@article{fdi:010087600,
  title = {{C}umulative incidence of {SARS}-{C}o{V}-2 infection within the homeless population : insights from a city-wide longitudinal study},
  author = {{M}osnier, {E}. and {L}oubiere, {S}. and {M}onfardini, {E}. and {A}libert, {A}. and {L}andier, {J}ordi and {N}inoves, {L}. and {B}osetti, {T}. and {A}uquier, {P}. and {M}osnier, {M}. and {W}akap, {S}. {N}. and {W}arszawski, {J}. and {T}inland, {A}.},
  editor = {},
  language = {{ENG}},
  abstract = {{O}bjectives {T}he aim of this study was to determine the risk factors associated with {SARS}-{C}o{V}-2 infection in a cohort of homeless people using survival analysis. {S}eroprevalence in the homeless community was also compared with that of the general population.{D}esign {C}ohort study.{S}etting {D}ata were collected across two testing sessions, 3 months apart, during which each participant was tested for anti-{SARS}-{C}o{V}-2 antibodies and completed a face-to-face survey.{P}articipants {A}ll homeless adults sleeping rough, in slums or squats, in emergency shelters or transitional accommodation in {M}arseille were eligible.{P}rimary outcome measures {O}ccurrence of a seroconversion event defined as a biologically confirmed {SARS}-{C}o{V}-2 infection. {L}ocal data from a national seroprevalence survey were used for comparison between homeless people and the general population.{R}esults {A} total of 1249 people were included. {SARS}-{C}o{V}-2 seroprevalence increased from 6.0% (4.7-7.3) during the first session to 18.9% (16.0-21.7) during the second one, compared with 3.0% (1.9-4.2) and 6.5% (4.5-8.7) in the general population. {F}actors significantly associated with an increased risk of {COVID}-19 infection were: having stayed in emergency shelters (1.93 (1.18-3.15)), being an isolated parent (1.64 (1.07-2.52)) and having contact with more than 5-15 people per day (1.84 (1.27-2.67)). {B}y contrast, smoking (0.46 (0.32-0.65)), having financial resources (0.70 (0.51-0.97)) and psychiatric or addictive comorbidities (0.52 (0.32-0.85)) were associated with a lower risk.{C}onclusion {W}e confirm that homeless people have higher infection rates than the general population, with increased risk in emergency shelters. {T}here is growing evidence that, in addition to usual preventive measures, public policies should pay attention to adapt the type of accommodation and overall approach of precariousness.},
  keywords = {{EPIDEMIOLOGY} ; {P}ublic health ; {COVID}-19 ; {FRANCE}},
  booktitle = {},
  journal = {{BMJ} {O}pen},
  volume = {13},
  numero = {2},
  pages = {[11 p.]},
  ISSN = {2044-6055},
  year = {2023},
  DOI = {10.1136/bmjopen-2022-065734},
  URL = {https://www.documentation.ird.fr/hor/fdi:010087600},
}