‘Migrants fromover there’ or ‘racial minorityhere’? Sexual networks and prevention practices among sub-Saharan African migrants in France

Abstract

Migrants from sub-Saharan Africa bear a disproportionate burden of HIV infection in Europe, with an increasing proportion of them acquiring HIV after migration. This transformation in the epidemic pattern has raised concerns about the sexual mixing and preventive behaviours of migrants. This paper aims at exploring how racial boundaries shape sexual networks and structure prevention practices among migrants from sub-Saharan Africa. Analyses are based on a French survey carried out among 1874 individuals born in sub-Saharan Africa, aged 18-49 and living in Paris and its surroundings. Our results provide evidence of the existence of African sexual networks, over and beyond those of national origin. The intra-African segregation of these sexual networks leads to sexual contacts between migrants from low- and high-HIV prevalence countries, which probably contribute to the development of the epidemic amongst these migrants. Moreover, racially-based perceptions of HIV-related risk seem to produce a specific attitude toward prevention practices as shown by higher rates of condom use among migrant women from sub-Saharan Africa with a partner born outside sub-Saharan Africa. As a consequence, community-based approaches to HIV prevention should take into account the identification of migrants from sub-Saharan Africa as a racial minority and not only focus on national borders.

A systematic review of post-migration acquisition of HIV among migrants from countries with generalised HIV epidemics living in Europe: mplications for effectively managing HIV prevention programmes and policy

“…Subtyping of a large number of samples would be required to determine if the incidence of HIV- 1 non-B variants is increasing over time in the newly diagnosed native population.Kramer (2008) [29] Sexual mixing (sexual partner with differing ethnicity) High risk = 42 % (84 % unprotected), Moderate risk = 59 % (no data), Low risk = 66 % (no data).SD: +++ V: ++ G: ++ OS: ++Convenience sample and social desirability bias Includes both first generation and second generation migrant with no distinction drawn between them in analysis.Lai (2013) [24]Sexual mixing: 50 % of men and 47 % of women reported partners born in different countries. Most partners from a different African country (men 19 %; women 20 %).SD: + V: ++ G: + OS: ++Convenience sample; low response rate (14 %); desirability bias; data does not support some conclusions reached in the discussion.Marsicano et al (2013) [28] Factors associated with epidemiological networks: Country of origin independently associated with the probability of isolates being detected in clusters OR for Italian vs. African origin: 5.3, 95 % CI: 2.2–12.9, P < 0.001; South American vs. African origin: 25.6, 95 % CI: 2.0–162.0, P < 0.001. SD: +++ V: ++ G: ++ OS: +++ARCA database has relative lack of country of origin and risk factor information for some patients which could have weakened the strength of the detected associations.…”

“…Similarly Marisciano et al (2013) reported that 50 % of men and 47 % of women had partners from a different country although most were from another African country [28]. …”

First HIV prevalence estimates of a representative sample of adult sub-Saharan African migrants in a European city. Results of a community-based, cross-sectional study in Antwerp, Belgium

“…The preference for African sexual partners, the existence of African sexual networks [16], and a culture of concurrency elevate the risk of HIV-transmission [3, 10]. Among those in a stable relationship, 33.7% had a sexual partner ‘on the side’ in the last year and 73.0% said their last sexual partner was of sub-Saharan African origin.…”

“…Also the increased mobility of migrants since the recent economic crisis is not accounted for in official population numbers [15]. Sub-Saharan African migrants who moved from other European countries to Belgium in search for job opportunities quickly become part of the local sexual networks [16], and this may also influence the Belgian HIV epidemic. Therefore, the present study’s objective was to obtain sound HIV prevalence estimates and to identify sub-groups that should be prioritized for HIV prevention through studying a representative sample of the heterogeneous sub-Saharan African migrant communities present in Antwerp city (i.e.…”

Exploring barriers to consistent condom use among sub-Saharan African young immigrants in Switzerland

“…Findings on commitment, trust, and reduced pleasure perception with condom use are in line with those of previous studies. Being in a long-term relationship is associated with lower condom use (Marsicano et al, 2013), as is the belief that condom-protected intercourse is less pleasurable (Barrett & Mulugeta, 2010;Higgins & Wang, 2015). In deciding whether to use condoms, pleasure is a more important factor for men than for women (Randolph, Pinkerton, Bogart, Cecil, & Abramson, 2007), which indicates that how condom use affects perceptions of sexual pleasure is based on gender.…”