Is hardship during migration a determinant of HIV infection? Results from the ANRS PARCOURS study of sub-Saharan African migrants in France:
type: Article
item type: journalArticle
is part of: AIDS
authors: Person
  surname: Desgrées du Loû
  given name: Annabel
authors: Person
  surname: Pannetier
  given name: Julie
authors: Person
  surname: Ravalihasy
  given name: Andrainolo
authors: Person
  surname: Le Guen
  given name: Mireille
authors: Person
  surname: Gosselin
  given name: Anne
authors: Person
  surname: Panjo
  given name: Henri
authors: Person
  surname: Bajos
  given name: Nathalie
authors: Person
  surname: Lydie
  given name: Nathalie
authors: Person
  surname: Lert
  given name: France
authors: Person
  surname: Dray-Spira
  given name: Rosemary
abstract: {Objectives: } In Europe, sub-Saharan African migrants are a key population for HIVinfection. 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%; P¼0.004) and women (52.4 vs. 30.5%; P¼0.02), concurrent partnerships among men (69.9 vs. 45.8%; P¼0.02), and transactional partnerships among women (8.6 vs. 2.3%; P¼0.006). Hardship increased risky behaviours: in women, lacking a residence permit increased casual and transactional partnerships [resp. odds ratio (OR)¼2.01(1.48–2.72) and OR¼6.27(2.25–17.44)]. Same trends were observed for lacking stable housing [OR¼3.71(2.75–5.00) and OR¼10.58 (4.68–23.93)]. {Conclusion:} Hardships faced by migrants increase HIV risks. Women, especially during the period without stable housing, appear especially vulnerable.
date: 02/2016
pages: 645-656
date submitted: 2016-02-03 09:21:26
short title: Is hardship during migration a determinant of HIV infection?
language: en
library catalog: CrossRef
description: 00000

AIDS
type: Journal
volume: 30
number: 4
identifier: DOI 10.1097/QAD.0000000000000957
identifier: ISSN 0269-9370