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Elise Marsicano
Paris XI-INSERM (France)
[email protected]
A disproportionate burden of HIV/AIDS
1,2
infections in Europe
 A growing proportion of sub-Saharan
African migrants acquired HIV after
having migrated3.
We describe their sexual
networks and preventive
behaviours in France.
 Little is known about the epidemic
dynamic in this population.
Sexual mixing : being with a partner born in a different country
 50% of men and 47% of women are in mixed relationships
 These proportions vary sharply with cohabitation status
Fig. 1 – Partner’s ethnicity by cohabitation and sex
100%
22
25
29
38
80%
12
20
60%
28
18
 Random probability survey conducted in 20054
 Face-to-face interviews in the street
 Trained and ethnically matched interviewers
Other country
Different SSA country
40%
63
58
44
20%
43
Same country of birth
Who are the respondents?
 973 women and 901 men
 Aged 18-49
 Born in a sub-Saharan African (SSA)
country (mostly from 6 countries)
 Living in Paris and its surrounding area
4
50%
arrived after 1998
11%
are illegal migrants
2
53%
are university graduates
1
20%
are unemployed
3
0%
Men
Women
Men
cohabiting
Women
non-cohabiting
Sexual mixing is high, especially among non-cohabiting relationships.
Being with a partner from a different SSA country is common, in
particular for women in non-cohabiting relationships.
Partners not from SSA are predominantly born in France.
Recent, young and highly educated
migrants yet economically disadvantaged.
Fear of HIV is very high (80%). It
is higher for women with a partner
from SSA than for women with a
partner not from SSA.
Condom use is higher
in non-cohabiting
relationships.
Tab. 1 – Factors associated with condom use, by cohabitation and sex
Cohabiting
Formal
relation
ship
No
sexual
mixing
Rare
condom
use
Men
% of condom use
22,8
%
Partner's ethnicity
Same country of birth
Different SSA country
Other country
Age gap
Man is 0-4 years older
Man is more than 4 years older
Relationship duration
0-5 years
6 years or more
Women
16,5
OR
%
Non-cohabiting
% of condom use
OR
23,6 1
27,7 1,24
16,7 0,63
12,6 1
17,1 1,17
25,7 1,67*
21,7 1
24,0 1,02
22,3 1
13,3 0,57
28,9 1
18,3 0,49**
22,3 1
13,7 0,79
Men
42,9
42,1
%
Partner's ethnicity
Same country of birth
Different SSA country
Other country
Age gap
Man is 0-4 years older
Man is more than 4 years older
Relationship duration
0-2 years
3 years or more
Women
OR
%
Casual
relation
ship
OR
35,6
1
57,1 1,96
46,0 0,78
35,0 1
42,4 1,16
52,2 1,96**
52,8
1
23,8 0,37***
43,8 1
40,5 0,85
54,4
1
25,5 0,39***
48,1 1
33,7 0,74
Sexual
mixing
Frequent
condom
use
* : p<0,1; **:p<0,05; ***:p<0,001
Controlled for age, diploma, number of partners over the past 12 months
For men, duration has a very strong impact on
condom use: the longer the relationship, the lower
the condom use whatever their cohabiting status.
For women, being with a partner not from SSA
increases the probability of using a condom both
in cohabiting and non-cohabiting relationships.
Among men in non-cohabiting relationships,
those who have a larger age gap with their
partner are less likely to use a condom.
From migrants to a racial minority?
 The majority of respondents have a
partner from SSA whether from the
same or a different country.
 Condom use is lower for women
with a SSA partner.
1.
2.
3.
4.
5.
6.
Spatial segregation and professionnal segmentation
experienced by SSA migrants5,6 probably produce
social and sexual SSA networks.
Partners not from SSA may perceive SSA women as
“at risk” and suggest (or impose?) condom use.
These results highlight the
necessity of taking into account
discrimination experienced by SSA
migrants in order to better analyse
the HIV/AIDS epidemic in these
populations.
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