According to the ANRS PARCOURS investigation, which studied the life trajectories of migrants from sub-Saharan Africa in France, sexual violence suffered on the French territory by migrant women multiplies their risk of HIV infection by 4.
The results of this study, conducted by Julie Pannetier and Annabel Desgrées du Loû, IRD researchers within the CEPED (IRD, Inserm, Paris Descartes University), show the association between administrative instability, living conditions, sexual violence and HIV infection among sub-Saharan African women who have migrated to France. These results, which are at the crossroads between two major current themes (the migratory crisis and the denunciation of sexual violence against women) are the subject of a publication in the first 2018 issue of the journal The Lancet Public Health.
Health is a major issue in the question of migrants and migrations in France and worldwide. The unstable position of migrants from sub-Saharan Africa, especially women, after their arrival in France, makes them vulnerable to different health problems, particularly HIV infection. The ANRS PARCOURS survey looked at the life journeys and health of migrants in France.
Large numbers of African women living in Ile-de-France have at some point in their lives suffered sexual violence (defined as sexual relations imposed against their will): 18% of women not infected with HIV, and 24% of those infected with HIV after their arrival in France, have been victims of forced relations.
If we consider only the sexual violence suffered since their arrival in France, it appears that African women’s risk of contracting HIV infection is greatly increased by sexual violence: 15.1% of women who have been infected with HIV since their arrival in France have suffered sexual violence in France (compared to 3.5% of non-infected women). Thus, after taking into account the age differences of these women at the time of the survey, and at that time of migration, as well as their different levels of education, sexual violence suffered in France is 4 times more frequent among women who have contracted HIV after migration, providing a strong argument for the causal role of sexual violence in the acquisition of the infection.
The researchers also analysed the impact of living conditions (administrative residence situation, accommodation type) and of types of sexual relations on the incidence of sexual violence. They show that administrative insecurity regarding residence (no residence permit or very short permit duration), unstable accommodation (needing to change accommodation regularly) and staying with friends or family, create direct exposure to sexual violence (whatever the type of relations) and indirect exposure (when instability is combined with multiple or occasional relationships, and sometimes transactional relations, i.e. in exchange for money, accommodation or assistance). However, women who have emigrated because of violence or threats in their country appear to be more exposed to sexual violence after migration.
As revealed by the editorial and commentary in the Lancet Public Health which are devoted to the article by Julie Pannetier and her colleagues, migrant women are not only exposed to sexual violence during their passage through transit countries. They are also exposed once they arrive in their destination country, due to the conditions imposed on them, particularly in terms of access to residence permits, shelter and accommodation. “The denial of their rights to normal living conditions is also a denial of their right to lives without violence and their right to choose who they want to have sexual relations with,” the authors of the commentary assert.
The ANRS PARCOURS survey was conducted from 2012 to 2013, in 74 health services in Ile de France. It studied life journeys and HIV and/or HBV infection among a random sample of almost 2500 immigrants from sub-Saharan Africa living in France. This research was co-ordinated by Annabel Desgrées du Loû, IRD researcher (CEPED, IRD-Université Paris Descartes). This study highlights the fact that many migrants from sub-Saharan Africa living in France with HIV were infected after their arrival, particularly women, for whom this rate is 30%.