Abstract #145  -  Migration as an aggravating factor for PLWHA: results from the AIDES & Toi survey
Authors:   Presenting Author:   ms Daniela Rojas - Association AIDES
Additional Authors:  Mr. Christian Andreo, Mr. Jean-Marie Le Gall, Mr. Joseph Situ, Ms. Joanne Otis, Mr. Martin Blais, Mr. Bruno Spire, Mr. Vincent Pelletier,
Aim: Some current policies, like criminalization of homosexuality, HIV transmission, and repression of sex workers or foreign people contribute to drive some groups more vulnerable to HIV infection and make access to health care and social services more difficult. AIDES, the largest French community-based organization caters for migrant and non-migrant people. The present work aims to evaluate if migrants face more social and clinical difficulties linked to HIV than non-migrants by comparing several variables in both groups using the results of the “AIDES et toi” survey.
Method / Issue: A cross-sectional nation-wide survey, filled out by 2434 respondents, was carried out in May 2007. During one week, a self-administered questionnaire was systematically offered to every person in contact with AIDES. The questionnaire includes standardized items concerning socio-demographics, health status and quality of life, sexuality, use of the organization and HIV stigma and disclosure. Statistical comparisons were made between groups using independent Student-t-tests and chi-square tests.
Results / Comments: 430 respondents of the survey (17.6% of the sample) were migrants, 62.5% (N=269) were HIV positive and 4.2% were not aware of his serostatus. 61.6% of HIV positive people were women. For HIV-positive migrants, mean age was 39.6 years old, and 56.2% were born in Sub-Saharan Africa, 14.8% in north Africa, 13.3% in western Europe, 6.4% in central America and 3.4% in eastern Europe. When HIV-positive migrants were compared to HIV-positive non-migrants, the results showed that the former reported significantly more being single (73.5 vs. 61.8%; p<0.001), unemployed (72.6% vs. 62.9%; p=0.002), with unstable accommodation (43.8% vs. 15.1%; p<0.001). Moreover, 14.7% of HIV-positive migrants (vs. 1.5% of non-migrants; p<0.001) had no economic resources at all. Regarding antiretroviral treatment, there were no differences between the two groups (about 83% on ARV treatment). Nevertheless, migrants seem to have a worse response to ARV treatment than non-migrants, reporting a smaller percentage of CD4 cell counts >350 (45% vs. 54.1%; p<0.001). Furthermore, migrants were not aware of their CD4 cell counts and viral load in larger percentages than non-migrants (26.2% vs. 11.1%; p<0.001 for CD4 cell count and 26.1% vs. 10.1%; p<0.001 for viral load). Finally, non-migrants reported significantly more frequently being co-infected by HCV 25.1% (vs. 13.1%; p< 0.001) and by HBV 12.5% vs. 7.3%; p=0.006). However, migrants were less aware of their HCV (10.4%) and HBV (8.5%) serologies than non-migrants (3.9% and 4.4%, respectively).
Discussion: These results reveal how some major difficulties for PLWHA become even larger when they concern migrants. Migrant HIV-positive people have to deal, as described before, with a double stigma that could explain part of these results. Actions for empowering and increasing the knowledge concerning rights, illness and treatment targeted to migrant PLWHA are needed.
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