Gosselin Anne, Lelièvre Eva, Ravalihasy Andrainolo, Lydié Nathalie, Lert France, Desgrées du Loû Annabel
CEPED, UMR 196 Université Paris Descartes-IRD, 45 rue des Saints Pères, Paris, France.
INED (French Institute for Demographic Studies), 133 Bd Davout, Paris, France.
PLoS One. 2017 Jan 27;12(1):e0170226. doi: 10.1371/journal.pone.0170226. eCollection 2017.
Migrants account for 35% of HIV diagnoses in the European Union (ECDC/WHO 2014). Little is known about the impact of such a lifelong infection diagnosis on lives that are already disrupted by migration. In this paper, we assess the impact of HIV diagnosis on activity, union, well-being among African migrants living in France, the second group most affected by HIV after MSM. We compare it with the impact of the diagnosis of Hepatitis B, another lifelong infection affecting African migrants.
We use the ANRS PARCOURS survey, a retrospective life-event survey led in 2012-2013 in 74 health structures in Paris greater area which collected 926 life histories of Sub-Saharan migrants living with HIV and 779 with Hepatitis B. We modelled the probability year by year since 18 years of age until data collection to lose one's activity, to experience a conjugal break up and degradation of well-being and we estimated the impact of migration and of HIV and Hepatitis B diagnoses on these probabilities, after adjustment on other factors, thanks to discrete-time logistic regressions.
Migration entailed loss of activity and conjugal break up, though HIV diagnosis after migration did not statistically impact on these outcomes. Yet HIV diagnosis had a massive negative impact on well-being (aOR = 11.31 [4.64-27.56] for men and 5.75 [2.79-11.86] for women). This negative impact on well-being tended to diminish for persons diagnosed after 2004. The negative impact of HIV diagnosis on African migrants' well-being seems to be attenuated in the last decade, which hints at a normalization of the subjective experience of HIV diagnosis.
在欧盟，移民占艾滋病病毒诊断病例的35%（欧洲疾病预防与控制中心/世界卫生组织，2014年）。对于这种终身感染诊断对本已因移民而受到扰乱的生活所产生的影响，我们知之甚少。在本文中，我们评估了艾滋病病毒诊断对居住在法国的非洲移民的活动、婚姻状况和幸福感的影响，非洲移民是继男男性行为者之后受艾滋病病毒影响的第二大群体。我们将其与乙型肝炎诊断的影响进行比较，乙型肝炎是另一种影响非洲移民的终身感染疾病。
我们使用了法国国家艾滋病研究机构（ANRS）的PARCOURS调查，这是一项回顾性生活事件调查，于2012年至2013年在巴黎大区的74个卫生机构开展，收集了926名感染艾滋病病毒的撒哈拉以南移民和779名感染乙型肝炎的移民的生活史。我们对自18岁起直至数据收集期间逐年失去活动能力、经历婚姻破裂和幸福感下降的概率进行建模，并通过离散时间逻辑回归，在对其他因素进行调整后，估计移民以及艾滋病病毒和乙型肝炎诊断对这些概率的影响。
移民导致活动能力丧失和婚姻破裂，不过移民后艾滋病病毒诊断在统计学上并未对这些结果产生影响。然而，艾滋病病毒诊断对幸福感有巨大的负面影响（男性的调整后比值比为11.31[4.64 - 27.56]，女性为5.75[2.79 - 11.86]）。对于2004年后被诊断出感染艾滋病病毒的人，这种对幸福感的负面影响趋于减弱。在过去十年中，艾滋病病毒诊断对非洲移民幸福感的负面影响似乎有所减轻，这暗示着艾滋病病毒诊断的主观体验正在趋于正常化。
