Publications des membres du Ceped

2022



  • Bertuzzi Leticia, El Aarbaoui Tarik, Heron Mégane, Gosselin Anne, Roy-de-Lachaise Laurine, Fossi Larissa, Della Corte Francesco, Vignier Nicolas, Melchior Maria, Schreiber Merritt, Vandentorren Stephanie et Vuillermoz Cécile (2022) « Longitudinal survey on the Psychological Impact of the COVID-19 Pandemic in Healthcare Workers (PsyCOVer) in France: study protocol », BMJ Open, 12 (1) (janvier), p. e053009. DOI : 10.1136/bmjopen-2021-053009. https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2021-053009.
    Résumé : Introduction In the pandemic, healthcare professionals face even higher levels of stress. It is therefore a priority to estimate the impact of the pandemic on mental health and to propose targeted strategies to improve resilience. The aims of the study were to (1) assess the mental health of healthcare professionals working with patients with COVID-19 and identify social determinants that may increase the risk of negative outcomes; and (2) test the effectiveness of an intervention to improve the resilience of healthcare professionals in France. Methods and analysis To evaluate the first objective, a national longitudinal study will be carried out among healthcare professionals working with patients with COVID-19. Participants will be recruited via an internet link that will be widely disseminated on social media, mailing lists, medical boards and French medical journals. Primary outcomes are mental health distress/symptoms and resilience. Secondary outcomes are burnout, social and occupational supports and substance use. To meet the second objective, an interventional study will be conducted. The main outcome is the effectiveness of the PsySTART-Responder and the Anticipate.Plan.Deter program. Qualitative analyses will be conducted to understand the strategies used to cope with the pandemic. Ethics and dissemination The study protocol was approved by the Sorbonne Université Ethical Committee (No 2020-CER-2020-27) and was declared to French Commission on Information Technology and Liberties, CNIL (N°2222413, 20-05-2021). The results of this study will provide a better understanding of mental health and social inequalities in mental health among healthcare professionals working in the pandemic; data about the effectiveness of the PsySTART-Responder and the Anticipate.Plan.Deter interventional program in France.


  • 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 < 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.


  • 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.


  • 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.
  • 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.

  • Gosselin Anne (2022) « Les inégalités intergénérationnelles à travers le prisme du statut migratoire », in Jeunesses. D'une crise à l'autre. (Amsellem-Mainguy et Lardeux eds.), première, Paris : Presses de Sciences Po, p. 192. (Collection académique). ISBN : 978-2-7246-3855-4.

  • Gosselin Anne, Malroux Inès, Desprat Diane, Devetter François-Xavier, Memmi Sarah, Pannetier Julie, Valat Emmanuel et Melchior Maria (2022) « Prévalence des risques psychosociaux au travail et santé mentale parmi les immigrés et descendants d’immigrés : résultats de l’enquête nationale Conditions de Travail-Risques psychosociaux 2016 », Bull Epidémiol Hebd, 7, p. 141-9. http://beh.santepubliquefrance.fr/beh/2022/7/2022_7_2.html.
    Résumé : Objectifs – Peu d’études se sont penchées sur les risques psychosociaux parmi les immigrés et les descendants d’immigrés et leur association avec la santé mentale. Notre étude a pour objectif : 1) de décrire la prévalence de deux indicateurs qui recouvrent les dimensions d’exigence psychologique, de latitude décisionnelle et d’isolement au travail : le job strain (tension au travail : faible latitude/forte demande) et l’iso-strain (combinaison d’une situation de job strain et d’un faible soutien social) selon le statut migratoire et modéliser la probabilité d’être exposé ; 2) vérifier que les associations entre le job strain, l’iso-strain et l’anxiété sont similaires pour tous les groupes (immigrés, descendants d’immigrés). Méthodes – Nous avons utilisé l’enquête nationale transversale Conditions de Travail-Risques Psychosociaux 2016 (N=24 640). L’anxiété a été mesurée par le score GAD-Mini, outil diagnostique pour repérer le trouble anxieux généralisé. Les prévalences du job strain et de l’iso-strain ont été décrites selon le statut migratoire et le sexe. Des régressions de Poisson ont été utilisées pour modéliser la probabilité d’être exposé au job strain et à l’iso-strain. La prévalence de l’anxiété a été ensuite décrite selon le statut migratoire et le sexe. Dans chaque groupe de population, nous modélisons la probabilité de l’anxiété en fonction des caractéristiques sociodémographiques, des antécédents de santé mentale et de l’expérience du job strain ou de l’iso-strain. Résultats – Les prévalences de risques psychosociaux varient fortement selon le statut migratoire, avec des immigrés plus exposés que la population majoritaire (ni immigrée, ni descendante d’immigrés). Après ajustement, être un immigré d’Afrique reste associé au job strain (ratio incidence risque ajusté : IRRa=1,21 ; IC95%: [0,99-1,47]), et être un descendant d’immigré d’Afrique à l’iso-strain (IRRa=1,33 [1,05-1,69]). La prévalence de l’anxiété était particulièrement haute parmi les descendants d’immigrés d’Afrique (12%). Dans cette population, le job strain et l’iso-strain étaient associés à l’anxiété (IRRa job strain=2,70 [1,22-6,01] ; IRRa iso-strain=4,26 [2,29-7,92]). Conclusion – Dans la lignée des travaux internationaux, notre étude montre que les immigrés et descendants d’immigrés sont particulièrement exposés au job strain et à l’iso-strain, ce qui pourrait contribuer à détériorer leur santé mentale.
    Mots-clés : ⛔ No DOI found.


  • Gosselin Anne, Warszawski Josiane, Bajos Nathalie et for the EpiCov Study Group (2022) « Higher risk, higher protection. COVID-19 risk among immigrants in France: results from the population-based EpiCov survey », European Journal of Public Health (avril 27), p. ckac046. DOI : 10.1093/eurpub/ckac046. https://doi.org/10.1093/eurpub/ckac046.
    Résumé : Immigrants and ethnic/racialized minorities have been identified as being at higher risk of COVID-19 infection, but few studies report on their exposures and prevention behaviours. This study aims to examine the social distribution of COVID-19 exposure (overcrowding, working outside the home, use of public transport to go to work) and prevention behaviours (use of face masks, washing hands, respect for physical distance) in France during the first wave of the epidemic.We used the EpiCov population-based survey from a random sample of individuals aged 15 years or more. We determined the distribution of the self-reported outcomes according to migratory status and sex, using chi2 tests. We modelled the probability of outcomes with logistic regression. Finally, we focused the analysis on the Greater Paris area and accounted for neighbourhood characteristics.A total of 111,824 participants were included in the study. Overall, immigrant groups from non-European countries were more exposed to COVID-19-related factors and more respectful of prevention measures. The probability of overcrowding and the use of public transport was higher for immigrants from sub-Saharan Africa (aOR=3.71 [3.19;4.32], aOR=6.36 [4.86; 8.32]) than for the majority population. Immigrant groups were less likely to have a non-systematic use of face masks and to breach physical distancing than the majority population (for immigrants from sub-Saharan Africa, aOR=0.32 [0.28; 0.37] and aOR=0.71 [0.61; 0.81], respectively). Living in a neighbourhood with a higher share of immigrants was associated with higher exposure and better prevention behaviours.In France, immigrants had a higher exposure to COVID-19-related factors and more systematic prevention behaviours.


  • Warszawski Josiane, Meyer Laurence, Franck Jeanna-Eve, Rahib Delphine, Lydié Nathalie, Gosselin Anne, Counil Emilie, Kreling Robin, Novelli Sophie, Slama Remy, Raynaud Philippe, Bagein Guillaume, Costemalle Vianney, Sillard Patrick, Fourie Toscane, Lamballerie Xavier de, Bajos Nathalie et Team Epicov (2022) « Trends in social exposure to SARS-Cov-2 in France. Evidence from the national socio-epidemiological cohort–EPICOV », PLOS ONE, 17 (5) (mai 22), p. e0267725. DOI : 10.1371/journal.pone.0267725. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0267725.
    Résumé : Background We aimed to study whether social patterns of exposure to SARS-CoV-2 infection changed in France throughout the year 2020, in light to the easing of social contact restrictions. Methods A population-based cohort of individuals aged 15 years or over was randomly selected from the national tax register to collect socio-economic data, migration history, and living conditions in May and November 2020. Home self-sampling on dried blood was proposed to a 10% random subsample in May and to all in November. A positive anti-SARS-CoV-2 ELISA IgG result against the virus spike protein (ELISA-S) was the primary outcome. The design, including sampling and post-stratification weights, was taken into account in univariate and multivariate analyses. Results Of the 134,391 participants in May, 107,759 completed the second questionnaire in November, and respectively 12,114 and 63,524 were tested. The national ELISA-S seroprevalence was 4.5% [95%CI: 4.0%-5.1%] in May and 6.2% [5.9%-6.6%] in November. It increased markedly in 18-24-year-old population from 4.8% to 10.0%, and among second-generation immigrants from outside Europe from 5.9% to 14.4%. This group remained strongly associated with seropositivity in November, after controlling for any contextual or individual variables, with an adjusted OR of 2.1 [1.7–2.7], compared to the majority population. In both periods, seroprevalence remained higher in healthcare professions than in other occupations. Conclusion The risk of Covid-19 infection increased among young people and second-generation migrants between the first and second epidemic waves, in a context of less strict social restrictions, which seems to have reinforced territorialized socialization among peers.
    Mots-clés : Body weight, COVID 19, Europe, France, Medical risk factors, Professions, SARS CoV 2, Virus testing.

2021

  • Gosselin Anne et Coulibaly Karna (2021) « « Précarité, risque d'infection VIH et niveaux de connaissances de la prévention combinée ». » (Communication orale), présenté à Colloque d'URACA, Paris.


  • Gosselin Anne, Malroux Inès, Desprat Diane, Devetter François-Xavier, Memmi Sarah, Pannetier Julie, Valat Emmanuel et Melchior Maria (2021) « Prevalence of psychosocial risks among immigrants in France and associations with mental health: findings from the national French Working Conditions Survey », International Archives of Occupational and Environmental Health (septembre 30). DOI : 10.1007/s00420-021-01763-2. https://doi.org/10.1007/s00420-021-01763-2.
    Résumé : Few studies examined psychosocial risks among immigrants and explored their association with mental health. Our study aims to 1) describe the prevalence of job strain and iso-strain according to migratory status and model the probability of exposure, 2) verify whether the association between job strain, iso strain and anxiety holds for all immigrant groups.


  • 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.


  • Gosselin Anne, Melchior Maria, Desprat Diane, Devetter François-Xavier, Pannetier Julie, Valat Emmanuel et Memmi Sarah (2021) « Were immigrants on the frontline during the lockdown? Evidence from France », European Journal of Public Health (août 14), p. ckab094. DOI : 10.1093/eurpub/ckab094. https://academic.oup.com/eurpub/advance-article/doi/10.1093/eurpub/ckab094/6352235.
    Résumé : Abstract In France, immigrants’ excess of mortality was higher than natives’ during the Spring 2020 lockdown. Were immigrants in frontline jobs and more exposed to Covid-19? Based on a nationally representative survey, we model the probability to work in a frontline job according to migratory status, taking sociodemographic and occupational characteristics into account. Compared to natives (Metropolitan France), being an African immigrant was associated to higher probability to work in a frontline job [adjusted odds ratio (aOR) = 1.82 (1.23–2.71)], as well as being born in French Overseas Departments [aOR = 1.64 (1.23–2.18)], reflecting racial division of work and higher Sars-Cov-2 exposure of immigrant and minority populations.


  • 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.

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.

  • 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.
  • Gosselin Anne, Coulibaly Karna, Carillon Severine, Zoumenou Iris, Frye Victoria et Albritton Tashuna (2020) « « Quand le Covid-19 met le racisme en évidence: les défis pour les projets de recherche communautaire en prévention du VIH en France et aux Etats-Unis » » (Poster), présenté à AFRAVIH, Dakar, Sénégal.


  • 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.


  • Gosselin Anne, Daly Alison, El Zaemey Sonia, Fritschi Lin, Glass Deborah, Perez Elena Ronda et Reid Alison (2020) « Does exposure to workplace hazards cluster by occupational or sociodemographic characteristics? An analysis of foreign‐born workers in Australia », American Journal of Industrial Medicine (juin 23). DOI : 10.1002/ajim.23146. https://onlinelibrary.wiley.com/doi/abs/10.1002/ajim.23146.
    Résumé : Background Disparities in exposure to occupational hazards may be linked to social position as well as the type of job a person holds. This study aimed to describe the prevalence of exposure to workplace hazards among three migrant worker groups and to assess whether social disparities in exposure for these groups remain after adjusting for occupational characteristics. Methods Data were collected in 2017/2018 from 1630 Australian workers born in New Zealand, India, and the Philippines. Weighted estimated prevalence of exposure to 10 carcinogens and four psychosocial hazards (discrimination, job strain, vulnerability, and insecurity) was calculated for sociodemographics and occupation. Regression estimated the likelihood of exposure by sociodemographics after adjustment for occupational characteristics. Results Exposure to workplace hazards ranged from 11.7% (discrimination) to 61.2% (exposed to at least one carcinogen). Compared with workers born in India, New Zealand born workers were over twice as likely to be exposed to diesel engine exhaust (adjusted odds ratio [aOR] = 2.60) and 60% more likely to be exposed to at least one carcinogen (aOR = 1.60) but less likely to be exposed to any psychosocial hazard. Social disparities by country of birth, sex, age, education, and number of years in Australia, as well as company size, employment type, and hours, worked remained associated with greater likelihood of reporting one or more workplace hazards after adjusting for occupational characteristics.


  • 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).

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.


  • 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
  • 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.
  • 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.


  • Ronda-Perez E., Gosselin Anne, Martínez Jose Miguel et Reid Alison (2019) « Injury vulnerability in Spain. Examination of risk among migrant and native workers », Safety Science, 115 (juin 1), p. 36-41. DOI : 10.1016/j.ssci.2019.01.026. http://www.sciencedirect.com/science/article/pii/S0925753518308737.
    Résumé : The search for work is one of the largest drivers of migration. Globally there are an estimated 244 million migrants. It is known that occupational accidents are higher in migrant compared with native-born workers; however, there is a lack of information about the reason for these differences. The aim of this study was to use the vulnerability index to identify whether migrant workers were more vulnerable to occupational health and safety risks than native-born workers among a cohort of 306 workers in Spain. Data come from the Spanish Platform of Longitudinal Studies on Immigrant Families (PELFI). For this analysis, we selected current workers with at least one year of work experience in Spain, 18–65 years of age and born in Colombia, Ecuador (n = 217) and a control sample of Spanish-born workers (n = 89). The occupational health and safety vulnerability tool was used. Prevalence and adjusted (by sociodemographic and occupational variables) Odds Ratio (aOR) was calculated to compare migrants with Spanish-born. Latin American workers had a significantly greater prevalence of exposure to occupational hazards (81% than Spanish-born 54%) and to inadequate policies and procedures (38,7% and 22,5% respectively). After adjusting for a range of demographic and occupation-related covariates, the risk of exposure to an overall vulnerability was increased among Latin American workers (aOR: 1,9 (0,9–4,0). Latin American workers were more likely to suffer work-related vulnerability and that may place them at higher risk of work related health problems.
    Mots-clés : Epidemiology, Migrant workers, Occupational health, Work injury.


  • Vignier Nicolas, Desgrées du Loû Annabel, Pannetier Julie, Ravalihasy Andrainolo, Gosselin Anne, Lert France, Lydie Nathalie, Bouchaud Olivier, Dray-Spira Rosemary, Chauvin Pierre et the PARCOURS Study Group (2019) « Social and structural factors and engagement in HIV care of sub-Saharan African migrants diagnosed with HIV in the Paris region », AIDS Care, 31 (7) (juillet 3), p. 897-907. DOI : 10.1080/09540121.2019.1576842. https://www.tandfonline.com/doi/full/10.1080/09540121.2019.1576842.
    Résumé : 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.
    Mots-clés : access, African migrants, and Evaluation, Health insurance, healthcare Quality, HIV, undocumented migrants.

2018

  • Gosselin Anne (2018) « La prise en compte de différentes temporalités dans l’approche biographique » (Communication orale invitée), présenté à Colloque Parcours de vie et santé: apport des approches biographiques en santé publique, Paris.


  • Gosselin Anne (2018) « Le titre de séjour pour raison médicale, un obstacle à l’accès au titre de séjour pérenne : résultats de l’enquête ANRS Parcours », Santé Publique, 30 (2) (août 7), p. 197-201. DOI : 10.3917/spub.182.0197. https://www.cairn.info/revue-sante-publique-2018-2-p-197.htm.
    Résumé : Objectifs : En France, les acteurs associatifs dénoncent depuis longtemps les difficultés rencontrées par les personnes étrangères détentrices d’un titre de séjour pour raison médicale dans l’accès à des titres de séjour pérennes (carte de 10 ans ou nationalité française). L’objectif de cette étude est de vérifier si une discrimination existe envers les personnes étrangères détentrices de ce titre, toutes choses égales par ailleurs.Méthodes : Nous utilisons les données de l’enquête quantitative rétrospective ANRS Parcours qui a été menée en 2012-2013 auprès de 1 705 immigrés subsahariens atteints de VIH/sida ou d’Hépatite B en Île-de-France. Cette enquête biographique a permis de reconstituer l’historique des titres de séjour. Au moyen de modèles logistiques à temps discret, nous modélisons les facteurs associés à l’obtention d’un titre de séjour pérenne et l’effet du titre de séjour pour soins sur cette probabilité. Des variables de contrôle permettent de prendre en compte le niveau d’étude, le motif de la venue en France, la période d’arrivée, la durée de séjour.Résultats : Le titre de séjour pour soins a un effet délétère sur l’accès à un titre de séjour pérenne (ORa compris entre 0,15 et 0,27 selon le groupe, p < 0,01). Par ailleurs, il y a un allongement du temps nécessaire pour obtenir un titre de séjour pérenne depuis 2005 comparé à avant 1996 pour l’ensemble des personnes étrangères participant à l’enquête.Conclusions : Nos résultats suggèrent une discrimination envers les personnes détentrices d’un titre de séjour pour raison médicale dans l’accès à un titre de séjour pérenne. Ainsi, c’est l’accès au droit à la santé des personnes étrangères qui est remis en question., Objectives: Various associations in France have denounced for a long time the difficulties encountered by foreigners with a residence permit for medical reasons to access permanent residence status (10-year resident’s card or French nationality). The objective of this study was to determine whether there is a real discrimination towards foreigners with a residence permit for medical reasons, with all other things being equal.Methods: This study was based on data from the retrospective quantitative ANRS Parcours survey, conducted in 2012-2013 among 1,705 Sub-Saharan immigrants with HIV/AIDS or Hepatitis B in Ile-de-France. This life-event survey reconstructed the immigrant’s permit history. Discrete time logistic models were then used to model the factors associated with obtaining a permanent residence permit and the impact of a residence permit for medical reasons on this probability. Control variables were used to take into account the level of education, the reason for arrival in France, the period of arrival, the duration of stay.Results: A residence permit for medical reasons has a negative impact on access to permanent residence status (aOr between 0.15 and 0.27 across subgroups, P < 0.01). Additionally, the time required to obtain permanent residence status has increased since 2005 compared to before 1996 for all foreigners participating in the survey.Conclusions: The results of this study suggest discrimination towards people with a residence permit for medical reasons in terms of access to permanent residence status, thereby placing their access to health care at stake.
    Mots-clés : discrimination sociale, émigrants & immigrants, France, titre de séjour pour soins.
  • Gosselin Anne (2018) « The impact of HIV and Hepatitis B on Sub-Saharan immigrants’ lives in Paris greater area – results from a life event history survey » présenté à Life History Research Society Conference, Paris.


  • Gosselin Anne, Desgrées du Loû Annabel et Lelièvre Eva (2018) « How to use sequence analysis for life course epidemiology? An example on HIV-positive Sub-Saharan migrants in France », Journal of Epidemiology and Community Health, 7 (6) (février 2), p. 507-512. DOI : 10.1136/jech-2017-209739. http://jech.bmj.com/lookup/doi/10.1136/jech-2017-209739.
    Résumé : Background Life course epidemiology is now an established field in social epidemiology; in sociodemography, the quantitative analysis of biographies recently experienced significant trend from event history analysis to sequence analysis. The purpose of this article is to introduce and adapt this methodology to a social epidemiology question, taking the example of the impact of HIV diagnosis on Sub-Saharan migrants’ residential trajectories in the Paris region. Methods The sample consists of 640 migrants born in Sub-Saharan Africa receiving HIV care. They were interviewed in healthcare facilities in the Paris region within the PARCOURS project, conducted from 2012 to 2013, using life event history calendars, which recorded year by year their health, family and residential histories. We introduce a two-step methodological approach consisting of (1) sequence analysis by optimal matching to build a typology of migrants’ residential pathways before and after diagnosis, and (2) a Cox model of the probability to experience changes in the residential situation. Results The seven-clusters typology shows that for a majority, the HIV diagnosis did not entail changes in residential situation. However 30% of the migrants experienced a change in their residential situation at time of diagnosis. The Cox model analysis reveals that this residential change was in fact moving in with one’s partner (HR 2.99, P<0.000) rather than network rejection. Conclusion This original combination of sequence analysis and Cox models is a powerful process that could be applied to other themes and constitutes a new approach in the life course epidemiology toolbox.

  • Gosselin Anne, Desgrées du Loû Annabel et Lelièvre Éva (2018) Prendre la mesure d’un tournant biographique : l’impact du VIH/sida sur les trajectoires de vie des immigrés subsahariens, Working Papers du CEPED (38), Paris : Ceped, 28 p. http://www.ceped.org/wp.
    Résumé : L’approche biographique en démographie permet de prendre en compte non pas la situation à un moment donné mais bien les trajectoires de vie dans leur ensemble ; l’objectif de cette étude est d’étudier les conséquences sur l’activité, le couple et le bien-être perçu d’un diagnostic de VIH dans les trajectoires de vies des immigrés subsahariens. Pour ce faire, une démarche méthodologique originale est proposée, à l’articulation entre des méthodes biographiques « classiques » qui s’intéressent à des transitions précises d’un état à un autre dans la trajectoire des individus et des méthodes dites holistes, qui prennent la trajectoire comme unité d’analyse. Les analyses reposent sur les données de l’enquête biographique Parcours, menée en 2012-2013 auprès de 926 immigrés subsahariens atteints de VIH/sida en Île-de-France. La combinaison de l’analyse de séquences et de modèles logistiques à temps discret à risques répétés permet de donner des résultats originaux sur l’impact du diagnostic dans des vies marquées par la migration. Pour la plupart des immigrés subsahariens, c’est la migration qui a un impact majeur sur les dimensions factuelles comme l’activité et la vie conjugale, et non le diagnostic. En revanche, le diagnostic entraîne une détérioration importante du bien-être perçu.
    Mots-clés : analyse biographique, analyse de séquences, immigrés, migration, trajectoires, VIH/sida.


  • Gosselin Anne, Desgrées du Loû Annabel, Lelièvre Eva, Lert France, Dray-Spira Rosemary, Lydié Nathalie et the Parcours Study Group (2018) « Understanding Settlement Pathways of African Immigrants in France Through a Capability Approach: Do Pre-migratory Characteristics Matter? », European Journal of Population, 34 (5) (janvier 22), p. 849-871. DOI : 10.1007/s10680-017-9463-z. http://link.springer.com/10.1007/s10680-017-9463-z.
    Résumé : With the increase in asylum-related immigration since 2015, understanding how immigrants settle in a new country is at the centre of social and political debate in European countries. The objective of this study is to determine whether the necessary time to settle for Sub-Saharan Africa immigrants in France depends more on pre-migratory characteristics or on the structural features of the host society. Taking a capability approach, we define settlement as the acquisition of three basic resources: a personal dwelling, a legal permit of a least 1year and paid work. We use data from the PARCOURS survey, a life-event history survey conducted from 2012 to 2013 that collected 513 life histories of Sub-Saharan African immigrants living in France. Situations regarding housing, legal status and activity were documented year by year since the arrival of the respondent. We use a Kaplan-Meier analysis and chronograms to describe the time needed for settlement, first for each resource (personal dwelling, legal permit and paid work) and then for the combined indicator of settlement. Discrete-time logistic regressions are used to model the determinants of this settlement process. Overall, women and men require 6 and 7years (medians), respectively, to acquire basic resources in France. This represents a strikingly long period of time in which immigrants lack basic security. The settlement process varies according to gender, but very few sociodemographic factors influence settlement dynamics. Therefore, the length of the settlement process may be due to structural features of the host society.
  • Gosselin Anne, Ravalihasy Andrainolo, Pannetier Julie, Lert France et Desgrées du Loû Annabel (2018) « When and Why? Timing and Determinants of Post-Migration HIV Acquisition among Sub-Saharan Immigrants in France » (Communication orale), présenté à 22nd International AIDS Conference 2018, Amsterdam, Pays-Bas.

  • Gosselin Anne (2018) « Dynamique et déterminants de l’infection VIH après la migration parmi les immigrés d’Afrique subsaharienne en France » (Communication orale), présenté à 9e Conférence Internationale Francophone sur le VIH et les Hépatites Virales (AFRAVIH 2018), Bordeaux. https://www.youtube.com/watch?v=T7LBEd6UO8o.
  • Gosselin Anne (2018) « Empowering Sub-Saharan immigrants in sexual health in Paris greater area: results from the Makasi Project » (Communication orale), présenté à 1st World Congress on Migration, Ethnicity, Race and Health MEHR 2018, Edimbourg, UK.


  • Gosselin Anne, Taeron Corinne, Mbiribindi Romain, Derche Nicolas et Desgrées du Loû Annabel (2018) « Empowering Sub-Saharan immigrants in sexual health in Paris greater area: results from the Makasi Project », European Journal of Public Health, 28 (suppl_1) (mai 1), p. 27. DOI : 10.1093/eurpub/cky047.026. https://academic.oup.com/eurpub/article/doi/10.1093/eurpub/cky047.026/4973070.


  • Vignier Nicolas, Desgrées du Loû Annabel, Pannetier Julie, Ravalihasy Andrainolo, Gosselin Anne, Lert France, Lydié Nathalie, Bouchaud Olivier, Dray Spira Rosemary et the PARCOURS Study Group (2018) « Access to health insurance coverage among sub-Saharan African migrants living in France: Results of the ANRS-PARCOURS study », éd. par Michael Gusmano, PLOS ONE, 13 (2) (février 15), p. e0192916. DOI : 10.1371/journal.pone.0192916. http://dx.plos.org/10.1371/journal.pone.0192916.
    Résumé : Background Migrants' access to care depends on their health insurance coverage in the host country. We aimed to evaluate in France the dynamic and the determinants of health insurance coverage acquisition among sub-Saharan migrants. Methods In the PARCOURS life-event retrospective survey conducted in 2012-2013 in health-care facilities in the Paris region, data on health insurance coverage (HIC) each year since arrival in France has been collected among three groups of sub-Saharan migrants recruited in primary care centres (N = 763), centres for HIV care (N = 923) and for chronic hepatitis B care (N = 778). Year to year, the determinants of the acquisition and lapse of HIC were analysed with mixed-effects logistic regression models. Results In the year of arrival, 63.4% of women and 55.3% of men obtained HIC. But three years after arrival, still 14% of women and 19% of men had not obtained HIC. HIC acquisition was accelerated in case of HIV or hepatitis B infection, for migrants arrived after 2000, and for women in case of pregnancy and when they were studying. Conversely, it was slowed down in case of lack of a residency permit and lack of financial resources for men. In addition, women and men without residency permits were more likely to have lost HIC when they had one. Conclusion In France, the health insurance system aiming at protecting all, including undocumented migrants, leads to a prompt access to HIC for migrants from sub-Saharan Africa. Nevertheless, this access may be impaired by administrative and social insecurities.
    Mots-clés : AFRIQUE SUBSAHARIENNE, FRANCE.


  • Vignier Nicolas, Dray Spira Rosemary, Pannetier Julie, Ravalihasy Andrainolo, Gosselin Anne, Lert France, Lydie Nathalie, Bouchaud Olivier, Desgrées du Loû Annabel et Chauvin Pierre (2018) « Refusal to provide healthcare to sub-Saharan migrants in France: a comparison according to their HIV and HBV status », European Journal of Public Health, 28 (5) (juillet 2), p. 904-910. DOI : 10.1093/eurpub/cky118. https://academic.oup.com/eurpub/advance-article/doi/10.1093/eurpub/cky118/5048003.
    Résumé : AbstractBackground. In this study, we aim to measure and compare the frequency of reported denial of care in sub-Saharan African migrants living in the Paris a
  • Vignier Nicolas, Gosselin Anne, Dray-Spira Rosemary, Pannetier Julie, Ravalihasy Andrainolo, Lert France, Lydié Nathalie, Bouchaud Olivier, Desgrées du Loû Annabel et Chauvin Pierre (2018) « Recours au titre de séjour pour raison de santé des immigrés originiares d'Afrique subsaharienne vivant en Ile-de-France en fonction de leur statut vis à vis du VIH et de l'hépatite B. » (Communication orale), présenté à Conference AFRAVIH, Bordeaux.
    Résumé : En 1998, la France a instauré un droit au séjour pour soins pour les personnes étrangères suite à une mobilisation associative portée notamment par les organisations de lutte contre le VIH/Sida. Peu de données existent sur le niveau de recours et le niveau d’acceptation de ces demandes, notamment en fonction des pathologies. L’objectif de cette étude est de mesurer la demande de titre de séjour pour raison médicale et ses facteurs associés parmi des immigrés originaires d’Afrique subsaharienne en fonction de leur statut vis à vis du VIH et de l’hépatite B.. Méthodes L’étude ANRS PARCOURS a été réalisée en 2012-2013 en Ile-de-France auprès de trois groupes de personnes originaires d’Afrique subsaharienne recrutées dans des services de prise en charge du VIH (N=922, groupe VIH), de l’hépatite B chronique (N=777, groupe VHB) ou dans des centres de santé (N=761 ; groupe de référence). Les participants ont été interrogés sur le fait d’avoir déjà sollicité un titre de séjour pour raison de santé et son obtention ou non. Résultats Une demande de titre de séjour pour raison de santé avait été effectuée par 49,6% des participants du groupe VIH, 32,3% du groupe VHB et 5,2% du groupe de référence (p<0,001). Le taux d’acceptation de ces demandes était de 88,6% dans le groupe VIH, 65,4% dans le groupe VHB et 55,3% dans le groupe de référence (p<0,001). Ainsi 43,5% des immigrés subsahariens suivis pour une infection par le VIH en Ile-de-France, 20,5% de ceux suivis pour une hépatite B chronique et 2,9% de ceux consultant en centre de santé avaient obtenus un titre de séjour pour raison de santé. Dans le groupe VHB, une demande avait plus souvent été effectuée parmi les patients sous traitement ou ayant été traité pour leur hépatite B (41,7% vs 25,6%, p<0,001) et plus souvent parmi les patients cirrhotiques (44,6% vs 30,3%, p=0,04). Au sein du groupe de référence, les personnes ayant déclaré souffrir d’une maladie chronique avaient plus souvent effectué une demande (8,9% vs 2,4%, p<0,001). Dans les groupes VIH et VHB, les personnes diagnostiquées plus de 3 ans après leur arrivée en France étaient moins à même d’avoir sollicité un titre de séjour pour raison de santé. Conclusion Une proportion importante des immigrés subsahariens franciliens vivant avec le VIH a bénéficié d’un droit au séjour pour raison de santé. Les personnes vivant avec une hépatite B chronique ont également fréquemment sollicité ce droit mais l’ont moins souvent obtenu, en particulier quand ils n’avaient pas d’indication à un traitement. Il semble beaucoup plus rarement sollicité et obtenu pour d’autres pathologies. Depuis mars 2016, l’évaluation médicale des demandes de droit au séjour pour soins ont été modifiées, ce qui pourrait entraîner une modification dans les attributions de droit au séjour.

2017

  • Desgrées du Loû Annabel, Pannetier Julie, Ravalihasy Andrainolo et Gosselin Anne (2017) « Recueillir des parcours de vie : repères méthodologiques et population enquêtée », in Parcours. Parcours de vie et de santé des Africains immigrés en France, éd. par Annabel Desgrées du Loû et France Lert, La Découverte, Paris, p. 27-50. (Recherches).
  • Gosselin Anne, Desgrées du Loû Annabel et Lelièvre Eva (2017) « L’impact du diagnostic VIH ou hépatite B sur les trajectoires de vie des immigrés subsahariens », in Parcours. Parcours de vie et de santé des Africains immigrés en France, éd. par Annabel Desgrées du Loû et France Lert, La Découverte, Paris, p. 209-224. (Recherches).
  • Gosselin Anne, Desgrées du Lou Annabel et Lelièvre Eva (2017) « L’installation en France au fil des décennies : la situation a-t-elle évolué ? », in Parcours. Parcours de vie et de santé des Africains immigrés en France, éd. par Annabel Desgrées du Loû et France Lert, La Découverte, Paris, p. 53-72. (Recherches).
  • Gosselin Anne (2017) « HIV and access to rights for Sub-Saharan immigrants in France results from the ANRS Parcours survey » (Communication orale), présenté à 13th Conference of the European Sociological Association, Athènes.

  • Gosselin Anne, Lelièvre Éva, Ravalihasy Andrainolo, Lert France, Lydié Nathalie et Desgrées du Lou Annabel (2017) « Migration and HIV: a double penalty? Assessing the respective impacts of migration and HIV diagnosis on Sub-Saharan immigrants' lives in Paris greater area. Results from the ANRS parcours survey » (poster), présenté à 9th IAS Conference on HIV Science (IAS 2017), Paris. http://programme.ias2017.org/.


  • Gosselin Anne, Lelièvre Eva, Ravalihasy Andrainolo, Lydié Nathalie, Lert France, Desgrées du Loû Annabel et for the Parcours Study Group (2017) « "Times Are Changing": The Impact of HIV Diagnosis on Sub-Saharan Migrants’ Lives in France », PLOS ONE, 12 (1) (janvier 27), p. e0170226. DOI : 10.1371/journal.pone.0170226. http://dx.doi.org/10.1371%2Fjournal.pone.0170226.
    Résumé : Background Migrants account for 35% of HIV diagnoses in the European Union (ECDC/WHO 2014). Little is known about the impact of such a lifelong infection diagnosis on lives that are already disrupted by migration. In this paper, we assess the impact of HIV diagnosis on activity, union, well-being among African migrants living in France, the second group most affected by HIV after MSM. We compare it with the impact of the diagnosis of Hepatitis B, another lifelong infection affecting African migrants. Methods We use the ANRS PARCOURS survey, a retrospective life-event survey led in 2012–2013 in 74 health structures in Paris greater area which collected 926 life histories of Sub-Saharan migrants living with HIV and 779 with Hepatitis B. We modelled the probability year by year since 18 years of age until data collection to lose one’s activity, to experience a conjugal break up and degradation of well-being and we estimated the impact of migration and of HIV and Hepatitis B diagnoses on these probabilities, after adjustment on other factors, thanks to discrete-time logistic regressions. Results Migration entailed loss of activity and conjugal break up, though HIV diagnosis after migration did not statistically impact on these outcomes. Yet HIV diagnosis had a massive negative impact on well-being (aOR = 11.31 [4.64–27.56] for men and 5.75 [2.79–11.86] for women). This negative impact on well-being tended to diminish for persons diagnosed after 2004. The negative impact of HIV diagnosis on African migrants’ well-being seems to be attenuated in the last decade, which hints at a normalization of the subjective experience of HIV diagnosis.

  • Gosselin Anne, Ravalihasy Andrainolo, Lert France, Lydié Nathalie et Desgrées du Lou Annabel (2017) « HIV and access to rights for sub-Saharan immigrants in France: results from the ANRS Parcours Survey » (poster), présenté à 9th IAS Conference on HIV Science (IAS 2017), Paris. http://programme.ias2017.org/.
  • Gosselin Anne, Taeron Corinne, Mbiribindi Romain, Derche Nicolas et Desgrées du Loû Annabel (2017) « Empowerment in sexual health for Sub-Saharan migrants in Paris: results from a community-based study » (communication orale), présenté à 10th European Public Health Conference EUPHA, Stockholm, Suède.
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