They are Nigerian, Guinean, Cameroonian, Ivorian. To women who call her from Ile-de-France, Libya or the Italian island of Lampedusa, Caroline Andoum does not hesitate to “speak crudely”. She discusses with them their sexual health and ways to protect themselves from AIDS. Mme Andoum is the general director of Bamesso et ses amis, a health association based in Blanc-Mesnil (Seine-Saint-Denis). While the 1er December is World AIDS Day, and 2023 marks the fortieth anniversary of the discovery of the virus, she has a lot to do to prevent infections among migrant women, who remain one of the populations that access the most difficulty in prevention and treatment.
According to the report published by Public Health France (SPF) on November 28between 4,200 and 5,700 people discovered their HIV status in 2022. This is less than in 2019, which is “encouraging about the dynamics of the epidemic”, according to the agency. However, “over the entire period 2012-2022, the number of discoveries is almost stable among heterosexual women born abroad”according to SPF, while it decreased for men who have sex with men (MSM) born in France, heterosexual women born in France, injection drug users and heterosexual men.
Women thus represent 31% of HIV-positive discoveries. Many of them come from sub-Saharan Africa. “A significant part of contamination occurs after migration”refers to SPF, which refers to the 2015 ANRS-Parcours study having estimated this rate between 25 and 35% for women from the region.
“There is a blind spot”
The men these women meet in France often belong to their community, suffering from a high prevalence of HIV. However, notes Caroline Andoum, women who arrive without papers and without resources are in a weak position to negotiate condoms with their partners if they refuse them. Even more so when they prostitute themselves to survive.
Under these conditions, the daily tablet to be taken as part of preventive treatment by pre-exposure prophylaxis (PrEP), authorized in France since 2016 and reimbursed by Social Security, has the double advantage of being able to be uncorrelated with sexual intercourse and to allow give women control over their protection. It is still necessary to make it known, and “only with community associations can we be efficient”according to Doctor Thomas Huleux, head of the infectious diseases office at the Seine-Saint-Denis departmental council.
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