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Shobowale O, Schmidt AJ, Meireles P, Rojas Castro D, Detandt S, Stutterheim SE, Weatherburn P, Jonas KJ. Determinants of HIV Testing Among Migrant Men Who Have Sex With Men from Sub-Saharan Africa and Other Regions Residing in 10 European Countries. AIDS Behav 2024; 28:488-506. [PMID: 38326669 PMCID: PMC10876736 DOI: 10.1007/s10461-023-04239-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 02/09/2024]
Abstract
Migrant men who have sex with men (mMSM) from sub-Saharan Africa (SSA) and other regions outside Europe are highly vulnerable to HIV. However, research on the determinants of HIV testing among mMSM from SSA, and how these differ across the categories of mMSM living in Europe, is limited. Using data from the European MSM Internet Survey (EMIS-2017), we assessed HIV testing prevalence and recency in mMSM from SSA and other mMSM residing in ten European countries, as well as the determinants of HIV testing across different mMSM categories with logistic regression analyses. Ever-testing for HIV was slightly higher in mMSM from SSA (83%) compared to other mMSM categories (75-80%), except for mMSM from Latin America and Caribbean region (84%). Overall, 20% of mMSM had never tested. In multivariable analysis, higher age (adjusted odds ratio [AOR] 1.05, 95% confidence interval [CI] 1.01-1.10), higher HIV knowledge (AOR 1.45, 95%-CI 1.11-1.90), and residence in smaller settlements (AOR 0.45, 95%-CI 0.21-0.96) were significantly associated with ever testing for HIV in mMSM from SSA. Comparing mMSM from SSA to mMSM from other regions, we found varying significant similarities (higher age, residence in smaller settlements and HIV knowledge) and differences (lower educational attainment, not identifying as gay, being a student, and limited disclosure of homosexual attraction) in the determinants of ever-testing for HIV. Community-specific interventions addressing identified sociodemographic and behavioral determinants to increase HIV testing uptake in the different mMSM categories and better data for further research are warranted.
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Affiliation(s)
- Oladipupo Shobowale
- Department of Work and Social Psychology, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands.
| | - Axel J Schmidt
- London School of Hygiene & Tropical Medicine (LSHTM), Sigma Research, London, UK
| | - Paula Meireles
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | | | - Sandrine Detandt
- Faculty of Psychology, Observatoire du Sida et des Sexualités Research Center, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Sarah E Stutterheim
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Peter Weatherburn
- London School of Hygiene & Tropical Medicine (LSHTM), Sigma Research, London, UK
| | - Kai J Jonas
- Department of Work and Social Psychology, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands
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Poncet L, Panjo H, Ringa V, Andro A. Do vulnerable groups access prevention services? Cervical cancer screening and HIV testing among homeless migrant women in the Paris metropolitan area. PLoS One 2021; 16:e0255900. [PMID: 34388200 PMCID: PMC8363022 DOI: 10.1371/journal.pone.0255900] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 07/26/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Homeless migrant women, facing adverse living conditions and barriers to legal status, are at risk of cervical cancer, HIV infection and may encounter barriers to screening services. We investigate factors associated with each screening in a population of migrant women in France and aim to determine the mean time since last HIV testing according to duration of residence in France. METHODS We use data from the DSAFHIR study (Rights and Health of Migrant Women in Emergency Housing) investigating health and migration experience of homeless migrant women housed in emergency housing hotels in the Paris Metropolitan area in 2017. We computed multivariate logistic regression models to investigate no lifetime cervical cancer screening (CCS) and no lifetime HIV test. We used linear regression models to analyze time since last HIV test. RESULTS We included 469 women. 46% of respondents had no lifetime CCS, 31% had no lifetime HIV test. Both screenings were associated with educational attainment and French proficiency. Compared with duration of residence < 1 year, duration ≥ 7 years was associated with a lower likelihood of no lifetime CCS (adjusted Odd Ratio = 0.17; 95% CI = 0.07-0.39). Compared to women born in North Africa, women born in West (aOR = 0.15; 95% CI = 0.07-0.33) and East Africa (aOR = 0.06; 95% CI = 0.02-0.20) were less likely to have no lifetime HIV test. Time since last HIV test increased for each additional year spent in France (coef = 0.21; 95% CI = 0.09, 0.33). CONCLUSION While access to CCS remains poor for recent migrants, HIV testing is more likely to occur shortly after migration.
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Affiliation(s)
- Lorraine Poncet
- UVSQ, Univ. Paris-Sud, Inserm, Primary Care and Prevention Team, CESP, Université Paris-Saclay, Villejuif, France
- French Collaborative Institute on Migration, Paris, France
| | - Henri Panjo
- UVSQ, Univ. Paris-Sud, Inserm, Primary Care and Prevention Team, CESP, Université Paris-Saclay, Villejuif, France
| | - Virginie Ringa
- UVSQ, Univ. Paris-Sud, Inserm, Primary Care and Prevention Team, CESP, Université Paris-Saclay, Villejuif, France
| | - Armelle Andro
- French Collaborative Institute on Migration, Paris, France
- Institute of Demography, Université Paris I Pantheon-Sorbonne, Paris, France
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Arora A, Quesnel-Vallee A, Lessard D, Mate K, Rodriguez-Cruz A, Kronfli N, Engler K, Vedel I, Lebouché B. Barriers and facilitators associated with steps of the HIV care cascade for migrants in OECD countries: a systematic mixed studies review protocol. BMJ Open 2020; 10:e040646. [PMID: 33158835 PMCID: PMC7651739 DOI: 10.1136/bmjopen-2020-040646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION In 2019, the United Nations signalled a substantial rise in the number of international migrants, up to 272 million globally, about half of which move to only 10 countries, including 8 member nations of the Organization for Economic Co-operation and Development (OECD). Migrants in OECD countries are often at higher risk for acquiring HIV and have a higher frequency of delayed HIV diagnosis. The barriers and facilitators that migrant people living with HIV (PLWH) in OECD countries face in relation to HIV care are insufficiently understood. The five-step HIV Care Cascade Continuum (HCCC) is an effective model to identify gaps, barriers and facilitators associated with HIV care. The purpose of this study is to generate a comprehensive, multilevel understanding of barriers and facilitators regarding the five steps of the HCCC model in OECD countries by migration status. METHODS AND ANALYSIS A systematic mixed studies review using a data-based convergent design will be conducted. Medline, Embase, Scopus, CINAHL and the Cochrane Library will be searched on 25 March 2020. Screening and critical appraisal will be conducted independently by the first author. Authors 3-5 will act as second reviewers, each independently conducting 33% of the screening and appraisal. Quantitative data will be transformed to qualitative data and be synthesised using thematic analysis. The Mixed Methods Appraisal Tool will be used for quality assessment. An advisory committee, composed of four migrant PLWH, will be involved in screening and appraising 5% of articles to build knowledge and experience with systematic reviews. They will also be involved in analysis and dissemination. ETHICS AND DISSEMINATION Ethics approval was obtained from the McGill University Health Centre (15-188-MUHC, 2016-1697, eReviews 4688). Publications arising from this study will be open-access. PROSPERO REGISTRATION NUMBER CRD42020172122.
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Affiliation(s)
- Anish Arora
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
- Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials, Canadian Institutes of Health Research, Montréal, Québec, Canada
| | - Amelie Quesnel-Vallee
- Department of Sociology, Faculty of Arts, McGill University, Montréal, Québec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada
| | - David Lessard
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
- Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials, Canadian Institutes of Health Research, Montréal, Québec, Canada
| | - Kedar Mate
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
- Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials, Canadian Institutes of Health Research, Montréal, Québec, Canada
| | - Adriana Rodriguez-Cruz
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
- Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials, Canadian Institutes of Health Research, Montréal, Québec, Canada
| | - Nadine Kronfli
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
- Department of Medicine, Chronic Viral Illness Service, Division of Infectious Diseases, McGill University Health Centre, Montréal, Québec, Canada
| | - Kim Engler
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
- Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials, Canadian Institutes of Health Research, Montréal, Québec, Canada
| | - Isabelle Vedel
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada
| | - Bertrand Lebouché
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
- Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials, Canadian Institutes of Health Research, Montréal, Québec, Canada
- Department of Medicine, Chronic Viral Illness Service, Division of Infectious Diseases, McGill University Health Centre, Montréal, Québec, Canada
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Vignier N, Desgrees Du Lou A, Pannetier J, Ravalihasy A, Gosselin A, Lert F, Lydie N, Bouchaud O, Dray Spira R, Chauvin P. Social and structural factors and engagement in HIV care of sub-Saharan African migrants diagnosed with HIV in the Paris region. AIDS Care 2019; 31:897-907. [PMID: 30709323 DOI: 10.1080/09540121.2019.1576842] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Migrants from sub-Saharan Africa (SSA) are often diagnosed at an advanced stage of HIV, and many of them have harsh living conditions. We aimed to evaluate the entry into care after HIV diagnosis and examine the related social determinants. The ANRS PARCOURS study is a life-event survey conducted in 2012-2013 in the Paris region among. Time between HIV diagnosis of SSA migrants living diagnosed HIV positive in France and HIV care and the determinants was assessed yearly by using mixed-effects logistic regression models. Among a total of 792 participants, 94.2% engaged in HIV care within the year of HIV diagnosis, 4.3% in the following year and 2.5% beyond the second year after diagnosis. The participants were more likely to engage in HIV care during years when they were effectively covered by health insurance and if the HIV test was carried out at the initiative of the doctor. Immigration for economic reasons or owing to threats in his/her country of origin was associated with delayed engagement in HIV care. Additionally, 4.3% of treated participants discontinued HIV care at least once at the time of the survey and more often if diagnosed at an advanced HIV disease stage and financially dependent.
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Affiliation(s)
- Nicolas Vignier
- a Department of Social Epidemiology , INSERM, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP) Paris , France.,b Department of Infectious and Tropical Diseases , Groupe hospitalier Sud Ile-de-France , Melun , France
| | | | - Julie Pannetier
- c IRD, INSERM , Université Paris Descartes, CEPED, SAGESUD team , Paris , France
| | | | - Anne Gosselin
- c IRD, INSERM , Université Paris Descartes, CEPED, SAGESUD team , Paris , France
| | - France Lert
- d INSERM , Center for Research in Epidemiology and Population Health (CESP-U 1018) , Villejuif , France
| | - Nathalie Lydie
- e Santé Publique France , French National Agency of Public Health , Saint-Maurice , France
| | - Olivier Bouchaud
- f Department of Infectious and Tropical diseases, and Laboratoire Educations et Pratiques de Santé (LEPS EA 3412) , Paris 13 University, Assistance Publique-Hôpitaux de Paris (AP-HP), Avicenne Hospital , Bobigny , France
| | - Rosemary Dray Spira
- a Department of Social Epidemiology , INSERM, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP) Paris , France
| | - Pierre Chauvin
- a Department of Social Epidemiology , INSERM, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP) Paris , France
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Bartelsman M, Joore IK, van Bergen JE, Hogewoning AA, Zuure FR, van Veen MG. HIV testing week 2015: lowering barriers for HIV testing among high-risk groups in Amsterdam. BMC Infect Dis 2017; 17:529. [PMID: 28764661 PMCID: PMC5540217 DOI: 10.1186/s12879-017-2617-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 07/18/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evaluation of the HIV Testing Week (HTW) 2015 in Amsterdam: the number of (positive) tested persons, characteristics and testing history of the tested population, the differences in attendance per location and the healthcare workers' experiences and opinions concerning the HTW. METHODS The HTW took place from 28 November till 4 December 2015. Anonymous HIV rapid testing (INSTI™ HIV1/HIV2 Ab test or Determine™ HIV-1/2 Ag/Ab test) was offered free of charge at four hospitals, 12 general practitioner (GP) clinics, a sexually transmitted infections (STI) clinic, a laboratory, sites of a community-based organisation, and at outreach locations. Home-based testing (OraQuick® In-Home HIV Test) was offered online. The focus was to motivate two groups to test: men who have sex with men (MSM) and non-Western migrants. Questionnaires regarding participant's characteristics and HIV testing history were collected. Also healthcare workers were asked to complete a questionnaire evaluating the HTW. RESULTS In total, 1231 participants were tested. With three positive HIV tests, the detection rate was 0.3% (95%CI 0.26-0.37). Of all participants, 24.7% (304/1231) were MSM. Respectively, 22.3% (275/1231) and 15.7% (193/1231) were first- and second-generation migrants from a non-Western country. Altogether, 56.7% (698/1231) of participants belonged to one of the targeted risk groups. For 32.7% (402/1231) of participants, it was the first time they received testing, and 35.1% (432/1231) were tested more than 1 year ago. Among MSM 13.2% were tested for the first time, among first- and second-generation non-Western migrants this percentage was significantly higher at 27.2% and 33.5% respectively (p < 0.01). The number of tested participants per location varied widely, especially between GP clinics (range 3-63). Healthcare workers were positive about the HTW: about half (46.2%) stated they would more readily offer an HIV test following their experience with the HTW. CONCLUSIONS This was the first time the Amsterdam HTW was organised on such a large scale. The majority of the tested population belonged to one of the targeted risk groups and received testing either for the first time or for the first time in over a year. It is important to further build upon the experiences of the HTW and offer free of charge low-threshold HIV testing more structurally. An evaluation of cost-effectiveness is also warranted for future editions of the HTW.
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Affiliation(s)
- M Bartelsman
- STI Outpatient Clinic, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, the Netherlands. .,Public Health Service of Amsterdam, Department of Infectious Diseases, STI Outpatient Clinic, Weesperplein 1, 1018 WZ, Amsterdam, the Netherlands.
| | - I K Joore
- Department of General Practice/Family Medicine, Division of Clinical Methods and Public Health, Academic Medical Center, Amsterdam, the Netherlands
| | - J E van Bergen
- Department of General Practice/Family Medicine, Division of Clinical Methods and Public Health, Academic Medical Center, Amsterdam, the Netherlands.,STI AIDS Netherlands (Soa Aids Nederland), Amsterdam, the Netherlands.,Epidemiology & Surveillance Unit, Centre for Infectious Disease Control, National Institute of Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - A A Hogewoning
- STI Outpatient Clinic, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, the Netherlands
| | - F R Zuure
- Department of Infectious Diseases Research and Prevention, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, the Netherlands.,Department of Internal Medicine, Center of Infectious diseases and Immunology Amsterdam (CINIMA), Academic Medical Center, Amsterdam, the Netherlands
| | - M G van Veen
- STI Outpatient Clinic, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, the Netherlands
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Chen W, Zhou F, Hall BJ, Tucker JD, Latkin C, Renzaho AMN, Ling L. Is there a relationship between geographic distance and uptake of HIV testing services? A representative population-based study of Chinese adults in Guangzhou, China. PLoS One 2017; 12:e0180801. [PMID: 28727786 PMCID: PMC5519047 DOI: 10.1371/journal.pone.0180801] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 06/21/2017] [Indexed: 01/26/2023] Open
Abstract
Achieving high coverage of HIV testing services is critical in many health systems, especially where HIV testing services remain centralized and inconvenient for many. As a result, planning the optimal spatial distribution of HIV testing sites is increasingly important. We aimed to assess the relationship between geographic distance and uptake of HIV testing services among the general population in Guangzhou, China. Utilizing spatial epidemiological methods and stratified household random sampling, we studied 666 adults aged 18-59. Computer-assisted interviews assessed self-reported HIV testing history. Spatial scan statistic assessed the clustering of participants who have ever been tested for HIV, and two-level logistic regression models assessed the association between uptake of HIV testing and the mean driving distance from the participant's residence to all HIV testing sites in the research sites. The percentage of participants who have ever been tested for HIV was 25.2% (168/666, 95%CI: 21.9%, 28.5%), and the majority (82.7%) of participants tested for HIV in Centres for Disease Control and Prevention, public hospitals or STIs clinics. None reported using self-testing. Spatial clustering analyses found a hotspot included 48 participants who have ever been tested for HIV and 25.8 expected cases (Rate Ratio = 1.86, P = 0.002). Adjusted two-level logistic regression found an inverse relationship between geographic distance (kilometers) and ever being tested for HIV (aOR = 0.90, 95%CI: 0.84, 0.96). Married or cohabiting participants (aOR = 2.14, 95%CI: 1.09, 4.20) and those with greater social support (aOR = 1.04, 95%CI: 1.01, 1.07) were more likely to be tested for HIV. Our findings underscore the importance of considering the geographical distribution of HIV testing sites to increase testing. In addition, expanding HIV testing coverage by introducing non-facility based HIV testing services and self-testing might be useful to achieve the goal that 90% of people living with HIV knowing their HIV status by the year 2020.
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Affiliation(s)
- Wen Chen
- Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, Guangdong, China
- School of Social Science and Psychology, Western Sydney University, Penrith, New South Wales, Australia
| | - Fangjing Zhou
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, Guangdong, China
- Department of Prevention and Treatment, Center for Tuberculosis Control of Guangdong Province, Guangzhou, Guangdong, China
| | - Brian J. Hall
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, Guangdong, China
- Global and Community Mental Health Research Group, Faculty of Social Sciences, Department of Psychology, University of Macau, Macau, China
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Joseph D. Tucker
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, Guangdong, China
- UNC-Project China, Guangzhou, Guangdong, China
- UNC Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Carl Latkin
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Andre M. N. Renzaho
- School of Social Science and Psychology, Western Sydney University, Penrith, New South Wales, Australia
| | - Li Ling
- Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, Guangdong, China
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Barriers and Facilitators to HIV Testing in Migrants in High-Income Countries: A Systematic Review. AIDS Behav 2015; 19:2012-24. [PMID: 26025193 DOI: 10.1007/s10461-015-1095-x] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Migrants, particularly from low- and middle-income countries, are at a heightened risk of adverse HIV outcomes. HIV testing may improve these outcomes. We reviewed and synthesised studies into migrants and HIV testing (outcome variable), published between January 1997 and April 2014. Papers using quantitative, qualitative and mixed methods designs, and samples with adult (≥18 years) migrants from low- and middle-income countries in high-income countries were included in the paper. Of 3155 papers retrieved, 31 met the inclusion criteria and are included in the review. A large number of barriers and facilitators to HIV testing were identified across the individual, social and structural levels. A number of study design and methodological issues, however, inhibited a comprehensive synthesis. There is no doubt that addressing HIV testing in migrants in high-income countries is complex; however, it has important implications for individual, community and population health, and a strong, empirically based response is warranted.
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Kesteman T, Lapostolle A, Costagliola D, Massari V, Chauvin P. Impact of migration origin on individual protection strategies against sexual transmission of HIV in Paris metropolitan area, SIRS cohort study, France. BMC Public Health 2015; 15:807. [PMID: 26289558 PMCID: PMC4545882 DOI: 10.1186/s12889-015-2051-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 07/10/2015] [Indexed: 11/25/2022] Open
Abstract
Background The impact of migration and country or region of origin on sexual behaviours and prevention of the sexual transmission of HIV has been scarcely studied in France. The objective of this study was to evaluate if and how individual attitudes of prevention towards HIV infection are different according to country or region of origins in Paris area, France. Methods 3006 individuals were interviewed in the Paris metropolitan area in 2010. Outcome variables were (i) the intention of the individual to protect oneself against HIV, and (ii) the adoption of a condom-based approach for protection against HIV. To explore factors associated with these outcomes, we constructed multivariate logistic regression models, first taking into account only demographic variables –including country of origin-, then successively adding socioeconomic variables and variables related to sexual behaviour and HIV perception and prevention behaviour. Results French and foreign people who have origins in Sub-Saharan Africa declared more intentions to protect themselves than French people with French parents (in foreign men, aOR = 3.43 [1.66–7.13]; in foreign women, aOR = 2.94 [1.65–5.23]), but did not declare more recourse to a condom-based approach for protection against HIV (in foreign men, aOR = 1.38 [0.38–4.93]; in foreign women, aOR = 0.93 [0.40–2.18]). Conversely, foreign women and French women from foreign origin, especially from Maghreb (Northern Africa), reported less intention of protection than French women with French parents. Conclusions These results underline the importance of taking culture and origins of target populations into consideration when designing information, education and communication about HIV and sexually transmitted diseases. These results also draw attention to fractions of the general population that could escape from prevention messages. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2051-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Thomas Kesteman
- Department of Social Epidemiology, Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), F75013, Paris, France. .,Institut Pasteur de Madagascar, BP 1274 Avaradoha, Antananarivo, 101, Madagascar.
| | - Annabelle Lapostolle
- Department of Social Epidemiology, Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), F75013, Paris, France.
| | - Dominique Costagliola
- Department of Social Epidemiology, Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), F75013, Paris, France.
| | - Véronique Massari
- Department of Social Epidemiology, Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), F75013, Paris, France.
| | - Pierre Chauvin
- Department of Social Epidemiology, Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), F75013, Paris, France.
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Massari V, Lapostolle A, Grupposo MC, Dray-Spira R, Costagliola D, Chauvin P. Which adults in the Paris metropolitan area have never been tested for HIV? A 2010 multilevel, cross-sectional, population-based study. BMC Infect Dis 2015. [PMID: 26198690 PMCID: PMC4509770 DOI: 10.1186/s12879-015-1006-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Despite the widespread offer of free HIV testing in France, the proportion of people who have never been tested remains high. The objective of this study was to identify, in men and women separately, the various factors independently associated with no lifetime HIV testing. METHODS We used multilevel logistic regression models on data from the SIRS cohort, which included 3006 French-speaking adults as a representative sample of the adult population in the Paris metropolitan area in 2010. The lifetime absence of any HIV testing was studied in relation to individual demographic and socioeconomic factors, psychosocial characteristics, sexual biographies, HIV prevention behaviors, attitudes towards people living with HIV/AIDS (PLWHA), and certain neighborhood characteristics. RESULTS In 2010, in the Paris area, men were less likely to have been tested for HIV at least once during their lifetime than women. In multivariate analysis, in both sexes, never having been tested was significantly associated with an age younger or older than the middle-age group (30-44 years), a low education level, a low self-perception of HIV risk, not knowing any PLWHA, a low lifetime number of couple relationships, and the absence of any history of STIs. In women, other associated factors were not having a child < 20 years of age, not having additional health insurance, having had no or only one sexual partner in the previous 5 years, living in a cohabiting couple or having no relationship at the time of the survey, and a feeling of belonging to a community. Men with specific health insurance for low-income individuals were less likely to have never been tested, and those with a high stigma score towards PLWHA were more likely to be never-testers. Our study also found neighborhood differences in the likelihood of men never having been tested, which was, at least partially, explained by the neighborhood proportion of immigrants. In contrast, in women, no contextual variable was significantly associated with never-testing for HIV after adjustment for individual characteristics. CONCLUSIONS Studies such as this one can help target people who have never been tested in the context of recommendations for universal HIV screening in primary care.
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Affiliation(s)
- Véronique Massari
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis Institute d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Department of Social Epidemiology, F-75012, Paris, France.
| | - Annabelle Lapostolle
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis Institute d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Department of Social Epidemiology, F-75012, Paris, France.
| | - Marie-Catherine Grupposo
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis Institute d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Department of Social Epidemiology, F-75012, Paris, France.
| | - Rosemary Dray-Spira
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis Institute d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Department of Social Epidemiology, F-75012, Paris, France.
| | - Dominique Costagliola
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis Institute d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Department of HIV Clinical Research, F-75013, Paris, France.
| | - Pierre Chauvin
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis Institute d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Department of Social Epidemiology, F-75012, Paris, France.
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Differences in recourse to HIV testing according to migration origin in the Paris metropolitan area in 2010. J Immigr Minor Health 2014; 15:842-5. [PMID: 23099525 DOI: 10.1007/s10903-012-9742-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In France, HIV prevention within Maghrebi or French of Maghrebi origin has been seldom studied. The purpose of this study is to compare the recourse to HIV test according to nationality and origin. Data were from the 2010 SIRS cohort, which included 3,006 households representative of the Paris metropolitan area. Results of the study show comparatively low HIV testing rate among Maghrebi and French of Maghrebi origin compared to French with French parents.
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Jolivet A, Cadot E, Florence S, Lesieur S, Lebas J, Chauvin P. Migrant health in French Guiana: are undocumented immigrants more vulnerable? BMC Public Health 2012; 12:53. [PMID: 22260085 PMCID: PMC3355028 DOI: 10.1186/1471-2458-12-53] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2011] [Accepted: 01/19/2012] [Indexed: 02/07/2023] Open
Abstract
Background Few data exist on the health status of the immigrant population in French Guiana. The main objective of this article was to identify differences in its health status in relation to that of the native-born population. Methods A representative, population-based, cross-sectional survey was conducted in 2009 among 1027 adults living in Cayenne and St-Laurent du Maroni. Health status was assessed in terms of self-perceived health, chronic diseases and functional limitations. The migration variables were immigration status, the duration of residence in French Guiana and the country of birth. Logistic regression models were conducted. Results Immigrants account for 40.5% and 57.8% of the adult population of Cayenne and St-Laurent du Maroni, respectively. Most of them (60.7% and 77.5%, respectively) had been living in French Guiana for more than 10 years. A large proportion were still undocumented or had a precarious legal status. The undocumented immigrants reported the worst health status (OR = 3.18 [1.21-7.84] for self-perceived health, OR = 2.79 [1.22-6.34] for a chronic disease, and OR = 2.17 [1.00-4.70] for a functional limitation). These differences are partially explained by socioeconomic status and psychosocial factors. The country of birth and the duration of residence also had an impact on health indicators. Conclusion Data on immigrant health are scarce in France, and more generally, immigrant health problems have been largely ignored in public health policies. Immigrant health status is of crucial interest to health policy planners, and it is especially relevant in French Guiana, considering the size of the foreign-born population in that region.
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Affiliation(s)
- Anne Jolivet
- INSERM, U707, Research Team on the Social Determinants of Health and Health Care, Faculté de médecine Pierre et Marie Curie, site St-Antoine, 27 Rue de Chaligny, 75571 Paris Cedex 12, France.
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