Vignier N. auteur aut IRD Desgrées du Loû Annabel auteur aut IRD Pannetier J. auteur aut IRD Ravalihasy Andrainolo auteur aut IRD Gosselin A. auteur aut IRD Lert F. auteur aut IRD Lydie N. auteur aut IRD Bouchaud O. auteur aut IRD Spira R. D. auteur aut IRD Parcours Study Group auteur aut IRD text journalArticle eng text/pdf reformatted digital access 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. specialized AFRIQUE SUBSAHARIENNE FRANCE 056 108 13 2 e0192916 [18 ] 2018 1932-6203 https://www.documentation.ird.fr/hor/fdi:010072439 10.1371/journal.pone.0192916 1932-6203 [F B010072439] https://www.documentation.ird.fr/hor/fdi:010072439 https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers18-03/010072439.pdf IRD - Base Horizon / Pleins textes 2018-04-03 2023-07-11 fdi:010072439 fre