PUBLI : Anne Gosselin, Julie Pannetier, Annabel Desgrées du Loû et al. « When and why ? Timing of post-migration HIV acquisition among sub-Saharan migrants in France », Sexually Transmitted Infections, Juillet 2019

  • Liste des auteurs : Anne Gosselin, Andrai­nolo Rava­li­hasy, Julie Panne­tier, France Lert, Annabel Desgrées du Loû, for the Parcours Study Group
  • Article en Open Access, télé­char­geable sur le site de la revue Sexually Trans­mitted Infections


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.