@article{fdi:010066175,
  title = {{I}s hardship during migration a determinant of {HIV} infection ? : results from the {ANRS} {PARCOURS} study of sub-{S}aharan {A}frican migrants in {F}rance},
  author = {{D}esgr{\'e}es du {L}oû, {A}nnabel and {P}annetier, {J}. and {R}avalihasy, {A}ndrainolo and {L}e {G}uen, {M}. and {G}osselin, {A}. and {P}anjo, {H}. and {B}ajos, {N}. and {L}ydie, {N}. and {L}ert, {F}. and {D}ray-{S}pira, {R}.},
  editor = {},
  language = {{ENG}},
  abstract = {{O}bjectives:{I}n {E}urope, sub-{S}aharan {A}frican migrants are a key population for {HIV} infection. {W}e analyse how social hardships during settlement in {F}rance shape sexual partnerships and {HIV} risk.{D}esign:{PARCOURS} is a life-event survey conducted in 2012-2013 in 74 health-care facilities in the {P}aris region, among three groups of sub-{S}aharan migrants: 926 receiving {HIV} care (296 acquired {HIV} in {F}rance), 779 with chronic hepatitis {B}, and 763 with neither {HIV} nor hepatitis {B} (reference group).{M}ethods:{H}ardships (lack of residence permit, economic resources and housing) and sexual partnerships were documented for each year since arrival in {F}rance. {F}or each sex, reported sexual partnerships were compared by group and their associations with hardships each year analysed with mixed-effects logistic regression models.{R}esults:{H}ardships were frequent: more than 40% had lived a year or longer without a residence permit, and more than 20% without stable housing. {M}ost of the migrants had nonstable and concurrent partnerships, more frequent among those who acquired {HIV} in {F}rance 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). {H}ardship 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)]. {S}ame trends were observed for lacking stable housing [{OR}=3.71(2.75-5.00) and {OR}=10.58 (4.68-23.93)].{C}onclusion:{H}ardships faced by migrants increase {HIV} risks. {W}omen, especially during the period without stable housing, appear especially vulnerable.},
  keywords = {{A}frican migrants ; {F}rance ; hardship ; hepatitis {B} ; {HIV} acquisition ; sexual risk ; {AFRIQUE} {SUBSAHARIENNE} ; {FRANCE}},
  booktitle = {},
  journal = {{A}ids},
  volume = {30},
  numero = {4},
  pages = {645--656},
  ISSN = {0269-9370},
  year = {2016},
  DOI = {10.1097/qad.0000000000000957},
  URL = {https://www.documentation.ird.fr/hor/fdi:010066175},
}