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Original Papers

Are migration routes disease transmission routes? Understanding Hepatitis and HIV transmission amongst undocumented Pakistani migrants and asylum seekers in a Parisian suburb

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Pages 395-411 | Received 13 Mar 2019, Accepted 04 Nov 2019, Published online: 27 Apr 2020
 

Abstract

Drawing on hospital-based interviews and fieldwork in a deprived Parisian suburb, this paper analyses the spatio-temporal dynamics of risk, exposure, and mobilities in individual stories of undocumented Pakistani male migrants, and asylum seekers—receiving treatment for single and combined diagnoses of HIV, and Hepatitis C and B. Inviting alignments with the ‘sexual’ turn in mobility studies, it prioritises the interface of all-male undocumented migration, mobility, sexuality, and homosociality in circumscribing disease transmission geneaologies. It questions the extent to which illegal migration routes are transmission routes, and risk environments assume different levels of intensity in everyday life in Pakistan, during the journey, and in France. It emphasises inadequately addressed epidemics of HIV and hepatitis in Pakistan, the significance of unequal routes to migrant healthcare in France, and the transnational adaptation of homosocial and sexual behaviours, including MSM. These factors interplay with intensified vulnerabilities relating to childhood sexual abuse, family traumas, sexual risks related to illegal migration and undocumented status in France, chronic stresses leading to depleted mental and physical health, and restrictions on heterosexual sex facing marginalised migrants. Further, temporal vulnerabilities relate to the colonial criminalisation of homosexuality in Pakistan, widespread sexual violence—and forms of contemporary exclusion and hostility regarding Muslim migrants in Europe. Particularly, we emphasise the paradox, and need to sensitively address, a complex confluence of hidden risks that are deeply embedded in ethnic communities of solidarity and support. The findings trouble the tendency to partition global hepatitis and HIV prevalence rates by ‘developed’ and ‘developing’ country variation.

Ethical Approval

It was given full ethical approval by the INSERM ethics committee and Institutional Review Board, France.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 Musafir means ‘traveller’, with connotations of pilgrim, migrant, and exile.

2 This prompted a report to the department authority for child protection.

3 As noted by Banerjee (Citation2000, 39), traditional homosexual liasons with and between Pathan men and youth had a significant place in the burgeoning corpus of Victorian and late Edwardian erotica, and served as a displacement channel for British officers who faced sexual restrictions on homosexuality in England.

Additional information

Funding

This project was funded by the Agence Nationale de Recherches sur le Sida et les Hepatites Virales (ANRS, ECTZ62614), France (IRB number IRB00003888).