Bridging the knowledge gap of biomedical HIV prevention tools among sub-saharan african immigrants in France. Results from an empowerment-based intervention

Karna Coulibaly; Marwân-Al-Qays Bousmah; Andrainolo Ravalihasy; Corinne Taéron; Romain Mbiribindi; Jean-Noël Senne; Flore Gubert; Anne Gosselin; Annabel Desgrées du Loû; MAKASI Study Group

doi:10.1016/j.ssmph.2023.101468

Bridging the knowledge gap of biomedical HIV prevention tools among sub-saharan african immigrants in France. Results from an empowerment-based intervention

SSM Popul Health. 2023 Jul 23:23:101468. doi: 10.1016/j.ssmph.2023.101468. eCollection 2023 Sep.

Authors

Karna Coulibaly^{1

2}, Marwân-Al-Qays Bousmah^{1

2}, Andrainolo Ravalihasy^{1

2}, Corinne Taéron³, Romain Mbiribindi⁴, Jean-Noël Senne⁵, Flore Gubert⁶, Anne Gosselin^{1

2

7}, Annabel Desgrées du Loû^{1

2}; MAKASI Study Group

Affiliations

¹ Université Paris Cité, IRD, Inserm, Ceped, F-75006, Paris, France.
² French Collaborative Institute on Migrations, CNRS, Aubervilliers, France.
³ ARCAT, Paris, France.
⁴ Afrique Avenir, Paris, France.
⁵ RITM, Université Paris-Saclay, Sceaux, France.
⁶ IRD, UMR LEDa-DIAL, PSL, Université Paris-Dauphine, CNRS, Paris, France.
⁷ Institut National D'Études Démographiques, Aubervilliers, France.

Abstract

Introduction: Biomedical HIV prevention tools are available in France to prevent new infections. However, evidence suggests a lack of knowledge of these tools among sub-Saharan African immigrants, who are particularly affected by HIV due to social hardship, an indirect factor of HIV acquisition. We analysed the impact of an empowerment-based intervention on the knowledge of treatment as prevention (TasP), pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) in a population of precarious sub-Saharan African immigrants.

Methods: Data were collected throughout the MAKASI project. Following an outreach approach, participants were recruited in public places based on their precarious situations and followed for six months (0, 3, 6 months) between 2018 and 2021. Participants were randomized into two groups and received an empowerment intervention sequentially (stepped wedge design). We used random-effects logistic regression models to evaluate the intervention effect on the knowledge of biomedical HIV prevention tools. ClinicalTrials.gov Identifier: NCT04468724.

Results: The majority of the participants were men (77.5%), and almost half of them had arrived in France within 2 years prior to inclusion (49.3%). At baseline, 56% of participants knew about TasP, 6% knew about PEP and 4% knew about PrEP. Receiving the intervention increased the odds of knowing about PEP (aOR = 2.02 [1.09-3.75]; p < 0.026). Intervention effects were observed for TasP and PrEP only after 6 months. We found significant time effects for PEP (at 3 months, aOR = 4.26 [2.33-7.80]; p < 0.001; at 6 months, aOR = 18.28 [7.39-45.24]; p < 0.001) and PrEP (at 3 months, aOR = 4.02 [2.10-7.72]; p < 0.001; at 6 months, aOR = 28.33 [11.16-71.91]; p < 0.001).

Conclusions: We showed that the intervention increased the knowledge of biomedical HIV prevention tools. The effect of the intervention was coupled with an important time effect. This suggested that exposure to the intervention together with other sources of information contributed to increased knowledge of biomedical HIV prevention tools among precarious sub-Saharan African immigrants.

Keywords: Empowerment intervention; France; Immigrants; Post-exposure prophylaxis; Pre-exposure prophylaxis; Sub-saharan african; Treatment as prevention.

Associated data

ClinicalTrials.gov/NCT04468724