Couple et sexualité des femmes d'Afrique sub-saharienne vivant avec le VIH/sida en France

Pourette, Dolorès

doi:10.1051/medsci/2008242s184

Cited by 17 publications

(11 citation statements)

References 26 publications

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“…In Burkina Faso, an analysis of the effects of gender on testing showed that while fear of rejection by partners, friends or family members was cited as a reason for not using testing in general, women also cited a fear of losing their livelihoods ( 37 ). A woman's precariousness and/or financial dependence is a factor that reinforces her vulnerability to the undesirable effects of sharing HIV status within the couple ( 38 ). For this reason, a study conducted in Mali as part of the Gundo-So program emphasized the need to strengthen programs supporting PLHIV and empower PLHIV so that they can make free and informed decisions regarding the disclosure of their HIV status ( 22 ).…”

Section: Discussionmentioning

confidence: 99%

Challenges of HIV Self-Test Distribution for Index Testing When HIV Status Disclosure Is Low: Preliminary Results of a Qualitative Study in Bamako (Mali) as Part of the ATLAS Project

Boye

Bouaré²,

Ky-Zerbo

et al. 2021

Front. Public Health

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Context: The rate of HIV status disclosure to partners is low in Mali, a West African country with a national HIV prevalence of 1.2%. HIV self-testing (HIVST) could increase testing coverage among partners of people living with HIV (PLHIV). The AutoTest-VIH, Libre d'accéder à la connaissance de son Statut (ATLAS) program was launched in West Africa with the objective of distributing nearly half a million HIV self-tests from 2019 to 2021 in Côte d'Ivoire, Mali, and Senegal. The ATLAS program integrates several research activities. This article presents the preliminary results of the qualitative study of the ATLAS program in Mali. This study aims to improve our understanding of the practices, limitations and issues related to the distribution of HIV self-tests to PLHIV so that they can offer the tests to their sexual partners.Methods: This qualitative study was conducted in 2019 in an HIV care clinic in Bamako. It consisted of (i) individual interviews with eight health professionals involved in the distribution of HIV self-tests; (ii) 591 observations of medical consultations, including social service consultations, with PLHIV; (iii) seven observations of peer educator-led PLHIV group discussions. The interviews with health professionals and the observations notes have been subject to content analysis.Results: HIVST was discussed in only 9% of the observed consultations (51/591). When HIVST was discussed, the discussion was almost always initiated by the health professional rather than PLHIV. HIVST was discussed infrequently because, in most of the consultations, it was not appropriate to propose partner HIVST (e.g., when PLHIV were widowed, did not have partners, or had delegated someone to renew their prescriptions). Some PLHIV had not disclosed their HIV status to their partners. Dispensing HIV self-tests was time-consuming, and medical consultations were very short. Three main barriers to HIVST distribution when HIV status had not been disclosed to partners were identified: (1) almost all health professionals avoided offering HIVST to PLHIV when they thought or knew that the PLHIV had not disclosed their HIV status to partners; (2) PLHIV were reluctant to offer HIVST to their partners if they had not disclosed their HIV-positive status to them; (3) there was limited use of strategies to support the disclosure of HIV status.Conclusion: It is essential to strengthen strategies to support the disclosure of HIV+ status. It is necessary to develop a specific approach for the provision of HIV self-tests for the partners of PLHIV by rethinking the involvement of stakeholders. This approach should provide them with training tailored to the issues related to the (non)disclosure of HIV status and gender inequalities, and improving counseling for PLHIV.

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Section: Discussionmentioning

confidence: 99%

Challenges of HIV Self-Test Distribution for Index Testing When HIV Status Disclosure Is Low: Preliminary Results of a Qualitative Study in Bamako (Mali) as Part of the ATLAS Project

Boye

Bouaré²,

Ky-Zerbo

et al. 2021

Front. Public Health

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“…En France, les recherches en sciences sociales sur la santé des migrants se multiplient. Elles interrogent plusieurs problématiques : les inégalités de santé [1,2,3], l'accès au dépistage et aux soins [4,5,6], l'articulation des parcours de maladie et de migration [7,8,9], les enjeux politiques de la santé des étrangers [10,11,12]. Les attentes des patients migrants vis-à-vis du médecin en contexte de maladie chronique restent peu explorées, de même que les caractéristiques de la relation médecin-patient [13].…”

Section: Introductionunclassified

Prise en charge du VIH et de l'hépatite B chronique chez les migrants subsahariens en France : le rôle-clé de la relation médecin-patient

Pourette¹

2013

Santé Publique

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In France, populations from sub-Saharan Africa represent a large proportion of the persons living with chronic hepatitis B or HIV. The objective of this study was to analyse the characteristics of the doctor-patient relationships in these diseases, when the patient is a sub-Saharan migrant, according to the doctor's objectives, the patient's expectations, and the context of care for these in diseases. A qualitative study by semi-structured interviews and by observations of medical consultations was conducted in four hospitals in Ile-de-France. Seventy-three patients from Sub-Saharan Africa living with chronic hepatitis B or HIV, and 13 doctors were interviewed. The study emphasizes the central role of the doctor-patient relationship in meeting the patient's expectations in relation to management. The characteristics of this relationship are different for these two diseases. For hepatitis B, a mismatch was observed between the doctor's objectives, centered on medical care, and the patient's expectations (information about the disease and treatment, support in everyday life with the infection and administrative procedures) in a context of misunderstanding and negative perception of hepatitis B. For HIV, the doctor's objectives and the patient's expectations were more closely matched because personal, social, and administrative difficulties are integrated into care. Management of sexual problems and legal obstacles to family entry and settlement remain uncertain. Similar studies in populations born in France would be necessary to complete these results.

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“…Most were young women who had come to France on their own. They had learned of 7 This was post-doctoral research conducted-at Inse~Ij research unit 569, and was funded by Sidaction and the Fondation de France (see also Pourette 2006Pourette , 2008aPourette , 2008b. 8 The recruitrnent criteria were as follows: over 18 years of age, born in a country of Sub-Saharan Africa, having been living in Fran~e for at least a year and having been diagnosed as mY-positive at least a year before the date of the survey.…”

Section: The Surveymentioning

confidence: 99%

Violence Against Migrant Women, Health and Sexuality:

Pourette¹

2011

Violence Against Women and Ethnicity: Commonalities and Differences Across Europe

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Research into violence against women has shown the impact it has on their health (Jaspard et al2003; Saurel-Cubizolles 2005). The experience of sexual violence in childhood or of intimate partner violence puts women at risk of health problems, particularly sexually transmitted diseases, as it makes women less able to negotiate safe sex or control their sexual and reproductive lives (Damant et al. 2003; Salomon and Hamelin 2008). Illness is a time of physical, physiological and social frailty. Research among people living with RN/AIDS has shown that the diagnosis leads to isolation from family and society, marked social vulnerability and exclusion from the labour market (Pierret 2006), particularly for foreign migrants (Lot et al. 2004). For these migrants, however, illness can open the way to regularising their administrative status by means of a residence permit for medical reasons. Illness thus becomes a political issue (Fassin 2001) though these permits are becoming increasingly hard to obtain, so limiting immigrant patients' access to citizenship and employment. Immigrant women are particularly disadvantaged. They are subject to inequality in a number of forms owing to their fragile administrative status, their gender, class and 'race', and their confinement to a limited fraction of the labour market, particularly formal or informal sector domestic service (Anderson 1997; Momsen 1999; Oso Casa 2005)irhe/administrative exclusion of immigrants and their exclusion from the labour market are products of an institutionalised racism (Bataille 1999) which hampers their access to Europe and to social and political rights. It makes women particularly vulnerable and exposes them to multiple forms of exploitation and interpersonal violence, intimate partner violence in particular. Those suffering from a stigmatised disease for which treatment is not available in their country of origin are even more vulnerable. For these sick, destitute immigrant women, survival often involves exploitation of their bodies (Sayad 1999), through domestic labour and through sexual exploitation; women's sexuality is still

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Couple et sexualité des femmes d'Afrique sub-saharienne vivant avec le VIH/sida en France

Cited by 17 publications

References 26 publications

Challenges of HIV Self-Test Distribution for Index Testing When HIV Status Disclosure Is Low: Preliminary Results of a Qualitative Study in Bamako (Mali) as Part of the ATLAS Project

Challenges of HIV Self-Test Distribution for Index Testing When HIV Status Disclosure Is Low: Preliminary Results of a Qualitative Study in Bamako (Mali) as Part of the ATLAS Project

Prise en charge du VIH et de l'hépatite B chronique chez les migrants subsahariens en France : le rôle-clé de la relation médecin-patient

Violence Against Migrant Women, Health and Sexuality:

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