Time since the last HIV test and migration origin in the Paris metropolitan area, France

Abstract

In France, the newly diagnosed infection rate was 372/100,000 for African immigrants versus 6/100,000 for the French-born population in 2008. In addition, people from sub-Saharan countries were at higher risk for late diagnosis than native-born French despite their more frequent use of HIV testing. The purpose of this study was to compare the mean time since the last HIV test according to migration origin. This study used data from the SIRS (a French acronym for health, inequalities, and social ruptures) cohort, which, in 2005, included 3023 households representative of the greater Paris area. HIV testing uptake and the time since the last test were studied in relation to socio-economic factors, psychosocial characteristics, and migration origin. Multivariate ANOVA analyses were performed using Stata 10. People from sub-Saharan Africa were more likely to have been tested in their lifetime (78.51%) than those of French (56.19%) or Maghreb (39.74%) origin (p<0.0000). The mean time, in years, since the last HIV test was shorter among sub-Saharan immigrants and Maghreb immigrants (2.15 and 2.53 years, respectively) than among native-born French (4.84 years) (F=12.67; p<0.0000). These differences remained significant even after adjusting for gender, age, number of steady relationships, time lived in France, and difficulty reading and/or writing French (F=5.73; p=0.0007). A gender analysis revealed the same pattern for both sexes, with greater differences in the mean duration by migration origin for women. These results and recent epidemiological data seem to show that since the early 2000s, measures aimed at increasing HIV testing and decreasing late diagnosis in sub-Saharan immigrants have been effective.

Keywords:

• HIV testing
• migrants
• socio-economic factors
• France

Acknowledgements

The SIRS cohort study has been supported by the Institute for Public Health Research (IRESP), the Directorate-General of Health (DGS), the Interministerial Delegation for Urban Affairs (DIV), the European Social Fund, the Regional Council of Ile-de-France, and the City of Paris. This study was part of a research project supported by a grant from the French National Agency for Research on AIDS (ANRS).