Publications des membres du Ceped

2023


  • 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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  • Ravalihasy Andrainolo, Ante-Testard Pearl Anne, Kardas-Sloma Lidia, Yazdanpanah Yazdan, De Allegri Manuela et Ridde Valéry (2023) « Quantitative Methods Used to Evaluate Impact of Combination HIV Prevention Intervention: A Methodological Systematic Review », AIDS and Behavior (janvier 27). DOI : 10.1007/s10461-023-04000-8. https://doi.org/10.1007/s10461-023-04000-8.
    Résumé : Combination HIV prevention aims to provide the right mix of biomedical, behavioral and structural interventions, and is considered the best approach to curb the HIV pandemic. The impact evaluation of combined HIV prevention intervention (CHPI) provides critical information for decision making. We conducted a systematic review of the literature to map the designs and methods used in these studies. We searched original articles indexed in Web of Science, Scopus and PubMed. Fifty-eight studies assessing the impact of CHPI on HIV transmission were included. Most of the studies took place in Asia or sub-Saharan Africa and were published from 2000 onward. We identified 36 (62.1%) quasi-experimental studies (posttest, pretest–posttest and nonequivalent group designs) and 22 (37.9%) experimental studies (randomized designs). The findings suggest that diverse methods are already rooted in CHPI impact evaluation practices as recommended but should be better reported. CHPI impact evaluation would benefit from more comprehensive approaches.
    Mots-clés : Combination HIV prevention intervention, Decision-making, Evidence-based, Impact evaluation.
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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, 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.

  • Meyer Jean-Baptiste, Ravalihasy Andrainolo, Pilon Marc, Giraud Gregory et Kim Hyunjee (2022) « Explorer l'avenir pour une université africaine durable : expansion de la jeunesse et universalisation de l'enseignement supérieur » (communication orale), présenté à Unesco World Higher Education Conference2022, Barcelone, Espagne. https://whec2022.net/resources/EXPLORER%20L%20AVENIR%20POUR%20UNE%20UNIVERSITE%20AFRICAINE%20DURABLE%20-%20IRD.pdf.
    Résumé : L’Afrique est la région où le taux d’inscription dans l’enseignement supérieur est le plus bas du monde. C’est aussi celle où la population des 20 à 25 ans, potentiellement étudiante, croîtra le plus dans les années à venir. Conformément aux ODD, la tendance à un rattrapage des moyennes mondiales d’entrée à l’université devrait se réaliser. C’est déjà le cas en Afrique septentrionale mais reste en devenir pour la partie sub-saharienne. Des projections établies par notre équipe de recherche permettent de représenter l’expansion de l’enseignement supérieur sous différentes hypothèses. Toutes révèlent qu’une pression considérable pèsera sur le secteur à court ou moyen terme (ODD 2030 et Agenda 2063 de l’Union Africaine). Comment y faire face ? La crise de la pandémie introduit une disruption dans cette situation déjà tendue. Paradoxalement, elle révèle pourtant une résilience systémique et des adaptations qui sont autant de solutions virtuelles (au double sens de potentielles/numériques) aux colossaux enjeux de la massification.
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  • Meyer Jean-Baptiste, Ravalihasy Andrainolo, Pilon Marc, Giraud Grégory et Kim Hyunjee (2022) « Exploring the future for a sustainable african university : youth expansion and universal higher education » (communication orale), présenté à World Higher Education conference. https://hal.ird.fr/ird-03692394.
    Résumé : Produit ouvert de connaissance Dans le cadre de la Conférence mondiale de l'UNESCO sur l'enseignement supérieur (WHEC2022) Section de l'enseignement supérieur de l'UNESCO| Division de l'éducation 2030
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  • Ravalihasy Andrainolo, Kardaś-Słoma Lidia, Yazdanpanah Yazdan et Ridde Valéry (2022) « Quantitative methods used to evaluate impact of health promotion interventions to prevent HIV infections: a methodological systematic review protocol », Systematic Reviews, 11 (1) (mai 6), p. 87. DOI : 10.1186/s13643-022-01970-z. https://doi.org/10.1186/s13643-022-01970-z.
    Résumé : Combination prevention is currently considered the best approach to combat HIV epidemic. It is based upon the combination of structural, behavioral, and biomedical interventions. Such interventions are frequently implemented in a health-promoting manner due to their aims, the approach that was adopted, and their complexity. The impact evaluation of these interventions often relies on methods inherited from the biomedical field. However, these methods have limitations and should be adapted to be relevant for these complex interventions. This systematic review aims to map the evidence-based methods used to quantify the impact of these interventions and analyze how these methods are implemented.
    Mots-clés : Combination HIV prevention, Evidence-based impact evaluation, Health promotion, Mathematical methods, Statistical methods, Study design.
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2021


  • Coulibaly Karna et Ravalihasy Andrainolo (2021) « Empowerment et migration/immigration : une rencontre tardive mais des travaux de plus en plus nombreux », De facto | Institut Convergences Migrations, 29 (décembre 15), p. 30-33. (Dossier « Penser les migrations à la lumière du pouvoir d’agir »). https://www.icmigrations.cnrs.fr/2021/11/26/defacto-029-04/.
  • Coulibaly Karna et Ravalihasy Andrainolo (2021) « « Comment mesurer l’empowerment en santé sexuelle des immigrés précaires ? Le cas de Makasi » » présenté à Séminaire du département Santé de l’Institut Convergences Migrations, Aubervilliers.


  • 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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2020



  • Audibert Martine, N’Landu Anaïs, Ravit Marion, Raffalli Bertille, Ravalihasy Andrainolo, Ridde Valéry et Dumont Alexandre (2020) « Forfait obstétrical et inégalités dans l’accès aux soins maternels en Mauritanie », Revue économique, 71 (6), p. 1045. DOI : 10.3917/reco.716.1045. http://www.cairn.info/revue-economique-2020-6-page-1045.htm?ref=doi.
    Résumé : La Mauritanie a introduit en 2002 un système de prépaiement des soins de santé maternelle, le forfait obstétrical. L’objectif de cette étude est de savoir si le forfait améliore la qualité de l’accès et réduit les inégalités dans le recours aux soins obstétricaux. Les données sont celles de l’enquête ménages MICS-Mauritanie de 2015. Deux méthodes ont été utilisées. La première est la méthode des indices de concentration. La seconde est la méthode de décomposition des inégalités par fonction d’influence recentrée qui estime des effets marginaux en tenant compte des caractéristiques des individus. Le forfait obstétrical permet aux femmes enceintes d’accéder à des soins de meilleure qualité et contribue à la réduction des inégalités d’accès.
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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.


  • 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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  • Meyer Jean-Baptiste, Pilon Marc et Ravalihasy Andrainolo (2020) Les effectifs étudiants en Afrique au XXIe siècle : évolution passée et exercice de prospective, Working Papers du CEPED (48), Paris : Ceped, 31 p. https://www.ceped.org/wp.
    Résumé : L’enseignement supérieur africain reste peu développé comparé aux autres régions du monde. Les taux d’inscription étudiante demeurent moins élevés, dans un contexte où la jeunesse du continent s’accroît considérablement et rapidement. Les objectifs du développement durable (ODD) des Nation unies ainsi que l’agenda 2063 de l’Union Africaine (UA) préconisent sans équi-voque une tendance à rattraper les niveaux mondiaux en la matière. Ce document de travail entend fournir des repères quanti-tatifs quant à ces développements escomptés. Il relève dans un premier temps les travaux analysant l’évolution quantitative de la population passant par l’enseignement supérieur, leurs méthodes, leurs conclusions et leurs anticipations. Puis l’analyse s’attache à décrire le contexte africain et le recueil de données le concernant. Enfin, des projections rigoureuses des effectifs étudiants sur les deux horizons (ODD et UA) sont établies.
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  • Pannetier Julie et Ravalihasy Andrainolo (2020) « Les femmes migrantes face aux violences sexuelles en France », The Conversation (mai 29). https://theconversation.com/les-femmes-migrantes-face-aux-violences-sexuelles-en-france-138896.
    Résumé : Les violences sexuelles envers les femmes immigrées sont fréquentes mais restent largement invisibles dans les statistiques publiques en Europe. Si l’opinion publique y a été sensibilisée dans les pays de transit comme en Libye, c’est beaucoup moins le cas lorsque ces violences ont lieu dans le pays de destination. Rappelons que les personnes originaires d’Afrique subsaharienne représentent 13 % des immigrés en France. Parmi ces personnes, la moitié sont des femmes. Même après la migration, les femmes sont confrontées à des contextes marqués par des insécurités multiples qui les exposent à des violences sexuelles, rarement documentées et analysées. Leurs effets sur la santé sont également peu étudiés.
    Mots-clés : ⛔ No DOI found.
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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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  • Ravit Marion, Ravalihasy Andrainolo, Audibert Martine, Ridde Valéry, Bonnet Emmanuel, Raffalli Bertille, Roy Flore-Apolline, N’Landu Anais et Dumont Alexandre (2020) « The impact of the obstetrical risk insurance scheme in Mauritania on maternal healthcare utilization: a propensity score matching analysis », Health Policy and Planning, 35 (4) (janvier 31). DOI : 10.1093/heapol/czz150. https://academic.oup.com/heapol/advance-article/doi/10.1093/heapol/czz150/5718854.
    Résumé : In Mauritania, obstetrical risk insurance (ORI) has been progressively implemented at the health district level since 2002 and was available in 25% of public healthcare facilities in 2015. The ORI scheme is based on pre-payment scheme principles and focuses on increasing the quality of and access to both maternal and perinatal healthcare. Compared with many community-based health insurance schemes, the ORI scheme is original because it is not based on risk pooling. For a pre-payment of 16–18 USD, women are covered during their pregnancy for antenatal care, skilled delivery, emergency obstetrical care [including caesarean section (C-section) and transfer] and a postnatal visit. The objective of this study is to evaluate the impact of ORI enrolment on maternal and child health services using data from the Multiple Indicator Cluster Survey (MICS) conducted in 2015. A total of 4172 women who delivered within the last 2 years before the interview were analysed. The effect of ORI enrolment on the outcomes was estimated using a propensity score matching estimation method. Fifty-eight per cent of the studied women were aware of ORI, and among these women, more than two-thirds were enrolled. ORI had a beneficial effect among the enrolled women by increasing the probability of having at least one prenatal visit by 13%, the probability of having four or more visits by 11% and the probability of giving birth at a healthcare facility by 15%. However, we found no effect on postnatal care (PNC), C-section rates or neonatal mortality. This study provides evidence that a voluntary pre-payment scheme focusing on pregnant women improves healthcare services utilization during pregnancy and delivery. However, no effect was found on PNC or neonatal mortality. Some efforts should be exerted to improve communication and accessibility to ORI. Maternal health, neonatal mortality, pre-payment scheme, universal health coverage, Mauritania, Sub-Saharan Africa Topic: pregnancycesarean sectionhealth care facilityinsurancemauritaniamotherspostnatal careobstetricsprenatal careneonatal mortalityhealth care usemalnutrition-inflammation-cachexia syndrome
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2019

  • 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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  • Pilecco Flávia Bulegon, Guillaume Agnès, Ravalihasy Andrainolo, Desgrées du Loû Annabel et the Parcours Study Group (2019) « Induced Abortion and Migration to Metropolitan Paris by Sub-Saharan African Women: The Role of Intendedness of Pregnancy », Journal of Immigrant and Minority Health, 22 (décembre 20), p. 682-690. DOI : 10.1007/s10903-019-00956-9. https://rdcu.be/b4SGo.
    Résumé : Migration can affect reproductive outcomes due to different socioeconomic and cultural contexts before and after migration, to changes in the affective and conjugal status of women and to their life conditions. The aim of this study is to investigate the association between international migration and abortion. The data came from a retrospective life-event survey from sub-Saharan African women living in Île-de-France. Differences in abortion distribution before and after migration were assessed using the Pearson chi-square test, and the association between the predictor and the outcome was investigated using Generalized Estimating Equations. A total of 363 women and 1377 pregnancies were investigated. Among these pregnancies, 15.6% that occurred before and 11.0% that occurred after migration was reported as ended in abortion (p = 0.011). The odds of reporting having had an abortion was lower after migration (OR 0.59, 95% CI 0.42-0.84), even after adjustment. However, after including intendedness of pregnancy in the model, this association lost its significance. The difference in induced abortion occurrence between before and after migration is almost entirely due to a change in the intendedness of pregnancy. Thus, socioeconomic and cultural issues have a greater weight in the decision to abort than the legal interdiction of this practice.
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  • 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.
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2018


  • Bédécarrats Florent, Amar Zakaria, Audibert Martine, Boillot François, Bonnet Emmanuel, Diarra Aissa, Dossa Inès, Dumont Alexandre, Fauveau Vincent, Arnaud Laurent, Philibert Aline, Raffalli Bertille, Ravalihasy Andrainolo, Ravit Marion, Ridde Valery et Vinard Philippe (2018) « Quelle couverture santé pour les femmes enceintes en Mauritanie ? », The Conversation, novembre 12. http://theconversation.com/quelle-couverture-sante-pour-les-femmes-enceintes-en-mauritanie-105407.
    Résumé : En Mauritanie, afin d’améliorer l’accès aux soins des femmes enceintes, un dispositif d’assurance volontaire ouvrant accès à divers services a été mis en place. Retour sur les premiers résultats.
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  • 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.


  • Pannetier Julie, Ravalihasy Andrainolo, Lydié Nathalie, Lert France et Desgrées du Loû Annabel (2018) « Protecting female migrants from forced sex and HIV infection », The Lancet Public Health, 3 (3) (mars), p. e112. DOI : 10.1016/S2468-2667(18)30027-6. http://linkinghub.elsevier.com/retrieve/pii/S2468266718300276.
    Résumé : While attracting international students is the declared objective of many countries of the global North, the regulation of movements of this migrant group does not escape the tensions that characterise policymaking on migration. This paper compares the evolution of student migration policies in three major European destinations - France, Spain and the UK - since the late 1990s. The aim is to evaluate whether policies in this area have converged or not, and the factors behind their evolution. Our findings suggest that despite common forces encouraging convergence, country-specific factors, such as countries' migration history and the political force in power, seem crucial in explaining important differences in actual policies across the three countries.
    Mots-clés : AFRIQUE SUBSAHARIENNE, EUROPE.
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  • Pannetier Julie, Ravalihasy Andrainolo, Lydié Nathalie, Lert France et Desgrées du Loû Annabel (2018) « Prevalence and circumstances of forced sex and post-migration HIV acquisition in sub-Saharan African migrant women in France: an analysis of the ANRS-PARCOURS retrospective population-based study », The Lancet Public Health, 3 (1) (janvier), p. e16-e23. DOI : 10.1016/S2468-2667(17)30211-6. http://linkinghub.elsevier.com/retrieve/pii/S2468266717302116.
    Résumé : Background : Sub-Saharan African migrant women are a key population at risk of HIV infection in Europe. Using data from the ANRS-PARCOURS study, we aimed to assess the prevalence of forced sex after migration and its association with post-migration acquisition of HIV as well as the circumstances of forced sex after migration, including housing and administrative insecurity, among sub-Saharan African migrant women living in the Paris Region, France. Methods The ANRS-PARCOURS study was a retrospective life-event survey done between February, 2012, and May, 2013, in health-care facilities in the Paris region of France. Women were eligible if they were born in sub-Saharan Africa, aged between 18 and 59 years, and had been diagnosed with HIV infection at least 3 months earlier for women receiving HIV care or not diagnosed with HIV. In this analysis, we used ANRS-PARCOURS study data to compare the incidence of forced sex after migration in three groups of sub-Saharan African migrant women: those who acquired HIV after migrating, those who acquired HIV before migrating, and those without HIV. We assessed the associations between forced sex, sexual partnerships, and living conditions after migration with mixed-effects logistic regression and generalised structural equation models. The study is registered with ClinicalTrials.gov, number NCT02566148. Findings We obtained data from 980 eligible individuals who participated in the ANRS-PARCOURS study (407 without HIV and 573 HIV-positive) from 54 randomly selected health-care facilities. We excluded 20 women whose HIV infection could not be dated and eight women with missing data from the analyses, for a total of 405 women in the reference group (without HIV) and 547 women in the HIV group (156 with post-migration HIV acquisition, 391 with pre-migration HIV). Women who acquired HIV after migration experienced forced sex after migration more frequently than women without HIV (24 [15%] vs 18 [4%]; p=0.001). Forced sex after migration was associated with being hosted by family or friends (beta=0.95, 95% CI 0.19-1.72) and lack of stable housing (beta=1.10, 0.17-2.03). Lack of a residence permit was also associated with forced sex after migration. Interpretation The social hardships faced by sub-Saharan African migrant women after migration, especially a lack of housing or lack of a residence permit, increases their exposure to sexual violence and to HIV infection.
    Mots-clés : AFRIQUE SUBSAHARIENNE, FRANCE.
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  • 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.
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  • 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
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  • 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.
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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).
  • Desgrées du Loû Annabel, Ravalihasy Andrainolo et Pannetier Julie (2017) « Des situations de précarité qui exposent aux risques sexuels et au VIH », 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. 139-159. (Recherches).
  • Pannetier Julie, Desgrées du Loû Annabel et Ravalihasy Andrainolo (2017) « Violences sexuelles : place dans le parcours de vie et relation avec le risque d’infection VIH en France », 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. 160-172. (Recherches).
  • Ravalihasy Andrainolo, Lert France et Vignier Nicolas (2017) « Santé, besoins de prévention et de soins », 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. 265-286. (Recherches).

  • 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.
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  • Pilecco Flavia B., Ravalihasy Andrainolo, Guillaume Agnès, Desgrées du Lou Annabel et PARCOURS Study Group (2017) « Induced abortion, migration and HIV: an analysis of migrants from sub-Saharan Africa living in Île-de-France » (poster (A-854-0192-01326), présenté à 9th IAS Conference on HIV Science (IAS 2017), Paris. http://programme.ias2017.org/.


  • Vignier Nicolas, Dray-Spira Rosemary, Lert France, Pannetier Julie, Ravalihasy Andrainolo, Gosselin Anne, Lydié Nathalie, Bouchaud Olivier, Desgrées du Loû Annabel et Grp Anrs-Parcours (2017) « Accès aux soins des personnes originaires d'Afrique subsaharienne vivant avec une hépatite B chronique = Health care access of Sub-Saharan African migrants living with chronic hepatitis B », Santé Publique, 3 (29), p. 361-370. DOI : 10.3917/spub.173.0361. https://www-cairn-info.frodon.univ-paris5.fr/revue-sante-publique-2017-3-page-361.htm.
    Résumé : Objective: The objective of this study was to analyse health care access of Sub-Saharan African migrants living with chronic hepatitis B (CHB) in France. Methods: The ANRS-Parcours survey was a life-event survey conducted in 2012-2013 among Sub-Saharan African migrants recruited by health care facilities managing CHB in the Paris region. Data were collected by face-to-face interview using a biographical grid and a standardized questionnaire. Results: 96.4% of the 619 participants basic health insurance coverage with CMU universal health insurance coverage in 18.6% of cases and AME state medical assistance in 23.4% of cases. One-third of basic health insurance beneficiaries did not have any complementary health insurance and 75.7% had long-term disease status. The median time to acquisition of health insurance cover after arrival in France was one year. 22.0% of participants reported delaying health care for financial reasons since their arrival in France and 9.7% reported being refused health care usually due to refusal of CMU or AME. Health care access was effective within one year of the diagnosis. Delayed health care access was more common among people without health insurance coverage in the year of diagnosis. Patients lost to follow-up for more than 12 months were rare. Conclusion: Sub-Saharan African migrants living with chronic hepatitis B rapidly access health insurance coverage and health care. However, barriers to health care access persist for some people, essentially due to absent or incomplete health insurance cover and refusal of care for AME or CMU beneficiaries.
    Mots-clés : AFRIQUE SUBSAHARIENNE, France, Health Care Quality, Access, and Evaluation, Health insurance coverage, Hepatitis B, migrants, sub-Saharan Africa.
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2016


  • Desgrées du Loû Annabel, Pannetier Julie, Ravalihasy Andrainolo, Gosselin Anne, Le Guen Mireille, Panjo Henri, Bajos Nathalie, Lydié Nathalie, Lert France et Dray-Spira Rosemary (2016) « La précarité augmente le risque d’infection VIH en France chez les migrants subsahariens. Résultats de l’étude ANRS- PARCOURS 2012-2013 » (Communication orale ( AFRAVIH2016 - 1046- S8.02), présenté à 8e Conférence Internationale Francophone VIH/Hépatites - AFRAVIH 2016, Bruxelles, Belgique. https://youtu.be/RKid6Hw7bm4?t=330.
    Résumé : En Europe, les migrants sub-sahariens sont le deuxième groupe le plus touché par le VIH, en partie parce qu’ils ont pu être infectés dans leurs pays d’origine, mais aussi du fait d’infections survenues dans le pays d’arrivée. En France, on estime que 30% des femmes et 44% des hommes nés en Afrique sub-saharienne et suivis pour un VIH ont été infectés après l’arrivée. Cependant les déterminants de l’acquisition après la migration sont mal connus.
    Mots-clés : ⛔ No DOI found.
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  • Desgrées du Loû Annabel, Pannetier Julie, Ravalihasy Andrainolo, Gosselin Anne, Le Guen Mireille, Panjo Henri, Bajos Nathalie, Lydié Nathalie, Lert France et Dray-Spira Rosemary (2016) « Hardships increase HIV infection risk among sub-Saharan migrants living in France. Results from the ANRS- PARCOURS study 2012-2013 » (Communication orale), présenté à EUPHA’s 6th European Conference on Migrant and Ethnic Minority Health, Oslo, Norvège.


  • Desgrées du Loû Annabel, Pannetier Julie, Ravalihasy Andrainolo, Le Guen Mireille, Gosselin Anne, Panjo Henri, Bajos Nathalie, Lydie Nathalie, Lert France et Dray-Spira Rosemary (2016) « Is hardship during migration a determinant of HIV infection? Results from the ANRS PARCOURS study of sub-Saharan African migrants in France: », AIDS, 30 (4), p. 645-656. DOI : 10.1097/QAD.0000000000000957. http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00002030-201602200-00013.
    Résumé : {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.
    Pièce jointe Desgrées du Loû et al. - 2016 - Is hardship during migration a determinant of HIV .pdf 196.3 kio
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  • Gosselin Anne, Ravalihasy Andrainolo, Lelièvre Eva, Lydié Nathalie, Lert France, Dray-Spira Rosemary et Desgrées du Loû Annabel (2016) « Migration and HIV/Aids: a double penalty? Impacts of migration and diagnosis on Sub-Saharan migrant women’ living conditions in France » (Poster), présenté à EUPHA’s 6th European Conference on Migrant and Ethnic Minority Health, Oslo, Norvège.

  • Gosselin Anne, Ravalihasy Andrainolo, Lelièvre Eva, Lydié Nathalie, Lert France, Dray-Spira Rosemary, Desgrées du Loû Annabel et Group PARCOURS Study (2016) « Migration et VIH : une double peine ? Impacts de la migration et du diagnostic sur les conditions de vie des femmes migrantes d’Afrique subsaharienne en France » (Communication orale ( AFRAVIH2016 - 1349), présenté à 8e Conférence Internationale Francophone VIH/Hépatites - AFRAVIH 2016, Bruxelles, Belgique. https://www.youtube.com/watch?v=3ZxlZCt-C1c.
    Résumé : Les femmes migrantes d’Afrique subsaharienne sont le deuxième groupe le plus touché par le VIH/sida en France. A l’heure où le débat est engagé en Europe sur les conditions d’accueil des migrants et sur l’impact de la migration sur les vies des personnes, nous mesurons les impacts respectifs de la migration et du diagnostic VIH sur les difficultés que ces femmes, soumises ainsi à une « double peine », peuvent rencontrer en France.
    Mots-clés : ⛔ No DOI found.
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  • Pannetier Julie, Ravalihasy Andrainolo, Le Guen Mireille, Gosselin Anne, Bajos Nathalie, Lydié Nathalie, Lert France, Dray-Spira Rosemary et Desgrées Du Loû Annabel (2016) « Forced sex, migration and HIV infection among women from sub-Saharan Africa living in France: Results from the ANRS PARCOURS study » (communication orale), présenté à 21st International AIDS Conference (AIDS 2016), Durban, South Africa. http://programme.aids2016.org/Programme/Session/126.

  • Pilecco Flavia B., Guillaume Agnès, Ravalihasy Andrainolo, Lert France, Bajos Nathalie, Lydie Nathalie, Dray-Spira Rosemary et Desgrées du Lou Annabel (2016) « HIV, hepatitis B and abortion among migrants from sub-Saharan Africa living in Île-de-France » (Communication orale (abstract p.136), présenté à 6th European Conference on Migrant and Ethnic Minority Health, Oslo, Norvège. http://eupha-migranthealthconference.com/wp-content/uploads/2016/06/abstract-book-eupha2016.pdf.

  • Pilecco Flavia B., Ravalihasy Andrainolo, Guillaume Agnès, Lert France, Bajos Nathalie, Lydié Nathalie, Dray-Spira Rosemary et Desgrées du Loû Annabel (2016) « VIH, hépatite B et avortement chez les migrantes d'Afrique subsaharienne vivant en Île-de-France: l'étude ANRS PARCOURS » (Communication orale ( AFRAVIH2016 - 1345), présenté à 8e Conférence Internationale Francophone VIH/Hépatites - AFRAVIH 2016, Bruxelles, Belgique. http://www.afravih2016.org/.
    Résumé : Les maladies chroniques telles que le VIH et l'hépatite B chronique (VHB) affectent fortement les migrants d'Afrique subsaharienne vivant en France. Ces maladies peuvent avoir un impact sur les décisions en matière de reproduction, en raison de la peur de transmettre le virus à l'enfant et de ne pas vivre assez longtemps pour grandir cet enfant. Cette étude a pour objectif d’estimer la prévalence d’une interruption volontaire de la grossesse (IVG) après l’arrivée en France et d'évaluer son association avec ces maladies chroniques chez les femmes migrantes d'Afrique sub-saharienne vivant en Île-de-France.
    Mots-clés : ⛔ No DOI found.
    Pièce jointe poster_flavia_bp_afravih v.3.pdf 669.1 kio
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  • Pilecco Flavia B., Ravalihasy Andrainolo, Guillaume Agnès, Lert France, Pannetier Julie et Desgrées du Lou Annabel (2016) « Aborto Induzido na Trajetória Migratória de Migrantes da África Subsaariana Vivendo em Île-de-France » (Communication orale (abstract p. 266), présenté à VII Congresso Brasileiro de Ciências Sociais e Humanas em Saúde, Cuiabá. http://cshs.com.br/Anais7CBCSS16.pdf.

  • Ravalihasy Andrainolo, Desgrées du Loû Annabel, Pannetier Julie, Vignier Nicolas, Lert France, Dray-Spira Rosemary, Lydié Nathalie et Groupe Parcours (2016) La consommation d’alcool chez les migrants originaires d’Afrique subsaharienne en France /// Andrainolo Ravalihasy, Annabel Desgrées du Loû, Julie Pannetier, Nicolas Vignier, France Lert, Rosemary Dray-Spira, Nathalie Lydié pour le groupe PARCOURS, Working Papers du CEPED (35), Paris : CEPED, 26 p. http://www.ceped.org/wp.
    Résumé : La migration peut engendrer différentes situations de vulnérabilité et de précarités sociales et économiques. Si les migrants subsahariens viennent de pays où la consommation d’alcool est moins fréquente qu’en France, les difficultés sociales rencontrées à l’arrivée peuvent s’accompagner d’une consommation d’alcool à risque. Parallèlement, les migrants subsahariens vivant en France constituent une population à risque en ce qui concerne l’infection à VIH et au virus de l’hépatite B, maladies pour lesquelles la consommation abusive d’alcool peut compliquer la prise en charge médicale. Il est donc nécessaire de mieux connaître la consommation d’alcool et les déterminants de cette consommation chez ces migrants. Nous proposons de décrire la consommation d’alcool et en analyser les déterminants chez les migrants subsaha-riens vivants en Île-de-France, à partir de l’enquête ANRS-PARCOURS menée en 2012-2013 en Île-de-France. Cette enquête a permis de mesurer la consommation d’alcool au moment de l’enquête chez des migrants subsahariens suivis pour une infection à VIH ou une hépatite B chronique, ou n’ayant aucune de ces deux maladies, mais également de recueillir des informations sur leur parcours migratoire et leur situation sociale en France. Notre analyse montre que la consommation d’alcool et la consommation à risque d’alcool sont présentes au sein de cette population même si elles sont moins fréquentes comparées à ce qu’on observe dans la population générale française. Ces modes de consommation sont associées à certaines situations de vulnérabilité engendrées par le parcours migratoire.
    Pièce jointe wp35.pdf 937.6 kio
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