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

Karna Coulibaly (1, 2, 3) , Marwân-Al-Qays Bousmah (4, 1, 5, 3) , Andrainolo Ravalihasy (1) , Corinne Taéron (6) , Romain Mbiribindi (7) , Jean-Noël Senne (8) , Flore Gubert (9) , Flore Gubert (9, 10, 3) , Anne Gosselin (11, 1, 2, 3) , Annabel Desgrées du Loû (1, 2)

1 CEPED - UMR_D 196 - Centre population et développement
2 SAGESUD - ERL Inserm U1244 - Santé, vulnérabilités et relations de genre au sud
3 IC Migrations - Institut Convergences Migrations [Aubervilliers]
4 SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale
5 ISSPAM - Institut des sciences de la santé publique [Marseille]
6 ARCAT - Pasaje Latino, Groupe SOS [Paris]
7 Afrique Avenir
8 RITM - Réseaux Innovation Territoires et Mondialisation
9 LEDa - Laboratoire d'Economie de Dauphine
10 PJSE - Paris Jourdan Sciences Economiques
11 INED - Institut national d'études démographiques

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.

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

Domaines: Santé publique et épidémiologie; Maladies infectieuses; Education

Karna Coulibaly, Marwân-Al-Qays Bousmah, Andrainolo Ravalihasy, Corinne Taéron, Romain Mbiribindi, et al.. Bridging the knowledge gap of biomedical HIV prevention tools among sub-saharan african immigrants in France. Results from an empowerment-based intervention. SSM - Population Health, 2023, 23, pp.101468. ⟨10.1016/j.ssmph.2023.101468⟩. ⟨hal-04185920⟩