PUBLI : Gosselin, Coulibaly, Ravalihasy, Ridde, Desgrées du Loû et al., « Finding the missing link : when community-based outreach in public space is key to engage migrants in health prevention programmes in Paris, France », Journal of Epidemiology and Community Health [en ligne], avril 2020

Liste complète des auteurs :

  • Anne Gosselin, Karna Couli­baly, Andrai­nolo Rava­li­hasy, Séve­rine Carillon, Valéry Ridde, Nicolas Derche, Romain Mbiri­bindi, Annabel Desgrées du Loû, pour le groupe MAKASI
  • Page de réfé­rence ici

Abstract

Back­ground One of the classic chal­lenges for preven­tion programmes is reaching the popu­la­tions they serve. In France, a substan­tial number of African migrants living with HIV acquired their infec­tion after migra­ting. The aim of this paper is to better unders­tand the charac­te­ris­tics of the popu­la­tion reached by a commu­nity-based outreach approach.

Methods We compared socio­de­mo­gra­phic charac­te­ris­tics across three different groups in the Paris greater area : (1) the general African migrant popu­la­tion (Popu­la­tion census), (2) the African migrant popu­la­tion using either the regular heal­th­care system or the system for vulne­rable popu­la­tions (PARCOURS Survey) and (3) the African migrant popu­la­tion reached through a commu­nity-based mobile unit (Afrique Avenir). Compa­ri­sons were conducted accor­ding to sex, age, region of origin, dura­tion of resi­dence and occu­pa­tional and legal statuses using χ2 tests.

Results The migrants reached by the mobile unit were mostly men (69%), 52% of whom were younger than 35 years old. They more often lived in preca­rious situa­tions than did the general sub-Saharan popu­la­tion (49% vs 35% were unem­ployed, respec­ti­vely, p<0.001) and the ones acces­sing the regular heal­th­care system. Fewer of them lived in preca­rious situa­tions than did migrants seeking heal­th­care consul­ta­tions for vulne­rable popu­la­tions (42% in the mobile unit vs 54% in heal­th­care consul­ta­tions were undo­cu­mented, p<0.028).

Conclu­sion Our study shows that the outreach approach can consti­tute a missing link in the preven­tion chain among sub-Saharan African migrants, reaching a group that differs from the general migrant popu­la­tion and from the migrant popu­la­tion in heal­th­care services—not only the newly arrived migrants who live in more preca­rious situa­tions but also those who have been in France for several years and are still affected by social hardship.