Gender, socio-economic status, migration origin and neighbourhood of residence are barriers to HIV testing in the Paris metropolitan area

Abstract

In France, numerous HIV patients still discover their HIV status as a result of AIDS-related symptoms. We investigated factors related to the absence of any HIV testing in men and women separately, using the data from the SIRS cohort, which includes 3023 households representative of the Paris metropolitan area in 2005. The failure to use HIV testing services was studied in relation to individual socio-economic and demographic factors as well as some psychosocial characteristics. The effect of the characteristics of the residential neighbourhood was also analysed using multilevel models. In multivariate analysis, the factors associated with no history of HIV testing in women were an age >44 years, the absence of any pregnancy during the previous 15 years, a low education level, unemployment, to have had no or only one steady relationship in one's lifetime, to have a religious affiliation and to live in a poor neighbourhood. In men, factors were age <30 or >44 years, to have had no or only one steady relationship during one's lifetime, to have a religious affiliation and to perceive oneself as being at low risk of HIV infection. An association according to the “migration origin” was observed among men: foreigners and French men born to (at least) one foreign parent were more likely not to have been tested than French men born to two French parents. We conclude that gender, social and territorial differences exist in HIV testing among people living in the Paris area. More systematic proposals of HIV test in primary care would be an effective policy to overcome these persistent social stratifications.

Keywords:

• HIV testing
• gender
• social inequalities
• migration status
• neighbourhood status

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).