Nicolas Vignier, Annabel Desgrées du Loû et al. « Social and structural factors and engagement in HIV care of sub-Saharan African migrants diagnosed with HIV in the Paris region », AIDS Care, Fev.2019

Résumé

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.