IRD, Institut de Recherche pour le Développement, Marseille, France.
SAGESUD Team, CEPED (Université Paris Descartes, IRD, Inserm), Paris, France.
J Epidemiol Community Health. 2018 Jun;72(6):507-512. doi: 10.1136/jech-2017-209739. Epub 2018 Feb 2.
Life course epidemiology is now an established field in social epidemiology; in sociodemography, the quantitative analysis of biographies recently experienced significant trend from event history analysis to sequence analysis. The purpose of this article is to introduce and adapt this methodology to a social epidemiology question, taking the example of the impact of HIV diagnosis on Sub-Saharan migrants' residential trajectories in the Paris region.
The sample consists of 640 migrants born in Sub-Saharan Africa receiving HIV care. They were interviewed in healthcare facilities in the Paris region within the PARCOURS project, conducted from 2012 to 2013, using life event history calendars, which recorded year by year their health, family and residential histories. We introduce a two-step methodological approach consisting of (1) sequence analysis by optimal matching to build a typology of migrants' residential pathways before and after diagnosis, and (2) a Cox model of the probability to experience changes in the residential situation.
The seven-clusters typology shows that for a majority, the HIV diagnosis did not entail changes in residential situation. However 30% of the migrants experienced a change in their residential situation at time of diagnosis. The Cox model analysis reveals that this residential change was in fact moving in with one's partner (HR 2.99, P<0.000) rather than network rejection.
This original combination of sequence analysis and Cox models is a powerful process that could be applied to other themes and constitutes a new approach in the life course epidemiology toolbox.
NCT02566148.
生命历程流行病学现在是社会流行病学中的一个成熟领域；在社会人口学中，传记的定量分析最近从事件历史分析转向了序列分析。本文的目的是介绍并适应这种方法到一个社会流行病学问题中，以 HIV 诊断对巴黎地区撒哈拉以南移民居住轨迹的影响为例。
该样本由 640 名在撒哈拉以南非洲接受 HIV 护理的移民组成。他们是在 2012 年至 2013 年期间的 PARCOURS 项目中在巴黎地区的医疗保健机构接受采访的，使用生命事件历史日历，记录他们逐年的健康、家庭和居住历史。我们引入了一种两步方法，包括（1）通过最佳匹配进行序列分析，以构建诊断前后移民居住路径的类型学，以及（2）对居住情况变化的 Cox 模型。
七种聚类的类型学表明，对于大多数人来说，HIV 诊断并没有导致居住情况的变化。然而，30%的移民在诊断时经历了居住情况的变化。Cox 模型分析表明，这种居住变化实际上是与伴侣住在一起（HR 2.99，P<0.000），而不是网络排斥。
这种序列分析和 Cox 模型的原始组合是一种强大的过程，可以应用于其他主题，并构成生命历程流行病学工具包中的一种新方法。
NCT02566148。
