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The role of social vulnerability after migration in France on “at-risk” sex:

the case of Subsaharan immigrants living in Paris area.

A. Desgrées du Loû , J. Pannetier, N. Bajos, A. Gosselin, A. Ravalihasy, F. Lert,

N. Lydié, R. Dray-Spira, and the PARCOURS Study group.

(1) CEPED, IRD, Paris ; (2) CESP, INSERM, Paris ; (3) INPES, Paris ; (4) IPLESP, INSERM, Paris

Abstract n° WEPDD0202

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BackgroundIn France, 31% of new HIV diagnoses in 2012 were among

immigrants from Subsaharan Africa (Cazein et al., 2014)

Virological data suggest that among them, at least a fourth of HIV infection cases might have occured in France (Lucas et al., 2012).

It is then necessary to identify conditions that expose Subsaharan immigrants to the risk of HIV infection in France .

We aimed to evaluate the role of social vulnerability after

migration on occasional, transactional and forced sex among

Subsaharan men and women immigrants living in France.

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Methods The PARCOURS survey 2012-2013 : a cross-sectional

study in the Paris area among migrants from Subsaharan Africa (aged 18-59)

Two random samples: HIV-infected outpatients N=926 HIV

uninfected outpatients N=763 Recruitment in health care centers Retrospective life-event questionnaireStudy indicators

Casual sex

After arrival in FranceTransactional sexForced sex

By Group (HIV/ non HIV)Sociodemographic characteristics Administrative, housing and financial situations in FranceSexual experiences before migration

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Results

No stable house

Hosted by family

Hosted by associations

Own house0

10

20

30

40

50

60

70

80

90

Rates of transactional sex according to housing situation in France

Y per 1000 PYR

No stab

le house

Hosted by f

amily

Hosted by a

ssocia

tions

Own house0

4

8

12

16

20

Rates of forced sex according to housing situation in France

WomenMen

Y per 1000 PYR

After arrival in France, experiences of social vulnerabilities were frequent: 1 in 2 people had at least one year without resident permit 1 in 3 people had at least one year without stable housing

92% occurred during the first five years following arrival

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Correlates of sexual situations (women)

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Conclusion

Among women, residential insecurity was frequent, especially in the first years following migration, and favoured casual and transactional sexuality and sexual abuse in France.

are more common among HIV infected Subsaharan migrants

Experiences in France of :

Casual relationshipsTransactional relationshipsForced sex

Recommendations :

- Residential and financial insecurity of immigrants after arrival in France should be addressed in order to reduce their risk to engage in at-risk sex, specially for women.

- Both for men and women, prevention of sexual risks should be strenghtened in the first years following arrival in France.

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Aknowledgements

• The PARCOURS survey was funded by the French National Agency for Research on Aids and Viral Hepatitis (ANRS). We thank all patients who agreed to participate in the PARCOURS survey, all medical staff members in the participating hospitals, as well as the community-based organisations RAAC-Sida, COMEDE and SOS hepatites who supported the survey.

• The PARCOURS Study Group:

A. Desgrées du Loû, F.Lert, R Dray-Spira, N. Bajos, N.Lydié (scientific coordinators), J. Pannetier, A. Ravalihasy, A. Gosselin, D. Pourette, with the support of A. Guillaume.

Methodological and ground support: Y. Le Strat, J. Gelly, N. Razafindratsima, P. Revault, J. Situ, P. Sogni, G. Vivier

• Data collection: The ClinSearch firm and the social research institute Ipsos.

www.parcours-sante-migration.com