The women affected come from Nigeria, Guinea, Cameroon and Côte d'Ivoire. When she's talking with the women who phone her from Ile-de-France, Libya or the Italian island of Lampedusa, Caroline Andoum has no problem with being blunt. She explains sexual health to them and tells them how to protect themselves from AIDS. Andoum is the managing director of Bamesso et Ses Amis (Bamesso and Friends), a health association based in Blanc-Mesnil in the Paris suburb of Seine-Saint-Denis. December 1 is World AIDS Day and 2023 marks the 40th anniversary of the discovery of the virus. Andoum has her work cut out to prevent infections among migrant women, who are one of the groups that have the most difficulty in accessing prevention and treatment.
According to the report published by Santé Publique France (SPF, Public Health France) on November 28, between 4,200 and 5,700 people found out they were HIV-positive in 2022. According to the agency, this is less than in 2019, which is "encouraging in terms of the dynamics of the epidemic." However, "over the entire 2012-2022 period, the number of those who learned this fact is almost stable among foreign-born heterosexual women," according to SPF, while it has fallen for French-born men who have sex with men (MSM), French-born heterosexual women, IV-drug users and heterosexual men.
Women account for 31% of new HIV-positive cases. Many of them come from sub-Saharan Africa. "A significant proportion of contaminations happen after migration," said SPF, referring to the 2015 ANRS-Parcours study estimating this rate at between 25% and 35% for women originating from the region.
The men these women meet in France often come from the same community, which has high rates of HIV. As Andoum pointed out, women who arrive without papers and without money are in a weak position to ask to use condoms with their partners if they refuse. Even more so when they become sex workers in order to survive.
In this kind of situation, the daily tablet to be taken as part of the preventive treatment by pre-exposure prophylaxis (PrEP) – authorized in France since 2016 and reimbursed by French social security – has the added advantage of not being directly linked to sexual intercourse, meaning that women can be in control of their own protection. But you have to know about it to benefit from it. "We can only be effective with the help of community associations," said Dr. Thomas Huleux, head of infectious diseases at the Seine-Saint-Denis departmental council.
You have 65% of this article left to read. The rest is for subscribers only.