Abstract
Newly arrived migrants are in a situation of physical and mental vulnerability and precariousness. As a result, they may be at risk of acquiring HIV infection and other sexually transmitted infections; but also, at risk of late treatment for their infection. This study evaluated the acceptability of screening for HIV and viral hepatitis and the perception and experience of screening in this vulnerable population. It also explored the different forms of participation in rapid voluntary testing for these infections among newly arrived migrants and assessed their knowledge about infectious communicable diseases in general, particularly in relation to high-risk sexual behavior. In addition, we asked a sample of 6 migrants for their reasons for not participating in this voluntary screening. The semi-structured in-depth interviews were conducted in a sample of twenty-five men housed in a first reception center in the north of Paris from 01/10/2019 to 30/07/2020. The interviews were recorded, transcribed, coded and analyzed. Observation was also used as a complementary qualitative method.
This protocol is registered and was approved by the Ethics Evaluation Committee and by the IRB ethics committee (authorization 00,003,888; 6 Sep 2019). It complies with the reference methodology (MR-004) of the French National Commission for Data Protection (CNIL). Most participants were satisfied with the screening program. Participation was either as an individual or in a group. The reasons for participation were categorized as a simple self check-up or as self-reassurance because of doubt or anxiety related to a risky situation. Group participation was also related to self-affirmation and to attesting good health to others in the group and particularly to the host society. There is a limited knowledge of hepatitis B and C in this population. Screening for infection offered an opportunity to speak with migrants about their sexual health and more broadly their general health.
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Notes
“Migrants from HCV-endemic countries have an average anti-HCV prevalence of 2% and account for a disproportionate number of all HCV cases (14%) in the EU/EAA” (ECDC, 2018a, 33). “The average prevalence of chronic hepatitis B in migrants living in the EU/EEA that were born in an HBV prevalent country is 5.5%, compared with an overall prevalence of 1.12% in the general EU/EEA population” (ECDC, 2018b, 28).
Iceland (chief epidemiologist of Iceland, 2007), Poland (information provided by country representative), and the Slovak Republic (public health authority of the SR and Slovak Medical University, 2000) report that HIV testing is offered for all migrants on arrival, as part of general health screening (ECDC, 2011).
Chest X-ray screening for active pulmonary tuberculosis, a review of vaccinations, an eyesight test, measurement of body mass index, and a blood glucose test.
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Acknowledgements
The authors gratefully acknowledge the assistance of the clinicians who participated in this screening. We thank Dr. Marion Dollat, Dr. Giuliana Troia, Dr. Armelle Pasquet-Cadre, Dr. Antoine Bachelard, and Prof. Yazdan Yazdanpanah, whose insight, expertise, and comments greatly aided our research and improved the manuscript. We are indebted to the staff of Social Security of Paris, the ADOMA host of the CAES of Boulangerie, for enabling us to continue this research. Any errors are, of course, ours alone. We would also like to show our special gratitude to the immigrant men who agreed to participate in this research.
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Azadi, B., Dollat, M., Troia, G. et al. Voluntary HIV and Viral Hepatitis Testing in Newly Arrived Migrant Men in a First Reception Center in the North of Paris—a Qualitative Study on the Perception and Forms of Participation. Int. Migration & Integration 23, 1599–1619 (2022). https://doi.org/10.1007/s12134-021-00897-z
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DOI: https://doi.org/10.1007/s12134-021-00897-z