%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Gosselin, A.
%A Ravalihasy, Andrainolo
%A Pannetier, J.
%A Lert, F.
%A Desgrées du Loû, Annabel
%A PARCOURS Study Group
%T When and why ? : timing of post-migration HIV acquisition among sub-Saharan migrants in France
%D 2020
%L fdi:010079084
%G ENG
%J Sexually Transmitted Infections
%@ 1368-4973
%K life-event history survey ; sub-saharan africa ; france ; prevention
%K FRANCE ; AFRIQUE SUBSAHARIENNE
%M ISI:000531402400013
%N 3
%P 227-231
%R 10.1136/sextrans-2019-054080
%U https://www.documentation.ird.fr/hor/fdi:010079084
%> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers20-05/010079084.pdf
%V 96
%W Horizon (IRD)
%X 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.
%$ 052 ; 108