PUBLI : Lorraine Poncet, Henri Panjo, Virginie Ringa et Armelle Andro, « Do vulnerable groups access prevention services ? Cervical cancer screening and HIV testing among homeless migrant women in the Paris metropolitan area », PLOS ONE, August 2021


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.

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.

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).

While access to CCS remains poor for recent migrants, HIV testing is more likely to occur shortly after migration.

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