Low knowledge of antiretroviral treatments for the prevention of HIV among precarious immigrants from sub-Saharan Africa living in the greater Paris area: Results from the Makasi project

PLoS One. 2023 Jun 14;18(6):e0287288. doi: 10.1371/journal.pone.0287288. eCollection 2023.

Abstract

Introduction: In France, combination prevention tools, particularly antiretroviral treatment for HIV prevention has been available for several years. We described the knowledge of these antiretroviral treatments among immigrants from sub-Saharan Africa, who are particularly affected by HIV, and the factors associated with this knowledge.

Methods: The data come from the Makasi study, which was conducted between 2019 and 2020 among precarious immigrants from sub-Saharan Africa recruited through a community-based outreach approach in the greater Paris area (n = 601). We described levels of knowledge of HIV treatment effectiveness (HTE), treatment as prevention (TasP), post-exposure prophylaxis (PEP), and pre-exposure prophylaxis (PrEP), by sex with chi2 test. We investigated factors associated with their knowledge with logistic regressions adjusted for sociodemographic characteristics, living conditions and sexual behaviors (p≤0.2).

Results: Respondents were mostly men (76%), from West Africa (61%), in precarious situation: 69% were unemployed, 74% were undocumented and 46% had no health coverage. Among this population, knowledge of HIV preventive treatments was heterogeneous. While HTE was well known (84%); TasP was known by only half of the respondents (46%), and PEP and PrEP were hardly known: 6% and 5%, respectively. Multivariate regressions models showed that these antiretroviral treatments for the prevention of HIV was better known by people with a higher level of education (PEP: aOR = 3.33 [1.09-10.20], p = 0.03; HTE: aOR = 4.33 [1.87-10.04], p<0.001), those who had a social network in France (TasP: aOR = 1.90, [1.33-2.73], p<0.001), those who had access to the health system and those who were exposed to sexual risks (TasP: aOR = 3.17, [1.03-9.69], p = 0.04; PrEP: aOR = 2.60 [0.72-9.34], p = 0.14).

Conclusions: There is a need for specific communication on antiretroviral treatment for HIV prevention that targets sub-Saharan immigrants, particularly those who have no access to the health-care system and those who are less educated.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Africa, Western
  • Anti-Retroviral Agents
  • Emigrants and Immigrants*
  • Female
  • France
  • HIV Infections* / drug therapy
  • HIV Infections* / epidemiology
  • HIV Infections* / prevention & control
  • Humans
  • Male
  • Paris / epidemiology

Substances

  • Anti-Retroviral Agents

Grants and funding

The MAKASI study was sponsored by the French Agency for Research on AIDS and Viral Hepatitis (ANRS), the Agence Régionale de Santé (ARS) Ile-de-France, the French Collaborative Institute on Migrations, the Université Paris Cité (ANR-18-IDEX-001) and a PhD grant from Sidaction (A0 2019- 12276 and 2022- 13327). This article was published with the support of Faculté Sociétés & Humanités of Université Paris Cité and the French Institute for Research on sustainable Development (IRD). The sponsors had no role in the design or conduct of the study; in the collection, analysis, or interpretation of data; nor in the preparation, review, or approval of the manuscript.