 37 (5) (octobre 1), p. daac139. DOI : 10.1093/heapro/daac139. https://doi.org/10.1093/heapro/daac139.
    Résumé : The concept of empowerment in sexual health is widely used in health promotion. This scoping review aims to identify how it is defined and measured. PubMed, Sage Journals, PsycInfo and the Web of Science are data sources. The inclusion criteria for studies were as follows: (1) an analysis of empowerment in sexual health, (2) quantitative evaluation and (3) publication in a peer-reviewed journal in French or English since January 1996. Data were extracted using a summary table of the definitions and indicators of empowerment in sexual health. Of the 2181 articles found, 29 met the inclusion criteria. Only 4 studies on 29 clearly defined empowerment in sexual health. Five dimensions emerged from the indicators used in the 29 studies in relation to sexual empowerment (social participation, participation in decision making, power to act, sexual health knowledge and gender norms), with two types of indicators: indicators unspecific to sexual health, which can be viewed as empowerment basic skills, and indicators specific to sexual health. Most studies concerned women and focused on individual empowerment, with a lack of measure of collective and structural levels of empowerment. Despite great heterogeneity in the definitions and indicators used, a set of core indicators emerged: participation in decision making, sexual negotiation power and sexual communication skills, knowledge and use of contraceptive methods, and HIV and sexually transmitted infections risk perception. This set could be systematically used in each study based on sexual empowerment concept, completed by supplementary indicators considering the specific context.Empowerment is at the heart of health promotion. The concept of empowerment in sexual health has been increasingly used in the field of health promotion, but there is a lack of a consensual definition and great heterogeneity in the indicators used to assess that concept and measure it, according to targeted populations and cultural contexts. In this scoping review on how empowerment in sexual health is defined and measured, five dimensions emerged: social participation, participation in decision making, power to act, sexual health knowledge and gender norms. Through these dimensions, two types of indicators were collected: indicators unspecific to sexual health, which can be viewed as empowerment basic skills, and indicators specific to sexual health. Despite great heterogeneity in the definitions and indicators used, a set of core indicators emerged: participation in decision making, sexual negotiation power and sexual communication skills, knowledge and use of contraceptive methods, and HIV and sexually transmitted infections risk perception. For future research, this set could be systematically used in each study based on sexual empowerment concept, and should be completed by supplementary indicators considering the specific context.
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  • Coulibaly Karna, Gosselin Anne, Carillon Severine, Taéron Corinne, Mbiribindi Romain, Desgrées du Loû Annabel et Equipe Makasi (2022) « « Les traitements antirétroviraux pour la prévention du VIH : des outils de prévention faiblement connus par les immigrés africains en situation de précarité vivant en Île-de-France ». » (communication orale #CO16.5), présenté à AFRAVIH, Marseille.
  • Coulibaly Karna, Gosselin Anne, Ravalihasy Andrainolo, Carillon Severine, Melchior Maria, Ridde Valery et Desgrées du Loû Annabel (2022) « « Définition et mesure des concepts en promotion de la santé : enseignements des études sur l’empowerment en santé sexuelle ». » (communication orale #May17_1030), présenté à Conférence mondiale de Promotion de la Santé, Montréal.
  • Desgrées du Loû Annabel et Eïd Julia (2022) « Médiation en santé à Ikambere : le regard des chercheures », La santé en action, 460, juin, p. 15-16.


  • Eïd Julia et Desgrées du Loû Annabel (2022) « Empowerment-based support program for vulnerable populations living with diabetes, obesity or high blood pressure: a scoping review », BMC Public Health, 22 (1) (novembre 9), p. 2051. DOI : 10.1186/s12889-022-14480-3. https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-14480-3.
    Résumé : Abstract Background The management of chronic diseases such as diabetes, obesity and high blood pressure is a major global health challenge, particularly among the most disadvantaged populations. Beyond the biomedical management of these diseases, comprehensive support that takes into account the peoples’ economic and social situation is fundamental. The objective of this scoping review is to create an inventory and an analysis of the different types of support for these chronic diseases among disadvantaged, immigrant or minority populations to contribute to a better definition and characterization of what should be global support for these vulnerable populations suffering from these diseases. Methods A search of PubMed, PsycINFO, Sages Journals and Web of Science was conducted (between March and May 2021) for articles published between January 2000 and May 2021. Articles were selected after screening titles, abstracts and full texts according to our 5 inclusion criteria. Results We included 16 articles. The diabetes, obesity and high blood pressure support programs described in these articles operate to improve physical and mental health and access to care. The approaches of these interventions are focused on the training and participation of people and the implementation of support actions adapted to the person. The majority of these interventions have a real attachment to the community. Conclusions This review of the literature shows that support for people with chronic diseases such as diabetes, obesity or high blood pressure is based on three pillars: empowerment, peer mediation and holistic and tailor-made support for the individual. The empowerment approach, which considers the capacities and resources of individuals and whose goal is to strengthen their ability to act on their health, appears to be entirely suited to the support of these chronic diseases. This review underlines the importance of moving away from a biomedical approach to a holistic approach truly focused on the person, their capacities and their needs.
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  • Hassambay Roukhaya, Bennis Fatem-Zahra, Rwegera Bernadette et Desgrées du Loû Annabel (2022) « L’approche communautaire en santé : un levier de protection des personnes vulnérables en temps de crise sanitaire ? », Les tribunes de la santé, 72, p. 83-92. DOI : 10.3917/seve1.072.0083.
    Résumé : Depuis ses débuts, la pandémie de Covid-19 exacerbe les inégalités sociales de santé, définies par l’Organisation mondiale de la santé (OMS) comme des différences systémiques sur le plan de la santé qui découlent des déterminants sociaux, exposant ainsi les populations les plus vulnérables à des risques de fragilisation et de paupérisation. Face à cela, le secteur associatif peut être un acteur clé et un pilier de la résilience de ces populations, grâce à son approche communautaire et sociale. Nous proposons dans cet article d’interroger l’apport de cette approche en temps de crise sanitaire en tant que levier d’action efficace pour protéger les populations vulnérables des effets de l’épidémie, à partir d’une étude de cas : l’association Ikambere, située en Île-de-France à Saint-Denis. Après avoir parcouru les bases théoriques et conceptuelles de l’approche communautaire en santé, cet article se propose d’analyser comment l’accompagnement proposé par Ikambere aux femmes vulnérables a favorisé leur montée en connaissances et en résilience pour se relever de la crise. Il conclut en soulignant l’importance de mieux inscrire l’approche communautaire comme un élément à part entière de la stratégie de santé publique pour lutter de façon plus pérenne et efficace contre les inégalités sociales de santé.
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  • Ridde Valery, Carillon Severine, Desgrées du Loû Annabel et Sombié I (2022) « Analyzing implementation of public health interventions : a need for rigor, and the challenges of stakeholder involvement », Revue d'Épidémiologie et de Santé Publique (juillet), p. S0398762022003650. DOI : 10.1016/j.respe.2022.06.001. https://linkinghub.elsevier.com/retrieve/pii/S0398762022003650.
    Résumé : Abstract Objectives This article shows how conceptual models can help to develop and evaluate public health interventions. It also reports on the challenges of getting stakeholders involved. Method The analysis is based on the reflexive approach applied by the authors during their participation in two public health intervention research (PHIR) projects, in France and in Burkina Faso. Results In Paris, PHIR aimed to enable sub-Saharan immigrants to appropriate the existing means of prevention and sexual health care and to strengthen their empowerment in view of preserving their health. Evaluation was carried out using mixed methods. The intervention process theory is based on Ninacs' conceptual model of individual empowerment. The Consolidated Framework For Implementation Research (CFIR) was mobilized a posteriori to analyze the process. PHIR stemmed from collaboration between a research team and two associations. The different stakeholders were involved in the evaluation process, as were, at certain times, persons in highly precarious situations. In Ouagadougou, a community-based dengue vector control intervention was deployed to address an essential but neglected need. As regards evaluation, we opted for a holistic, mixed method approach (effectiveness and process). The contents of the intervention were determined based on tacit knowledge, a community preference survey and solid evidence. The theoretical framework of the intervention consisted in an eco-biological model of vector control. The implementation analysis combined an internal assessment of implementation fidelity with an external CFIR process analysis. All stakeholders were involved in the evaluation process. Discussion Analysis confirmed not only the value of process evaluations in PHIR, but also the primordial importance of a rigorous approach. Stakeholder involvement is a major challenge to be addressed early in the planning of RISPs; with this in mind, effective and ethically sound assessment mechanisms need to be drawn up. Interdisciplinary evaluative approaches should be preferred, and the use of justified, relevant, and flexible frameworks is highly recommended. Conclusion Lessons learned for those wishing to engage in the process evaluation of a public health intervention are hereby presented.
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2021

  • Desgrées du Loû Annabel et Gosselin Anne (2021) « Penser les migrations à la lumière du pouvoir d’agir », De facto, 29 (décembre), p. 7-8.


  • Gosselin Anne, Melchior Maria, Carillon Séverine, Gubert Flore, Ridde Valéry, Kohou Veroska, Zoumenou Iris, Senne Jean-Noël et Desgrées du Loû Annabel (2021) « Deterioration of mental health and insufficient Covid-19 information among disadvantaged immigrants in the greater Paris area », Journal of Psychosomatic Research (avril 30), p. 110504. DOI : 10.1016/j.jpsychores.2021.110504. https://www.sciencedirect.com/science/article/pii/S0022399921001495.
    Résumé : Objectives The aim of this study is to provide information on changes in mental health among disadvantaged immigrants from Sub-Saharan Africa in the Greater Paris area and their level of information about Covid-19. Methods Prior to the Covid-19 epidemic, the Makasi community-based cohort followed 850 immigrants from sub-Saharan Africa in the Greater Paris area. Between the 1st of April and the 7th of June 2020, all participants scheduled for a follow-up survey were systematically included into an additional COVID-19-related wave of data collection (N = 100). We compared participants' type of housing, level of food insecurity, work and mental health (PHQ9) before and during the first COVID-19-related lockdown, using paired-Mc Nemar chi-2 tests. We next described their level of information on Covid-19 and policy measures, broken down by sex. Results Among the 100 participants, 68% had no legal residence permit. Food insecurity was more often reported during lockdown than before (62% vs 52%). 9% of participants had a score indicative of severe depression (PHQ9) before lockdown and 17% afterwards (p = 0.17). Only 51% knew about the possibility of asymptomatic transmission of the COVID-19 virus. Conclusions This study brings original information on a hard-to-reach population group. Our results suggest that the lockdown had a detrimental impact on various economic and mental health aspects among disadvantaged migrants residing in the Greater Paris area.
    Mots-clés : Covid-19, Immigrants, Lockdown/containment, Mental health, Social epidemiology.
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  • Inghels Maxime, Kouassi Arsène Kra, Niangoran Serge, Bekelynck Anne, Carillon Séverine, Sika Lazare, Koné Mariatou, Danel Christine, Desgrées du Loû Annabel, Larmarange Joseph et for the research team ANRS 12323 DOD-CI (2021) « Telephone peer recruitment and interviewing during a respondent-driven sampling (RDS) survey: feasibility and field experience from the first phone-based RDS survey among men who have sex with men in Côte d’Ivoire », BMC Medical Research Methodology, 21 (1) (février 5), p. 25. DOI : 10.1186/s12874-021-01208-x. https://doi.org/10.1186/s12874-021-01208-x.
    Résumé : Many respondent-driven sampling (RDS) methodologies have been employed to investigate hard-to-reach populations; however, these methodologies present some limits. We describe a minimally investigated RDS methodology in which peer recruitment and interviewing are phone-based. The feasibility of the methodology, field experiences, validity of RDS assumptions and characteristics of the sample obtained are discussed.
    Mots-clés : Côte d’Ivoire, Men who have sex with men, Phone-based survey, Respondent-driven sampling.
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  • Melchior M., Desgrées du Loû Annabel, Gosselin Anne, Datta G. D., Carabali M., Merckx J. et Kaufman J. S. (2021) « À quand une prise en compte des disparités ethnoraciales vis-à-vis de l’infection à COVID-19 en France ? », Revue d'Épidémiologie et de Santé Publique (février). DOI : 10.1016/j.respe.2021.01.006. https://www.sciencedirect.com/science/article/pii/S0398762021000456.


  • Ravalihasy Andrainolo, Rude Nathalie, Yazdanpanah Yazdan, Kardas-Sloma Lidia, Desgrées du Loû Annabel, Gosselin Anne et Ridde Valéry (2021) « Development and Validation of an HIV/AIDS Empowerment Scale for Impact Intervention Evaluation. An Example from the MAKASI Intervention », American Journal of Health Education (août 6), p. 1-11. DOI : 10.1080/19325037.2021.1955230. https://www.tandfonline.com/doi/full/10.1080/19325037.2021.1955230.
    Résumé : Background The MAKASI intervention aimed to empower sub-Saharan immigrants living in the Paris metropolitan area regarding sexual health and reduce their HIV exposure. The intervention was developed based upon a theoretical model of individual empowerment. Purpose A scale was developed using sixteen 4-point Likert items adapted from existing tools to measure HIV/AIDS empowerment as an intervention outcome. This study describes the psychometric validation of this scale. Methods Data from 433 participants were used. Construct validity and internal consistency were assessed using factor analysis and Cronbach’s alpha coefficient (α). The scale’s predictive validity for health and social outcomes was assessed using bivariable logistic regressions. Results Five dimensions were identified: i) sexual communication; ii) perceived control at the individual level; iii) knowledge of HIV treatment and social resources; iv) ability to find and understand healthcare information; and v) ability to understand and use disease prevention messages. The internal consistency (α = 0.71) and predictive validity (p < .05) were satisfactory.
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  • Zoumenou Iris, Carillon Séverine, Desgrées du Loû Annabel et Gosselin Anne (2021) « La recherche communautaire comme cercle vertueux d’empowerment : l’exemple du projet Makasi », De facto, 29 (décembre), p. 10-17.

2020



  • Carillon Séverine, Gosselin Anne, Coulibaly Karna, Ridde Valery et Desgrées du Loû Annabel (2020) « Immigrants facing Covid 19 containment in France : An ordinary hardship of disaffiliation », Journal of Migration and Health, 1-2, p. 100032. DOI : 10.1016/j.jmh.2020.100032. https://linkinghub.elsevier.com/retrieve/pii/S2666623520300325.
    Résumé : In order to limit the spread of the SARS-CoV-2 virus, the majority of governments have introduced population containment. Certain population groups, including immigrants in precarious situations, are experiencing the impact of this measure in a brutal manner. This article is based on accounts of containment experiences collected by telephone within the framework of a pre-existing intervention research carried out among immigrants to France from Sub-Saharan Africa who are in a precarious situation. It highlights certain social effects of containment and the logics at work in the precarious situations. This research shows how this a priori unprecedented situation affects individual capacities to act and generates a ‘disaffiliation process’ causing individuals to shift towards ‘social non-existence’, repeating lived experiences and exacerbating pre-existing logics. The ordeal of containment proves to be an ordinary experience for these individuals.
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  • Coulibaly Karna, Gosselin Anne, Ravalihasy Andrainolo, Carillon Séverine, Ridde Valéry, Derche Nicolas, Mbiribindi Romain, Desgrées du Loû Annabel et Makasi Study Group and the (2020) « Atteindre les populations exposées à l’infection VIH en France : apport de l’approche communautaire développant « l’aller-vers » » (poster), présenté à , Faculté de Médecine Sorbonne Universités, Paris, France. https://transversalmag.fr/ressources/documents/1/8d53143-1144-JSS2020_Programme_VF_1.PDF.
  • Desgrées du Loû Annabel (2020) « Les migrants dans l'épidémie : un temps d'épreuves cumulées », De facto, 18, p. 7-8.
    Résumé : Dans l'urgence et le temps suspendu où nous avons tous pris place, ce numéro spécial de De facto s'est imposé à nous pour donner à voir ce que font aux immigrés le confinement et les bouleversements liés à l'épidémie de Covid-19. Dès le début du confinement, Didier Fassin, anthropologue, soulignait ' l'inégalité des vies en temps d'épidémie '. Les personnes en situation de migration font partie de ceux pour qui les temps d'épidémie sont des temps d'épreuves cumulées. L'hébergement groupé dans les centres de rétention et les campements de rue multiplie les risques sanitaires pour les migrants. Michel Agier en dresse un état des lieux et lance un appel au ' désencampement '. Quand on n'a pas de véritable ' chez soi ', le confinement accroît l'angoisse et l'inconfort comme le rapporte Annabel Desgrées du Loû à propos des femmes immigrées vivant en hôtel sociaux et en centres d'hébergement. En temps d'épidémie, l'étranger est trop facilement assimilé à la menace sanitaire. À partir d'une caricature parue en 1883 dans un journal satirique américain, Antonin Durand rappelle cette vieille histoire de la peur du migrant comme vecteur de diffusion des maladies et de la tentation de la xénophobie quand vient la crise. Pourtant, François Héran montre la très faible part que représentent les entrées de migrants dans la mobilité internationale vers la France, ce qui permet de tordre le coup à l'idée reçue que c'est par les migrants qu'arrivent les maladies. Simeng Wang nous propose une vidéo sur les discriminations vécues par les jeunes Chinois en janvier et février, avant que l'épidémie ne devienne une réalité mondiale. Et c'est bien parce que cette crise COVID-19 secoue tout le corps social que le conseil scientifique mis en place pour guider les autorités comprend deux chercheurs en sciences sociales. Parmi eux, Laetitia Atlani-Duault, fellow de l'Institut Migrations, a pris le temps de répondre à quelques questions posées par François Héran.
    Mots-clés : ⛔ No DOI found.
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  • Desgrées du Loû Annabel (2020) « Etre confinée en hotel social ou en hébergement d'urgence », De facto, 18 (avril), p. 30-35. https://www.icmigrations.cnrs.fr/2020/04/07/defacto-018–03/.
    Résumé : La situation actuelle est particulièrement angoissante et inconfortable pour les immigrées précaires, qui vivent en hôtel social ou en centre d’hébergement, souvent à plusieurs par chambre, sans un « lieu à soi » où se réfugier. D’autant plus lorsque l’accueil par les associations n’est plus possible.
    Mots-clés : ⛔ No DOI found.
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  • Desgrées du Loû Annabel, Gosselin Anne et Pannetier Julie (2020) « Vivre avec le VIH quand on est immigré africain en France : quelles spécificités ? L’enquête Parcours », in VIH – Hépatites virales – Santé sexuelle (sous la dir. de Pr Christine Katlama et des Dr Jade Ghosn et Gilles Wandeler), AFRAVIH.


  • Gosselin Anne, Coulibaly Karna, Ravalihasy Andrainolo, Carillon Séverine, Ridde Valéry, Derche Nicolas, Mbiribindi Romain et Desgrees du Loû Annabel (2020) « Finding the missing link: when community-based outreach in public space is key to engage migrants in health prevention programmes in Paris, France », J Epidemiol Community Health (avril 28). DOI : 10.1136/jech-2019-213394. https://jech.bmj.com/content/early/2020/04/29/jech-2019-213394.
    Résumé : Background One of the classic challenges for prevention programmes is reaching the populations they serve. In France, a substantial number of African migrants living with HIV acquired their infection after migrating. The aim of this paper is to better understand the characteristics of the population reached by a community-based outreach approach. Methods We compared sociodemographic characteristics across three different groups in the Paris greater area: (1) the general African migrant population (Population census), (2) the African migrant population using either the regular healthcare system or the system for vulnerable populations (PARCOURS Survey) and (3) the African migrant population reached through a community-based mobile unit (Afrique Avenir). Comparisons were conducted according to sex, age, region of origin, duration of residence and occupational and legal statuses using χ2 tests. Results The migrants reached by the mobile unit were mostly men (69%), 52% of whom were younger than 35 years old. They more often lived in precarious situations than did the general sub-Saharan population (49% vs 35% were unemployed, respectively, p<0.001) and the ones accessing the regular healthcare system. Fewer of them lived in precarious situations than did migrants seeking healthcare consultations for vulnerable populations (42% in the mobile unit vs 54% in healthcare consultations were undocumented, p<0.028). Conclusion Our study shows that the outreach approach can constitute a missing link in the prevention chain among sub-Saharan African migrants, reaching a group that differs from the general migrant population and from the migrant population in healthcare services—not only the newly arrived migrants who live in more precarious situations but also those who have been in France for several years and are still affected by social hardship.
    Mots-clés : community-based organisations, HIV/aids, migrants, outreach, prevention.
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  • Gosselin Anne, Desgrées du Loû Annabel, Casella-Colombeau Sara, Vignier Nicolas et Melchior Maria (2020) « Situational brief : the health of asylum seekers and undocumented migrants in France during COVID-19 », Www.migrationandhealth.org. www.migrationandhealth.org.


  • Inghels Maxime, Carillon Séverine, Desgrées du Loû Annabel et Larmarange Joseph (2020) « Effect of organizational models of provider-initiated testing and counseling (PITC) in health facilities on adult HIV testing coverage in sub-Saharan Africa », AIDS Care, 32 (2) (février 1), p. 163-169. DOI : 10.1080/09540121.2019.1626339. https://doi.org/10.1080/09540121.2019.1626339.
    Résumé : The purpose of this paper is to identify which Provider-Initiated HIV Testing and Counseling (PITC) organizational models are the most efficient to maximize testing coverage. We conducted a systematic literature review to identify published articles that evaluated routine PITC programs implemented in adult health facilities in Sub-Saharan Africa. We considered only articles measuring PITC offer, PITC acceptability and PITC coverage. Adjusted meta-regression models were performed to measure the association between PITC offer, acceptability and coverage with PITC organizational model. A total of 30 articles were included in the meta-analysis. Overall, 85.4% [95%CI: 77.2–93.5] of patients were offered a test, and 87.1% [82.4–91.7] accepted the test resulting in a PITC coverage of 74.3% [66–82.6]. Four types of PITC organizational models were identified: PITC initiated and performed during the consultation (model A), PITC initiated before consultation (model B), PITC referred on-site (model C) and PITC referred off-site (model D). Compared to model A, model B had a similar coverage (aOR: 1.02 [0.82–1.26]). However, coverage was lower for model C (aOR: 0.81 [0.68–0.97]) and model D (aOR: 0.58 [0.44–0.77]). Initiating the testing process before or during medical consultation is recommended for maximizing testing coverage among patients.
    Mots-clés : HIV testing, organizational models, Provider initiated testing and counseling, Sub-Saharan Africa, testing cover.
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  • Inghels Maxime, Kouassi Arsène Kra, Niangoran Serge, Bekelynck Anne, Carillon Séverine, Sika Lazare, Danel Christine, Kone Mariatou, Desgrées du Loû Annabel et Larmarange Joseph (2020) « Cascade of Provider-Initiated Human Immunodeficiency Virus Testing and Counselling at Specific Life Events (Pregnancy, Sexually Transmitted Infections, Marriage) in Côte dʼIvoire: », Sexually Transmitted Diseases, 47 (1) (janvier), p. 54-61. DOI : 10.1097/OLQ.0000000000001084. http://Insights.ovid.com/crossref?an=00007435-202001000-00012.
    Résumé : BACKGROUND: Despite the implementation of Provider Initiated Testing and Counselling (PITC) in 2009, PITC coverage remains low in Cote d'Ivoire. The purpose of this study is to determine whether an human immunodeficiency virus (HIV) test was offered and performed at specific life events where PITC is recommended by national guidelines. METHODS: In 2017, a cross-sectional telephone survey was conducted among a representative sample of 3,867 adults from the general population in Côte d'Ivoire. The occurrences of the following events over the past 5 years were documented: pregnancy (event A) or partner's pregnancy (event B) of the last child, sexually transmitted infection (event C) and marriage (event D). For each of these events, participants were asked (i) if they consulted a health care professional, (ii) if they were offered an HIV test during that consultation and (iii) if they accepted it. RESULTS: Consulting a health care provider was reported by 94.9%, 58.3%, 70.3% and 19.1% of those who reported events A, B, C and D respectively. In case of medical consultations following events A, B, C and D, respectively 70.1%, 33.1%, 28.1%, and 78.8% of individuals were offered an HIV test. The testing acceptance was high regardless of the event. Overall, testing coverage was 63.7%, 16.9%, 13.4% and 14.5% for events A, B, C and D respectively. CONCLUSIONS: Increasing HIV testing coverage in Côte d'Ivoire requires (i) facilitating attendance to health services in case of sexually transmitted infections, marriage and pregnancy-for men-and (ii) strengthening routine testing offer on these occasions.
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  • Inghels Maxime, Kouassi Arsène Kra, Niangoran Serge, Bekelynck Anne, Carillon Séverine, Sika Lazare, Danel Christine, Koné Mariatou, Desgrées du Loû Annabel, Larmarange Joseph et ANRS 12323 DOD-CI Study Group (2020) « Pratiques et facteurs associés au dépistage récent du VIH en population générale, Côte d’Ivoire. Résultats de l’étude ANRS 12323 DOD-CI », Bulletin De La Societe De Pathologie Exotique (1990), 113 (5) (décembre 28), p. 268-277. DOI : 10.3166/bspe-2021-0154. https://bspe.revuesonline.com/article.jsp?articleId=42002.
    Résumé : With 2.9% of HIV prevalence in the general population, Côte d'Ivoire is one of the countries most affected by the HIV epidemic in West Africa. In this country, only 63% of people infected with HIV are aware of their status. A cross-sectional phone survey was conducted with a representative sample of 3,867 individuals to describe the practices and factors associated with a recent HIV testing (≤ 1 year) in Côte d'Ivoire. Data relative to the last done HIV test as well as the socio-demographic characteristics, sexual behavior, access to information, perceptions, capacities and autonomy as well as social and geographical environment of the participants were collected. Logistical regression models were used to identify the associated factors with a recent HIV test (≤ 1 year). Lack of information is one of the main barriers to HIV testing (only 60% of individuals know a place to get tested). For men, despite the fact that HIV testing is free of charge, poor economic conditions seem to be a barrier to testing. The social environment, including peer influence, also appears to have an effect on testing among men. For women, testing is associated with their perceptions of HIV exposure. There is a need to rethink the current HIV testing communication in Côte d'Ivoire and to identify economic or social incentives to remove access barriers to HIV testing.
    Mots-clés : Africa, Western, Afrique subsaharienne, Cote d'Ivoire, Côte d’Ivoire, Cross-Sectional Studies, Dépistage, Enquête téléphonique, Female, HIV Infections, HIV Testing, Humans, Male, Population générale, Sexual Behavior, VIH.
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  • Inghels Maxime, Kouassi Arsène Kra, Niangoran Serge, Bekelynck Anne, Carillon Séverine, Sika Lazare, Danel Christine, Kone Mariatou, Desgrees du Lou Annabel, Larmarange Joseph et for the ANRS 12323 DOD-CI Study Group (2020) « Practices and Obstacles to Provider-Initiated HIV Testing and Counseling (PITC) Among Healthcare Providers in Côte d’Ivoire », AIDS and Behavior (mai 24). DOI : 10.1007/s10461-020-02923-0. https://doi.org/10.1007/s10461-020-02923-0.
    Résumé : Practices of Provider-Initiated HIV Testing and Counseling (PITC) remains suboptimal in Côte d’Ivoire. The aim of this survey was to identify the practices and obstacles to PITC among healthcare professionals in Côte d'Ivoire. A nationally representative cross-sectional survey was conducted in 2018 by telephone among three separate samples of midwives, nurses and physicians practicing in Côte d'Ivoire. The number of HIV tests proposed during consultation in the month preceding the survey was collected for each professional. Factors associated with the number of proposed tests were identified through ordinal logistic regression models. A total of 298 midwives, 308 nurses and 289 physicians were interviewed. Midwives proposed the test more frequently, followed by nurses and physicians. Among midwives, a higher number of proposed tests was associated with the perception that HIV testing does not require specific consent compared to other diseases (aOR 4.00 [95% CI 1.37–14.29]). Among nurses, having received HIV training and the presence of community HIV counselors were associated with a higher number of proposed tests (aOR 2.01 [1.31–3.09] and aOR 1.75 [1.14–2.70], respectively). For physicians, the presence of a voluntary testing center was associated with a higher number of proposed tests (aOR 1.69 [1.01–2.86]). PITC practices and barriers differed across professions. Beyond improving environmental opportunities such as dedicated staff or services, strengthening the motivations and capabilities of healthcare professionals to propose testing could improve PITC coverage.
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  • Inghels Maxime, Kouassi Arsène Kra, Niangoran Serge, Bekelynck Anne, Carillon Séverine, Sika Lazare, Koné Mariatou, Danel Christine, Desgrées du Loû Annabel et Larmarange Joseph (2020) « Perceptions, préférences et recours aux offres communautaires de dépistage du VIH chez les hommes ayant des relations sexuelles avec d’autres hommes (HSH) en Côte d’Ivoire » (communication orale (session SPD1), présenté à AFRAVIH 2020, Dakar. http://www.afravih2020.org/.
    Résumé : Objectifs Depuis la fin des années 2000, se sont développées des offres de dépistage dédiées à destination des HSH. Portées par des ONG communautaires et favorisées par la formation de pairs éducateurs à la réalisation de tests rapides, ce dépistage communautaire serait plus adapté pour atteindre cette population. Mais qu’en est-il du point de vue des intéressés eux-mêmes ? Matériels et Méthodes Une enquête par téléphone de type Respondent driven sampling (RDS) auprès de 518 HSH a été réalisée en 2018 en Côte d’Ivoire. Le questionnaire portait, entre autres, sur la connaissance, la pratique, la satisfaction et les préférences concernant les offres de dépistage dédiées aux HSH. Résultats Seule la moitié des enquêtés (47 %) ont déclaré connaître un lieu de dépistage dédié aux HSH. Parmi ceux-ci, 79 % en avaient déjà fréquenté un. Ces derniers ont rapporté avoir été bien accueillis, s’être sentis en confiance, que la confidentialité avait été respectée et 95 % ont déclaré qu’ils y retourneraient. En termes de préférences, 37 % des enquêtés ont déclaré préférer les lieux de dépistage indifférenciés (c.-à-d. accueillant tout type de patient), 34 % les lieux communautaires et 29 % sans préférence. Ceux préférant le dépistage communautaire mentionnaient une meilleure écoute et s’y sentir plus en confiance, notamment du fait de la présence d’autres HSH. À l’inverse, ceux préférant une offre généraliste mentionnaient le manque de discrétion et d’anonymat des offres communautaires et vouloir éviter le regard des autres. Les hommes les plus éloignés du « milieu HSH », se définissant comme bisexuels/hétérosexuels, attirés principalement par des femmes, ne connaissant pas une association HSH ou n’ayant pas dévoilé leur homosexualité ont plus tendance à préférer un lieu généraliste. Conclusion Si le dépistage communautaire est bien adapté aux HSH qui y ont recours, le maintien d’une offre de dépistage indifférenciée reste essentiel.
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  • Inghels Maxime, Kouassi Arsène Kra, Niangoran Serge, Bekelynck Anne, Carillon Séverine, Sika Lazare, Koné Mariatou, Danel Christine, Desgrées du Loû Annabel et Larmarange Joseph (2020) « Perceptions, preferences and access to community-based HIV testing services among Men who have Sex with Men (MSM) in Côte d'Ivoire » (communication orale (présentation orale de poster), présenté à INTEREST 2020, online. http://interestworkshop.org/.
    Résumé : Background: Dedicated HIV testing settings have been developed for Men who have Sex with Men (MSM) since the end of the 2000s. These facilities are supported by community-based NGOs and promoted by peer educators, who are trained in the use of rapid HIV tests. As such, this community-based HIV-testing should be adapted to reach the MSM populations. However, little is known about the direct MSM’ point of view regarding such community-based services. Materials and methods: A respondent-driven sampling telephone survey of 518 MSM was conducted in 2018 in Côte d'Ivoire. The questionnaire examined knowledge, practice, satisfaction, and preferences regarding MSM-community-based HIV testing services. Results: Only half of the respondents (47%) reported knowing a community-based HIV testing site dedicated to MSM. Of these, 79% had already attended one. They reported that they were welcomed, that they felt confident, that confidentiality was respected, and 95% said they would return to one of these sites. In terms of preferences, 37% of respondents said they preferred undifferentiated HIV testing sites (i.e., “all patients” or “general population” HIV testing sites), 34% preferred community-based sites, and 29% had no preference. Those who preferred community-based HIV testing reported better listening and feeling more confident, particularly because of the presence of other MSM. Conversely, those preferring undifferentiated HIV testing sites mentioned the lack of discretion and anonymity of community-based sites and wanting to avoid the gaze of others. They feared to be recognized by other patients in a context where they want to keep secret their sexual preferences. Men who were furthest away from the MSM community, defining themselves as bisexual/heterosexual, attracted primarily to women, not knowing a dedicated MSM NGO, or not having disclosed their homo/bisexuality to one member of their family were more likely to prefer undifferentiated HIV testing sites. Conclusion: Community-based HIV testing is well suited for MSM who identify as homosexual and those close to the MSM community while maintaining undifferentiated HIV testing is essential for others. Both types of activities need to be maintained and developed. It is also crucial that healthcare professionals in undifferentiated HIV testing sites are properly trained in non-judgemental reception of people with diverse sexual practices and identities.
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  • Melchior Maria, Desgrées Du Loû Annabel, Gosselin Anne, Datta Geetanjali D., Carabali Mabel, Merckx Joanna et Kaufman Jay S. (2020) « Migrant status, ethnicity and COVID-19: More accurate European data are greatly needed », Clinical Microbiology and Infection (octobre 22). DOI : 10.1016/j.cmi.2020.10.014. https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(20)30645-5/abstract.
    Résumé : In past months, systematically higher levels of severe COVID-19 illness and death among individuals belonging to migrant or ethnic minority groups have been reported in several countries, including the US, the UK, Sweden, Brazil, Spain, and South Africa. In particular, racialized populations tend to have less access to testing, higher rates of severe disease, higher mortality rates, and worse sequalae when they survive the infection (1-5). The interacting social, behavioral and biological pathways underlying these disparities are doubtlessly complex, but the hierarchy of social advantage in racialized societies drives health status, exposure, housing, employment and access to healthcare, and undoubtedly plays the dominant role (6).
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  • Mouté Charles, Desgrées du Loû Annabel, Beninguisse Gervais et DeBeaudrap Pierre (2020) « Impact of disability on the transitions to adulthood of men and women in Cameroon », Alter, 14 (1) (février), p. 27-39. DOI : 10.1016/j.alter.2019.09.007. https://linkinghub.elsevier.com/retrieve/pii/S1875067219301440.
    Résumé : The transition to adulthood is a critical stage in human development because it shapes the future lives of many young people. Little is known about how disability affects this transition. Most of the available evidence comes from high-resource settings, where the situation differs greatly from that of resource-limited countries. Using the data from the HandiVIH ANRS 12302 study, we aimed to examine the effect of disability on the social markers of the transition to adulthood in an African context with regard to gender and the nature and severity of the limitations. Our results show that men and women with disabilities experience significant delays in completing the different transitions to adulthood and, consequently, live in more precarious situations at the beginning of adulthood. We also found complex variations in the effects of disability with regard to disability characteristics and gender. These results call for gender- and disability-sensitive transitional programmes to achieve the goal of equal opportunity as envisioned in the sustainable development goals.
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  • Niangoran Serge, Inghels Maxime, Kouassi Arsène Kra, Bekelynck Anne, Carillon Séverine, Sika Lazare, Koné Mariatou, Desgrées du Loû Annabel et Larmarange Joseph (2020) « Connaissances des médecins sur les hépatites virales B et C en Côte d’Ivoire et facteurs associés » (poster PL189), présenté à AFRAVIH 2020, Dakar. http://www.afravih2020.org/.
    Résumé : Objectifs Avec une prévalence de 8% à 10% pour l’hépatite B et de 1% pour l’hépatite C, les hépatites virales constituent un problème de santé publique majeur en Côte d’Ivoire. Alors que ces infections sont mal connues en population générale, qu’en est-il des médecins ? Matériels et Méthodes Une enquête transversale par téléphone a été réalisée en 2018 auprès d’un échantillon aléatoire de 316 médecins exerçant dans des structures de santé en Côte d’Ivoire. Le questionnaire administré portait notamment sur l’évaluation des connaissances sur les hépatites virales B et C ainsi que leurs attitudes personnelles face au dépistage et à la vaccination. Un score de connaissance a été créé à partir de 14 variables (figure) et les facteurs associés ont été mesurés à l’aide d’un modèle multivarié de Poisson. Résultats La grande majorité des médecins citent spontanément la cirrhose et le cancer du foie comme principales complications des hépatites virales. Les modalités de dépistage sont également bien connues. Les connaissances en termes de modes de transmission et de moyens de prévention sont inégales, tandis qu’un tiers a une idée des prévalences des hépatites B et C en Côte d’Ivoire. En matière de prise en charge, moins de la moitié connaît les indications de traitement pour l’hépatite B ou l’existence d’un traitement curatif pour l’hépatite C (figure). De même, peu connaissent les coûts des traitements ou des examens comme la charge virale VHB. Le score de connaissances varie selon le type de structure, le sexe, le fait de connaître un proche porteur d’une hépatite virale, le fait qu’une ONG intervienne ou non dans la structure de santé, avoir suivi une formation sur les hépatites virales et le fait de s’être soi-même fait dépister. Conclusion La lutte contre les hépatites virales passe nécessairement par une implication accrue de l’ensemble des médecins, et notamment par des formations continues à la prévention et à la prise en charge qui doivent être développées.
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  • Pannetier Julie, Ravalihasy Andrainolo, Desgrées du Loû Annabel, Lert France, Lydie Nathalie et Groupe Parcours (2020) « Les violences sexuelles envers les femmes immigrées d’Afrique subsaharienne après la migration en France », Populations et Sociétés, 577 (mai), p. 1-4.
    Résumé : L’enquête Parcours réalisée en 2012-2013 dans des établissements de santé en Île-de-France permet d’étudier les violences sexuelles que les femmes immigrées originaires d’Afrique subsaharienne ont subies après leur migration et d’examiner le contexte social de leur survenue. L’insécurité résidentielle et administrative accroît ces violences sexuelles. Un tiers des femmes séropositives pour le VIH a été infecté après la migration, et rapporte quatre fois plus souvent avoir été victime de rapports sexuels forcés que les femmes non infectées.
    Mots-clés : ⛔ No DOI found.
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2019


  • Coulibaly Karna, Gosselin Anne, Carillon Séverine, Ridde Valéry, Derche Nicolas, Taéron Corinne, Kohou Veroska, Mbiribindi Romain, Zoumenou Iris, Desgrées du Loû Annabel et Makasi Study Group and the (2019) « Sub-Saharan and Caribbean immigrants enrolled in HIV prevention project in Paris greater area: results from Makasi pilot project » (poster), présenté à , Londres, UK. http://www.aidsimpact.com/abstracts/-LZelQ5uF-ifnaYYbnJD.
  • Desgrées du Loû Annabel (2019) « Santé des immigrés : la transition épidémiologique à l'échelle individuelle », La Revue du praticien, 69 (5) (mai), p. 550-554.

  • Desgrées du Loû Annabel (2019) « Des femmes africaines ensemble face à la maladie », Études, Mai (5), p. 31-42. https://www.cairn.info/revue-etudes-2019-5-page-31.htm.
    Résumé : Ikambere, qui signifie « la maison accueillante » en kinyarwanda, est une association créée en 1997 par Bernadette Rwegera, venue en France pour rejoindre son mari, juste avant le génocide du Rwanda (1994). Créée au pire moment de l’épidémie du sida, l’association, installée à Saint-Denis au nord de Paris, accueille et accompagne les femmes touchées par cette maladie, pour la plupart africaines.
    Mots-clés : ⛔ No DOI found.
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  • Desgrées du Loû Annabel et Dupont Jano (2019) Ikambere, la maison qui relève les femmes, Paris : Ikambere, Editions de l'Atelier, 139 p. ISBN : 978-2-7082-4623-2.
    Résumé : Au cœur de Saint-Denis, il y a un lieu où les femmes migrantes touchées par le VIH trouvent refuge. Créée il y a vingt-deux ans par Bernadette Rwegera, française d’origine rwandaise, l’association Ikambere parie sur la puissance de vie de ces femmes atteintes d’une maladie qui les isole, pour la plupart venues d’Afrique et confrontées aux aspects les plus durs de l’exil. Ce livre raconte comment, ensemble, ces femmes se relèvent et reviennent à la vie : l’accueil inconditionnel et chaleureux à Ikambere, autour d’un repas, comme en famille; le partage avec d’autres qui ont connu les mêmes difficultés ; l’acquisition des clés pour s’installer en France, comprendre et contrôler sa maladie ; la place de la fête et de la joie. À la manière d’un carnet de voyage, les illustrations restituent la saveur de la vie à Ikambere : le repas, les séances d’esthétique ou de danse dans lesquels puiser l’énergie pour les petits combats du quotidien. Le récit retrace l’épopée de ces femmes puissantes; il donne aussi la parole aux professionnels qui les accompagnent. Ikambere aide les femmes à se redresser, mais ce sont elles seules qui puisent au plus profond d’elles-mêmes la force d’avancer, de faire des projets et de les réaliser.
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  • Gosselin Anne, Carillon Séverine, Coulibaly Karna, Ridde Valéry, Taéron Corinne, Kohou Veroska, Zouménou Iris, Mbiribindi Romain, Derche Nicolas, Desgrées du Loû Annabel et for the MAKASI Study Group (2019) « Participatory development and pilot testing of the Makasi intervention: a community-based outreach intervention to improve sub-Saharan and Caribbean immigrants’ empowerment in sexual health », BMC Public Health, 19 (1) (décembre), p. 1646. DOI : 10.1186/s12889-019-7943-2. https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-7943-2.
    Résumé : Background: Sub-Saharan and Caribbean immigrants are particularly affected by HIV in Europe, and recent evidence shows that a large portion of them acquired HIV after arrival. There is a need for efficient interventions that can reduce immigrants’exposure to HIV. We describe the pilot phase of a community-based empowerment outreach intervention among sub-Saharan and Caribbean immigrants in the greater Paris area aimed at 1) constructing the intervention, 2) assessing its feasibility, and 3) assessing the feasibility of its evaluation based on a stepped-wedge approach. Methods: 1) To develop the intervention, a literature review was conducted on existing interventions and participatory approaches developed, including the constitution of peer groups. 2) To assess the intervention’s feasibility, a pilot was conducted between April 2018 and December 2018. A daily register was used to collect data on sociodemographic characteristics of all persons who visited the mobile team to assess eligibility and acceptability. 3) To assess the feasibility of performing a stepped-wedge trial to evaluate the intervention, we compared eligibility, enrolment and retention at 3 months in two arms (immediate vs deferred). Chi-squared tests were used to compare reach and retention between the two arms. Results: Intervention development. The Makasi intervention was designed as an outreach intervention that starts with the persons’capacities and helps them appropriate existing resources and information and obtain knowledge about sexual health, based upon motivational interviewing techniques .Intervention Feasibility.Between April 2018 and December 2018, a total of 485 persons were identified as eligible. Participation in the intervention was proposed to 79% of eligible persons. When proposed, the persons enrolled in the intervention with a response rate of 69%. Some were lost to follow-up, and 188 persons were finally included. Evaluation Feasibility. The proportions of eligible (45 and 42%) individuals and of enrolled individuals (65 and 74%) were similar and not significantly different in the immediate and deferred arms, respectively. Conclusions: A community-based outreach intervention aimed at improving sub-Saharan and Caribbean immigrants’empowerment in sexual health is feasible. The pilot phase was key to identifying challenges, designing a relevant intervention and validating the stepped-wedge protocol for evaluation
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  • Gosselin Anne, Desgrées du Loû Annabel, Ravalihasy Andrainolo et Lelièvre Eva (2019) « The Impact of HIV and Hepatitis B on Sub-Saharan Immigrants’ Lives in Paris Greater Area: Results from a Life Event History Survey » (communication orale), présenté à Society for Longitudinal and Lifecourse Studies Conference, Potsdam.


  • Gosselin Anne, Ravalihasy Andrainolo, Pannetier Julie, Lert France, Desgrées du Loû Annabel et Parcours studyy group (2019) « When and why? Timing of post-migration HIV acquisition among sub-Saharan migrants in France », Sexually Transmitted Infections, 26 juillet (juillet 26), p. sextrans-2019-054080. DOI : 10.1136/sextrans-2019-054080. https://sti.bmj.com/content/early/2019/07/26/sextrans-2019-054080.
    Résumé : Objective Recent studies highlighted that many HIV-positive migrants in Europe acquired their infections post-migration. However, the timing of these infections is not always known. This study aims to estimate the timing of post-migration HIV acquisition among sub-Saharan migrants in France and to understand the correlates of post-migration infection. Methods Within the PARCOURS retrospective survey conducted in 2012–2013 in 74 healthcare facilities in the Paris region, life-event data were collected among a random sample of 926 patients living with HIV in HIV services and 763 patients undiagnosed with HIV in primary care centres born in sub-Saharan Africa (reference group). Based on previous analysis, we considered the first 6 years in France after migration as a settlement period. Among the persons who acquired HIV after migration, we estimated the proportion of persons infected during settlement (0–6 years after migration) and after settlement (>6 years after migration) by using an algorithm that combines life-event data and a modelisation of CD4+ T-cell count decline. We then assessed the determinants of HIV acquisition during settlement and after settlement using bivariate logistic regression models. Results Overall, 58% of sub-Saharan migrants who acquired HIV after migration were infected during the first 6 years in France. HIV acquisition during settlement was found to be linked to short/transactional partnerships and lack of a resident permit. 42% of migrants had contracted HIV after settlement. After settlement, HIV acquisition was associated with short/transactional but also with concurrent partnerships and not with social hardship. Conclusion Two profiles of HIV post-migration acquisition emerged. The majority of HIV post-migration acquisition occurs during the settlement period: comprehensive combination prevention programmes among recently arrived migrants are needed. However, long-term migrants are also at risk for HIV through multiple partnerships. Prevention programmes should address the different profiles of migrants at risk for post-migration HIV acquisition.
    Mots-clés : france, life-event history survey, prevention, sub-saharan africa.
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  • Gosselin Anne, Zoumenou Iris, Carillon Séverine, Taéron Corinne, Mbiribindi Romain, Derche Nicolas, Kohou Veroska, Coulibaly Karna, Ridde Valéry et Desgrées du Loû Annabel (2019) « L’alliance chercheurs-associatifs-système de santé. Makasi : une recherche interventionnelle pour renforcer les capacités des immigrés d’Afrique subsaharienne en matière de santé » (communication orale), présenté à Colloque Recherche Interventionnelle pour Lutter Contre les Inégalités, Paris.

  • Inghels Maxime, Kouassi Arsène Kra, Niangoran Serge, Bekelynck Anne, Carillon Séverine, Danel Christine, Sika Lazare, Koné Mariatou, Desgrées du Loû Annabel et Larmarange Joseph (2019) « Cascade of provider-initiated HIV testing and counselling at specific life events (pregnancy, STIs, marriage plan) in Côte d’Ivoire » (poster), présenté à AIDS Impact, London. http://www.aidsimpact.com/abstracts/-LZpZjJNQzSUV6vuH4Ku.
    Résumé : Aim In Côte d’Ivoire, only 57.8% of women and 37.0% of men have been HIV-tested at least once, which is insufficient to control the epidemic. The objective of this study is to describe at a population level if an HIV test was offered and performed at specific life-events where provider-initiated HIV testing is recommended. Method/Issue A cross-sectional telephone survey was conducted in 2017 among a representative sample of 3 867 individuals from the general population in Côte d'Ivoire. For each individual, the occurrence of the following events over the past 5 years was documented: birth of a child, Sexually Transmitted Infections—STIs, marriage. For each of these events, they were asked (i) if they have consulted a health professional, (ii) if they were offered an HIV test during that consultation and (iii) if they accepted it. The factors associated with each of these three steps were analyzed in separate logistic regression models stratified by type of event. Results/Comments While 63.7% of women were HIV-tested during their last pregnancy, only 16.9% of men were tested during their partner’s last pregnancy and this proportion fell to 13.4% for people with an STI and 14.5% for people who got married. These levels of HIV testing were mainly driven by a lack of medical consultation (except for pregnant women) and a lack of testing proposal (except for pre-marital check-up). Testing acceptability was high. Discussion Improving HIV testing coverage in Côte d’Ivoire requires (i) facilitating attendance to health services in case of STIs, marriage plans and pregnancy—for men—and (ii) strengthening routine testing proposal during these occasions.
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  • Inghels Maxime, Kouassi Arsène Kra, Niangoran Serge, Bekelynck Anne, Carillon Séverine, Sika Lazare, Danel Christine, Koné Mariatou, Desgrées du Loû Annabel et Larmarange Joseph (2019) « Practices and Barriers to Provider-initiated HIV Testing and Counseling (PITC) among Midwives, Nurses and Physicians in Côte d'Ivoire » (poster WEPEC215), présenté à 20th ICASA, Kigali. http://www.professionalabstracts.com/icasa2019/iplanner/#/presentation/2236.
    Résumé : Background: Despite the implantation of Provider Initiated Testing and Counselling (PITC) in 2009, testing proposal remains lows in Cote d'Ivoire, even in recommended situations. The purpose of this study is to identify the practices and obstacles to PITC among midwives, nurses and physicians in Côte d´Ivoire. Methods: A nationally representative cross-sectional survey was conducted in 2018 by telephone among three separate samples of midwives, nurses and physicians practicing in Côte d´Ivoire. The number of HIV tests proposed during consultation in the month preceding the survey was collected for each professional. Factors associated with the number of proposed tests were identified through ordinal logistic regression models. These factors were classified in three dimensions according to the conceptual framework of work performance (Motivation-Capability-Opportunity). Results: A total of 298 midwives, 308 nurses and 289 physicians were interviewed. Midwives proposed the test more frequently, followed by nurses and physicians. Among midwives, a higher number of proposed test was associated with the perceptions (motivation dimension) that HIV testing do not require a specific consent compared to other diseases (aOR 4,00 [95% CI 1.37-14.29]). Among nurses, having received a HIV training (i.e. capability) and the presence of community HIV counselors (i.e. opportunity) was associated with a higher number of proposed tests (aOR 2.03 [1.33-3.12] and aOR 1.86 [1.21-2.87] respectively). For physicians, the presence of a voluntary testing center (i.e. opportunity) was associated with a higher number of proposed tests (aOR 1.69 [1.01-2.86]). Conclusion: PITC practices and barriers were different across professions. Beyond improving environmental opportunities such as dedicated staff or services, strengthening the motivations and capabilities of healthcare professionals to propose testing could improve PITC coverage.
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  • Le Guen Mireille, Marsicano Élise, Bajos Nathalie, Desgrées du Loû Annabel et for the Parcours study group (2019) « Union break-up after HIV diagnosis among sub-Saharan African migrants in France: disclosing HIV status is linked with staying in union », AIDS Care, 31 (6) (juin 3), p. 699-706. DOI : 10.1080/09540121.2018.1554240. https://www.tandfonline.com/doi/full/10.1080/09540121.2018.1554240.
    Résumé : Sub-Saharan African migrants living in France are particularly affected by HIV. Due to the fear of sexual transmission of the virus, those in a relationship could experience a union break-up after an HIV diagnosis. Based on data from the time-event ANRS-Parcours survey that was conducted among a representative sample of sub-Saharan migrants living with HIV (France, 2012-2013), we studied union break-ups after HIV diagnosis among people who were in a relationship at the time of their diagnosis. Women experienced a more rapid union break-up after HIV diagnosis than did men. The living conditions of men were not correlated to their risk of union break-up while among women, having a personal dwelling reduced the risk of union break-up. For both sexes, less established relationships were more likely to break up after HIV diagnosis. Having disclosed the HIV status to a partner was associated with a reduced risk of separation between partners, after adjustment on socio-economic conditions and migration characteristics.
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  • Pannetier Julie et Desgrées du Loû Annabel (2019) « Immigration et santé: de l’étude des différences à celle des inégalités », in Inégalités en perspectives, éd. par Etienne Gérard et Nolwen Henaff, Paris : Editions des archives contemporaines, p. 163-175. ISBN : 978-2-8130-0231-0. http://eac.ac/articles/1626.
    Résumé : Les disparités de santé entre populations immigrées et non-immigrées ont mis du temps à émerger comme objet de recherche légitime. Elles ont d’abord été explorées en lien avec les pratiques culturelles et les conditions sanitaires (présence d’épidémies, d’agents pathogènes) dans les pays d’émigration. Ce chapitre présente, à partir d’une étude sur le saturnisme infantile en France et les grands résultats de l’enquête PARCOURS, en quoi les inégalités de santé entre populations immigrées et natives sont liées aux inégalités sociales et notamment aux conditions de logement. L’accès aux soins pour les personnes immigrées et la prise en charge qui leur est offerte va, selon les cas, minimiser ou aggraver ces inégalités sociales et de santé.
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