@article{fdi:010073916,
  title = {{R}enunciation of health care by people living with {HIV} in {F}rance is still associated with discrimination in health-care services and social insecurity : results from the {ANRS}-{VESPA}2 survey},
  author = {{F}iorentino, {M}arion and {S}uzan-{M}onti, {M}. and {V}ilotitch, {A}. and {S}agaon {T}eyssier, {L}uis and {D}ray-{S}pira, {R}. and {L}ert, {F}. and {S}pire, {B}. and {ANRS}-{VESPA}2 {S}tudy {G}roup},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {T}his study aimed to estimate the frequency of renunciation of health care among people living with {HIV} ({PLHIV}) in {F}rance, including health care unrelated to {HIV}, and to characterize associated socioeconomic and psychosocial risk factors.{M}ethods: {T}he cross-sectional {ANRS}-{VESPA}2 survey was conducted on adult {PLHIV} attending {F}rench hospitals in 2011. {C}orrelates of health-care renunciation in the 12 months before the survey were assessed through logistic modelling. {R}esults: {A}mong the 3,020 {PLHIV} included in the sample, 17% declared health-care renunciation during the preceding year and 42% had a high level of social insecurity. {D}uring the previous 2 years, 8% and 11%, respectively, were discriminated against by medical staff and family. {I}n multivariate analysis, positive associations were found between health-care renunciation and a high level of social insecurity (adjusted odds ratio [95% {CI}] 3.44 [2.54, 4.65]; {P}<0.001), having children (1.52 [1.10, 2.10]; {P}=0.01), smoking tobacco (1.50 [1.13, 1.98]; {P}=0.01), discrimination by medical staff (1.53 [1.22, 2.29]; {P}=0.04) or family (2.48 [1.75, 3.52]; {P}<0.001), major depressive episodes (1.46 [1.02, 2.09]; {P}=0.04), past or current drug injection (1.54 [1.03, 2.30]; {P}=0.04), and younger age (0.98 [0.97, 1.00]; {P}=0.03). {H}ealth-care renunciation was also negatively associated with {HIV} diagnosis after 1996 (1996–2002: 0.64 [0.46, 0.90]; {P}=0.01; ≥2003: 0.56 [0.40, 0.77]; {P}=0.001). {C}onclusions: {I}n spite of universal health insurance in {F}rance, barrier - and refusal-renunciation of health care by {PLHIV} remain frequent. {P}oor psychosocial outcomes and discrimination by families and health-care providers compound the negative effect of social insecurity on health-care seeking in this population. {T}o ensure optimal medical care, strategies are needed to prevent discrimination against {PLHIV} in health-care services. {S}pecial attention must be provided to patients experiencing social insecurity.},
  keywords = {{SIDA} ; {SANTE} {PUBLIQUE} ; {PROTECTION} {SOCIALE} ; {SYSTEME} {DE} {SANTE} ; {ANTHROPOLOGIE} {DE} {LA} {SANTE} ; {ENQUETE} ; {ACCES} {AUX} {SOINS} ; {DISCRIMINATION} {SOCIALE} ; {FRANCE}},
  booktitle = {},
  journal = {{A}ntiviral {T}herapy},
  volume = {23},
  numero = {},
  pages = {443--450},
  ISSN = {1359-6535},
  year = {2018},
  DOI = {10.3851/{IMP}3220},
  URL = {https://www.documentation.ird.fr/hor/fdi:010073916},
}