When migrants from sub-Saharan Africa contract AIDS in France

Originally from countries hard hit by the AIDS epidemic, migrants from sub-Saharan Africa would arrive in France already infected with HIV. If this statement may seem logical, it is actually false. The HIV epidemic among migrants is not an "import" disease. Between 35% and 49% of HIV-positive immigrants born in Cameroon, Mali, Congo or Côte d'Ivoire were infected on French soil. For more than half of them, the infection occurred during their first six years of life in France, according to the survey "Journey" of the National Agency for Research on AIDS (ANRS) presented at the 22nd International Conference on HIV / AIDS currently being held in Amsterdam.

To determine this delay, the researchers interviewed 277 men and women from sub-Saharan Africa living with HIV in the Paris region on their stories of life. They also took into account biological information that provides information on the stage of infection.

The survey shows that half of the migrants obtained stable housing and resources, as well as a residence permit after six years. "Before this pivotal moment, they go through many periods of precariousness. However, we know that these periods of instability are badociated with an increased risk of contamination ", commented on Figaro Anne Gosselin, researcher at the Population and Development Center (Institute for Research for Development / Paris Descartes University) and responsible for this work

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Women pay a heavy price for this administrative and financial instability. About one in three HIV-positive women in sub-Saharan Africa became infected after arriving in France. Again the ANRS Pathways survey highlights that there is a correlation between contracting HIV in France and having had a forced bad act. "During these periods of great instability, some are led to accept bad in exchange for accommodation," says the researcher.

This situation of deprivation also leads men to adopt risky behaviors. The survey shows that condom use is far from systematic, even though they have multiple partners. "These men and women face life-saving emergencies on a daily basis. In these precarious living conditions, it is certain that the issue of badual health and prevention is generally not placed in the foreground, "raises François Berdougo, co-head of the risk reduction group of Médecins du Monde.

Sensitizing migrant populations to prevention

However, the ANRS Parcours survey shows that more than two out of five infections occur after this critical 6-year period. "This is why prevention with this population, which has been settled for a longer time, must also be a priority to reverse the epidemic," insists Anne Gosselin.

For specialists, one of the most important tools is screening. Offering a rapid test as soon as migrant populations arrive would make it possible to identify HIV-positive people who do not know each other and offer them treatment. A support beneficial for them but also for their partners: once the multiplication of the controlled virus, it becomes undetectable. The risks of transmission are then almost zero. "Screening is also an opportunity to talk about badual health, prevention, condoms but also PrEP for pre-exposure prophylaxis," says François Berdougo.

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Authorized since January 2016 in France, PrEP is taking a drug, Truvada, continuously or before and after unprotected bad to reduce the risk of HIV infection. Nearly 7000 people in France benefit, including more than 97% of men who have bad with men (MSM). "But today, we are stumbling on the spread of this tool in other population groups, and in particular the migrants from sub-Saharan Africa who represent the second most affected group of the HIV epidemic behind MSM, "regrets François Berdougo, who emphasizes that" PrEP could especially allow women to be masters of their protection, regardless of their partner. "