Impact of migration origin on individual protection strategies against sexual transmission of HIV in Paris metropolitan area, SIRS cohort study, France.
BACKGROUND
The impact of migration and country or region of origin on sexual behaviours and prevention of the sexual transmission of HIV has been scarcely studied in France. The objective of this study was to evaluate if and how individual attitudes of prevention towards HIV infection are different according to country or region of origins in Paris area, France.


METHODS
3006 individuals were interviewed in the Paris metropolitan area in 2010. Outcome variables were (i) the intention of the individual to protect oneself against HIV, and (ii) the adoption of a condom-based approach for protection against HIV. To explore factors associated with these outcomes, we constructed multivariate logistic regression models, first taking into account only demographic variables -including country of origin-, then successively adding socioeconomic variables and variables related to sexual behaviour and HIV perception and prevention behaviour.


RESULTS
French and foreign people who have origins in Sub-Saharan Africa declared more intentions to protect themselves than French people with French parents (in foreign men, aOR = 3.43 [1.66-7.13]; in foreign women, aOR = 2.94 [1.65-5.23]), but did not declare more recourse to a condom-based approach for protection against HIV (in foreign men, aOR = 1.38 [0.38-4.93]; in foreign women, aOR = 0.93 [0.40-2.18]). Conversely, foreign women and French women from foreign origin, especially from Maghreb (Northern Africa), reported less intention of protection than French women with French parents.


CONCLUSIONS
These results underline the importance of taking culture and origins of target populations into consideration when designing information, education and communication about HIV and sexually transmitted diseases. These results also draw attention to fractions of the general population that could escape from prevention messages.
Department of Social Epidemiology, Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), F75013, Paris, France. kesteman@agora.eu.org.|Institut Pasteur de Madagascar, BP 1274 Avaradoha, Antananarivo, 101, Madagascar. kesteman@agora.eu.org.
Thomas
T
Kesteman
Department of Social Epidemiology, Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), F75013, Paris, France. alapostolle@gmail.com.
Annabelle
A
Lapostolle
Department of Social Epidemiology, Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), F75013, Paris, France. dominique.costagliola@iplesp.upmc.fr.
Dominique
D
Costagliola
Department of Social Epidemiology, Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), F75013, Paris, France. veronique.massari@iplesp.upmc.fr.
Véronique
V
Massari
Department of Social Epidemiology, Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), F75013, Paris, France. pierre.chauvin@iplesp.upmc.fr.
Pierre
P
Chauvin
D000328:Adult; D017954:Africa South of the Sahara / Q000208:ethnology; D000352:Africa, Northern / Q000208:ethnology; D015331:Cohort Studies; D003466:Cultural Characteristics; D004641:Emigration and Immigration; D005006:Ethnicity; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000208:ethnology / Q000517:prevention & control; D054625:Healthcare Disparities; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010297:Paris / Q000453:epidemiology; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control; D055815:Young Adult