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

Annabel Desgrees-du-Lou; Julie Pannetier; Andrainolo Ravalihasy; Mireille Le Guen; Anne Gosselin; Henri Panjo; Nathalie Bajos; Nathalie Lydie; France Lert; Rosemary Dray-Spira; PARCOURS Study Group

doi:10.1097/QAD.0000000000000957

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

AIDS. 2016 Feb 20;30(4):645-56. doi: 10.1097/QAD.0000000000000957.

Authors

Annabel Desgrees-du-Lou¹, Julie Pannetier, Andrainolo Ravalihasy, Mireille Le Guen, Anne Gosselin, Henri Panjo, Nathalie Bajos, Nathalie Lydie, France Lert, Rosemary Dray-Spira; PARCOURS Study Group

Collaborators

PARCOURS Study Group:
I Delacroix, B El Harrar, V Garrait, L Richier, K Bourdic, M Duracinski, C Goujard, Y Quertainmont, D Peretti, M A Khuong, J Krause, M Poupard, B Taverne, G Tran Van, A Adda Lievin, P Bonnard, H Cordel, M G Lebrette, F X Lescure, P Thibault, N Velazquez, J P Vincensini, J F Bergmann, E Badsi, J Cervoni, M Diemer, A Durel, P Sellier, M Bendenoun, J D Magnier, E Bui, J Tredup, P Campa, N Desplanque, M Sebire, D Ponscarme, N Colin de Verdière, V de Lastours, J Gouguel, C Gatey, C Lascoux-Combe, V Garrait, F Taieb, N De Castro, L Gérard, G Pahlavan, B Phung, F L'Heriteau, A Dia, A Lepretre, G Morau, C Rioux, V Joly, Y Yazdanpanah, S Legac, L Blum, M Deschaud, M Buisson, P Kousignian, C Minozzi, M Karmochkine, D Batisse, J Pavie, M Eliaczewicz, L Weiss, G Gonzalez, P Castiel, I Pierre, M Beumont, D Jayle, J Derouinau, M Manea, E Bourzam, S Abgral, S Mattioni, R Barruet, N Sayre, O Bouchaud, M Tatay, M Gousseff, F Mechai, T Kandel, P Honoré, M Coupard, F Bani-Sadr, L Belarbi, G Spiridon, T Tahi, H Mehawej, D Salmon, B Silbermann, A Calboreanu, P Loulergue, H Bouchez, V Le Baut, M P Pietri, D Trois-Vallets, V Favret, J P Viard, A Sobel, J Gilquin, A Cros, A Maignan, Y Welker, H Masson, B Montoya, J L Ecobichon, E Froguel, P Simon, M S Nguessan, S Tassi, A Devidas, L Gerard, H Touahri, J L Delassus, M A Bouldouyre, V Favret, C Winter, S Pelletier, M C Samba, S Herson, A Simon, M Bonmarchand, N Amirat, N Smail, S Seang, H Stitou, L Schneider, R Tubiana, L Epelboin, M A Valantin, C Katlama, S Ben Abdallah, P Bourse, Y Dudoit, C Blanc, C Charlier-Woerther, O Lortholary, P H Consigny, A Gergely, M Shoai-Tehrani, G Cessot, C Duvivier, F Touam, K Benhadj, H Ait Mohand, E Klement, P Chardon, A Pumpo, T Asselah, N Guilly, N Boyer, F Mouri, C Castelnaud, M Pouteau, T Poynard, Y Benhamou, G Bonyhay, P Lebray, J Massard, J Moussali, V Ratziu, M Rudler, D Thabut, R Pais, E Luckina, A Simon, M C Samba, S Pelletier, N Smail, J C Duclos Vallée, D Samuel, A Coilly, F Roudot-Thoraval, C Hezode, E Lopes, V Bourcier, N Ganne, P Nahon, J Cohelo, J C Trinchet, G Gnkontchou, V Grando, S Brulé, P Sogni, H Fontaine, V Mallet, S Tripon, A Vallet Pichard, S Pol, M Corouge, M Benazra, A Noble, L Bousquet, D Mohand, L Serfaty, N Carbonell, C Corpechot, M Lequoy, H Mathiex-Fortunet, A Pascale, O Rosmorduc, O Chazouillères, S Mezhoud, T Andreani, H Regnault, A Poujol-Robert, F Benjelloun, S Levy, D Roulot, U Warzocha, C Cambonie, O Bouchaud, F Mechai, M Goussef, N Vignier, T Kandel, P Honore, F Harnois, G Macaigne, K Fernandes, J F Bergmann, P Sellier, M Bendenoun, J D Magnier, V Ozenne, D Ancel, I Popa-Gregoriou, F Amiot, A Garioud, J D Grangé, D Chaslin-Ferbus, S Gil-Diez, P Bonnard, M G Lebrette, H Cordel, F X Lescure, J P Vincensini, A Adda Lievin, P Thibault, N Velazquez, S Barge, I Rosa, L Costes, L Richier, A Seif, C Chandemerle, M Lalande, T Mazars, J P Aubert, O Taulera, I Alix, F Fleury, O Lefebvre, P Revault, M Petruzzi, C Menard, J J Bourcart, C Georges, M Andlauer, Y Girardeau, F Tapié de Celeyran, P Bordon, N Dardel, D Levy, O Taulera, M L Pintir Rageau, S Dehaudt, C Aparicio, U Loeung, C Toussaint, V Vasseur, A Andel, O Cha, P Xu, V Sivalingam, I Hiesse, S Ouaret, L Zahzam, E Bui, E Baut, M A Temple, A Gillet, C Leata, J Legoff, F Jardin, E Jean Baptiste, E Corp, J Nau, B Chatelin, P Weeger, N Hervier, L Lacroze, L Ballonard, A Seif, I Alix, F Fleury, O Lefebvre, P Revault, M Petruzzi, C Menard, Y Chahan, J Prost, D Spindler, L Rodin Zita, Nguyen, K Dambielle, P Bourlier, P Zaidi, F Block, N Bessah, G Barbier, G Pilorget, N Touazi, F Rouges, C Chalal, L Cavanna, A Sabah, M C Charansonnet, G Ibanez, M Lesourd, M Orbach-Roulière, J P Vilanova, M Smadja, E Rozenkier, C Vincent, V Bontemps, A Ngaleu, F Bensidhoum, J A Dolidier, M Gharmaoui, B Hubert-Andreani, V Vinçon, K Royer, S Vernerey-Martin, C Meunier, S Djouhri, V Ngadjeu, F Villebrun, D Soletchnik, M Deroche, S Henry, M Geminel, C Tison, M Dupuy, E Balgone, M Esteve, C Terra, Charles, L Rossignol, C Bismuth, G Gillemot, M Vanbana, M Djouab, G Lyon, F Ogier, J Gelly, P Vidigal, A Gibier, A Simonnet-Richard, C Alvarez-Malgras, C Dufresne, B Huault, I Cornuche, H Touitou, S D'Epiro, F Michard, N Guesnier, F Siecat, N Pinard, H Gaborieau, A Beaupin, G Albouy, C Besacier, A Soares, J Le Breton

Affiliation

¹ aIRD bCEPED, UMR 196 Université Paris Descartes-IRD, Sorbonne Paris Cités, Paris cINSERM, CESP-U 1018, Villejuif dINPES, Saint-Denis eSorbonne Universités, UPMC Univ Paris 06, Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France.

Abstract

Objectives: In Europe, sub-Saharan African migrants are a key population for HIV infection. We analyse how social hardships during settlement in France shape sexual partnerships and HIV risk.

Design: PARCOURS is a life-event survey conducted in 2012-2013 in 74 health-care facilities in the Paris region, among three groups of sub-Saharan migrants: 926 receiving HIV care (296 acquired HIV in France), 779 with chronic hepatitis B, and 763 with neither HIV nor hepatitis B (reference group).

Methods: Hardships (lack of residence permit, economic resources and housing) and sexual partnerships were documented for each year since arrival in France. For each sex, reported sexual partnerships were compared by group and their associations with hardships each year analysed with mixed-effects logistic regression models.

Results: Hardships were frequent: more than 40% had lived a year or longer without a residence permit, and more than 20% without stable housing. Most of the migrants had nonstable and concurrent partnerships, more frequent among those who acquired HIV in France compared with reference group, as were casual partnerships among men (76.7 vs. 54.2%; P = 0.004) and women (52.4 vs. 30.5%; P = 0.02), concurrent partnerships among men (69.9 vs. 45.8%; P = 0.02), and transactional partnerships among women (8.6 vs. 2.3%; P = 0.006). Hardship increased risky behaviours: in women, lacking a residence permit increased casual and transactional partnerships [resp. odds ratio (OR) = 2.01(1.48-2.72) and OR = 6.27(2.25-17.44)]. Same trends were observed for lacking stable housing [OR = 3.71(2.75-5.00) and OR = 10.58 (4.68-23.93)].

Conclusion: Hardships faced by migrants increase HIV risks. Women, especially during the period without stable housing, appear especially vulnerable.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Disease Transmission, Infectious*
Female
HIV Infections / epidemiology*
HIV Infections / transmission*
Humans
Male
Middle Aged
Paris
Retrospective Studies
Sexual Behavior
Social Isolation / psychology*
Socioeconomic Factors
Transients and Migrants*
Young Adult