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Van Landeghem E, Arbier A, Pratt CSA, Senga M, Scheerder G, Reyniers T, Hensen B, Nöstlinger C. PrEP Among Sub-Saharan African Diaspora Communities in Belgium - a Participatory Action Research Study. J Community Health 2024; 49:156-165. [PMID: 37580443 PMCID: PMC10881606 DOI: 10.1007/s10900-023-01269-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2023] [Indexed: 08/16/2023]
Abstract
In Belgium, migrants from Sub-Saharan Africa (SSA) accounted for 45% of new heterosexual HIV infections in 2021, while only 1.5% of PrEP starters were of SSA descent. We explored the acceptance of PrEP and barriers towards PrEP uptake and use among SSA migrant and diaspora communities in Belgium using a participatory action research approach. Trained community researchers (CRs), involved in all phases of the study, co-designed and moderated group discussions (GDs) while simultaneously providing information on HIV and PrEP during workshops. Extensive summaries and field notes were analysed using reflexive thematic analysis. CRs were involved in data analysis, interpretation and reporting. We conducted seven GDs with 51 participants. We identified five major themes: (1) Participants had limited PrEP knowledge, which created feelings of surprise and annoyance about not being informed. This was partly explained by (2) the taboo and stigma that surrounds sexuality and HIV, which could shape PrEP acceptance. (3) Participants shared feelings of otherness due to experiences of racism and discrimination, also in relationship to HIV prevention. (4) PrEP was considered a high-threshold prevention tool, because of its perceived side-effects and its specialized service delivery. (5) Despite nuanced opinions about PrEP, all participants agreed that PrEP promotion should be mainstreamed, so everyone can make an informed decision. In conclusion, PrEP seemed acceptable among our participants. Our qualitative study provides insights into the intersecting barriers to accessing HIV services, showing that SSA diaspora communities are 'hardly reached' rather than 'hard to reach' by PrEP promotion messages.
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Affiliation(s)
- Ella Van Landeghem
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155 Antwerp, Antwerp, 2000, Belgium.
| | - Alida Arbier
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155 Antwerp, Antwerp, 2000, Belgium
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Christian Sydney A Pratt
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155 Antwerp, Antwerp, 2000, Belgium
| | - Mikaza Senga
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155 Antwerp, Antwerp, 2000, Belgium
| | - Gert Scheerder
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155 Antwerp, Antwerp, 2000, Belgium
| | - Thijs Reyniers
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155 Antwerp, Antwerp, 2000, Belgium
| | - Bernadette Hensen
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155 Antwerp, Antwerp, 2000, Belgium
| | - Christiana Nöstlinger
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155 Antwerp, Antwerp, 2000, Belgium
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De Jesus M, Warnock B, Moumni Z, Sougui ZH, Pourtau L. The impact of social capital and social environmental factors on mental health and flourishing: the experiences of asylum-seekers in France. Confl Health 2023; 17:18. [PMID: 37029423 PMCID: PMC10081295 DOI: 10.1186/s13031-023-00517-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 03/31/2023] [Indexed: 04/09/2023] Open
Abstract
BACKGROUND There is growing interest on how social capital and related social environmental factors impact overall population health and well-being. The nature of asylum-seekers' social environment alters once they migrate to a new context and these changes influence their mental health and well-being. However, there is limited scholarship on how these social environmental factors impact the mental health, well-being, and capacity to flourish of asylum-seekers. METHODS The aim of the study, therefore, was to examine how specific social environmental factors-social networks, social support, and social cohesion at various levels (micro, meso, and macro)-influence the mental health, well-being, and capacity to flourish of asylum-seekers in France. In collaboration with a community-based organization, we used a qualitative research design to conduct 120 semi-structured interviews with asylum-seekers in France. RESULTS The emerging salient themes depicted how the asylum-seekers' usual informal social networks comprised of family and friends had been disrupted since they migrated to France, which impacted their mental health and well-being. Conversely, staying connected with their informal transnational social networks via social media and developing ties with new local informal and formal social networks allowed them to receive different forms of social support, and buffered some of the negative mental health consequences. However, the lack of social cohesion due to a lack of belonging, marginalization, and current harmful migration-related policies impeded asylum-seekers' capacity to flourish. CONCLUSION While social support derived from social networks buffered some negative impacts on mental health and well-being, the overall lack of social cohesion ultimately impeded asylum-seekers' capacity to flourish within their host communities, which was further exacerbated by harmful migration policies of exclusion within France. Introducing more inclusive policies related to the governance of migration and an intersectoral approach that views health in all policies is key to promoting social cohesion and flourishing among asylum-seekers in France.
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Affiliation(s)
- Maria De Jesus
- Collegium de Lyon, Université de Lyon, Lyon, France.
- School of International Service, American University, 4400 Massachusetts Ave, NW, Washington, DC, 20016, USA.
- Center on Health, Risk, and Society, American University, Washington, DC, USA.
| | - Bronwyn Warnock
- School of International Service, American University, 4400 Massachusetts Ave, NW, Washington, DC, 20016, USA
| | - Zoubida Moumni
- Psychologie de la Santé, Université Lumière Lyon 2, 69365, Lyon, France
| | - Zara Hassan Sougui
- Santé Publique, Université Claude Bernard Lyon 1, 69100, Villeurbanne, France
| | - Lionel Pourtau
- Pôle Recherche et Innovation, Habitat et Humanisme, 69300, Caluire et Cuire, France
- LEIRIS, Université Paul Valéry Montpellier 3, 34090, Montpellier, France
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Van Poel E, Collins C, Groenewegen P, Spreeuwenberg P, Bojaj G, Gabrani J, Mallen C, Murauskiene L, Šantrić Milićević M, Schaubroeck E, Stark S, Willems S. The Organization of Outreach Work for Vulnerable Patients in General Practice during COVID-19: Results from the Cross-Sectional PRICOV-19 Study in 38 Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3165. [PMID: 36833862 PMCID: PMC9960761 DOI: 10.3390/ijerph20043165] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic disproportionately affected vulnerable populations' access to health care. By proactively reaching out to them, general practices attempted to prevent the underutilization of their services. This paper examined the association between practice and country characteristics and the organization of outreach work in general practices during COVID-19. Linear mixed model analyses with practices nested in countries were performed on the data of 4982 practices from 38 countries. A 4-item scale on outreach work was constructed as the outcome variable with a reliability of 0.77 and 0.97 at the practice and country level. The results showed that many practices set up outreach work, including extracting at least one list of patients with chronic conditions from their electronic medical record (30.1%); and performing telephone outreach to patients with chronic conditions (62.8%), a psychological vulnerability (35.6%), or possible situation of domestic violence or a child-rearing situation (17.2%). Outreach work was positively related to the availability of an administrative assistant or practice manager (p < 0.05) or paramedical support staff (p < 0.01). Other practice and country characteristics were not significantly associated with undertaking outreach work. Policy and financial interventions supporting general practices to organize outreach work should focus on the range of personnel available to support such practice activities.
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Affiliation(s)
- Esther Van Poel
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| | - Claire Collins
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
- Research Centre, Irish College of General Practitioners, D02 XR68 Dublin, Ireland
| | - Peter Groenewegen
- Netherlands Institute for Health Services Research, 3500 BN Utrecht, The Netherlands
- Department of Sociology, Department of Human Geography, Utrecht University, 9000 Ghent, Belgium
| | - Peter Spreeuwenberg
- Netherlands Institute for Health Services Research, 3500 BN Utrecht, The Netherlands
| | - Gazmend Bojaj
- Management of Health Institutions and Services, Heimerer College, 10000 Prishtina, Kosovo
| | - Jonila Gabrani
- Faculty of Medicine, University of Basel, 4001 Basel, Switzerland
| | | | - Liubove Murauskiene
- Public Health Department, Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania
| | | | - Emmily Schaubroeck
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
| | - Stefanie Stark
- Institute of General Practice, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen-Nürnberg, Germany
| | - Sara Willems
- Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
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Ravalihasy A, Rude N, Yazdanpanah Y, Kardas-Sloma L, Desgrées du Loû A, Gosselin A, Ridde V. Development and Validation of an HIV/AIDS Empowerment Scale for Impact Intervention Evaluation. An Example from the MAKASI Intervention. AMERICAN JOURNAL OF HEALTH EDUCATION 2021. [DOI: 10.1080/19325037.2021.1955230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Andrainolo Ravalihasy
- Centre Population et Développement (IRD, Université de Paris, Inserm ERL 1244 SAGESUD)
- Institut de Recherche Pour le Développement
- UMR 1137, Inserm, University of Paris, IAME
- French Collaborative Institute on Migrations, CNRS
| | - Nathalie Rude
- UFR Santé, EA 481 Neurosciences, Université de Franche Comté
| | | | | | - Annabel Desgrées du Loû
- Centre Population et Développement (IRD, Université de Paris, Inserm ERL 1244 SAGESUD)
- Institut de Recherche Pour le Développement
- French Collaborative Institute on Migrations, CNRS
| | - Anne Gosselin
- Centre Population et Développement (IRD, Université de Paris, Inserm ERL 1244 SAGESUD)
- French Collaborative Institute on Migrations, CNRS
- ERES, Social Epidemiology Unit, IPLESP, INSERM S1136
| | - Valéry Ridde
- Centre Population et Développement (IRD, Université de Paris, Inserm ERL 1244 SAGESUD)
- Institut de Recherche Pour le Développement
- French Collaborative Institute on Migrations, CNRS
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Carillon S, Gosselin A, Coulibaly K, Ridde V, Desgrées du Loû A. Immigrants facing Covid 19 containment in France : An ordinary hardship of disaffiliation. J Migr Health 2020; 1-2:100032. [PMID: 34405180 PMCID: PMC8351997 DOI: 10.1016/j.jmh.2020.100032] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 12/04/2020] [Accepted: 12/06/2020] [Indexed: 12/16/2022] Open
Abstract
The precarious immigrant population is often invisible because it is at the interstices of care devices and, in the current epidemic context, isolation facilities. Confinement affects individuals' abilities to act, and generates a "disaffiliation process" to placing this precarious immigrant population even more on the margins of society. Covid-19 crisis exacerbates pre-existing difficulties, generating not so new situations for these precarious immigrant population. Need to formulate specifics interventions : targeted outreach intervention, participatory approach and deliberative spaces ; promote health promotion intervention; right based intervention.
In order to limit the spread of the SARS-CoV-2 virus, the majority of governments have introduced population containment. Certain population groups, including immigrants in precarious situations, are experiencing the impact of this measure in a brutal manner. This article is based on accounts of containment experiences collected by telephone within the framework of a pre-existing intervention research carried out among immigrants to France from Sub-Saharan Africa who are in a precarious situation. It highlights certain social effects of containment and the logics at work in the precarious situations. This research shows how this a priori unprecedented situation affects individual capacities to act and generates a ‘disaffiliation process’ causing individuals to shift towards ‘social non-existence’, repeating lived experiences and exacerbating pre-existing logics. The ordeal of containment proves to be an ordinary experience for these individuals.
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Affiliation(s)
- Séverine Carillon
- Centre Population et Développement (CEPED), Institut de recherche pour le développement (IRD) et Université de Paris, Inserm ERL 1244, Paris, France
- Corresponding author at: Centre Population et Développement (CEPED), Institut de recherche pour le développement (IRD) et Université de Paris, Inserm ERL 1244, Paris, France.
| | - Anne Gosselin
- Centre Population et Développement (CEPED), Institut de recherche pour le développement (IRD) et Université de Paris, Inserm ERL 1244, Paris, France
- French Collaborative Institute on Migrations/CNRS, Paris, France
- Department of Social Epidemiology (ERES), Pierre Louis Institute for Epidemiology and Public Health (IPLESP/ INSERM UMR_S 1136), Paris, France
| | - Karna Coulibaly
- Centre Population et Développement (CEPED), Institut de recherche pour le développement (IRD) et Université de Paris, Inserm ERL 1244, Paris, France
| | - Valéry Ridde
- Centre Population et Développement (CEPED), Institut de recherche pour le développement (IRD) et Université de Paris, Inserm ERL 1244, Paris, France
- French Collaborative Institute on Migrations/CNRS, Paris, France
- IRD, French Institute for Sustainable Development, France
| | - Annabel Desgrées du Loû
- Centre Population et Développement (CEPED), Institut de recherche pour le développement (IRD) et Université de Paris, Inserm ERL 1244, Paris, France
- French Collaborative Institute on Migrations/CNRS, Paris, France
- IRD, French Institute for Sustainable Development, France
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