Title

Bridging the gap: the impact of an empowerment based intervention on the knowledge of biomedical HIV prevention tools among sub-Saharan African precarious immigrants in France. Results from the Makasi project

Presenter

Karna Coulibaly

Authors

K. Coulibaly^1,2, M.-a.-Q. Bousmah^1,2, A. Ravalihasy^3,1,2, J.-N. Senne⁴, F. Gubert³, A. Gosselin^5,2,1, A. Desgrées du Loû^3,1,2, on behalf of the Makasi study group

Institutions

¹Université Paris Cité, Ceped (Université Paris Cité, IRD, Inserm), Paris, France, ²CNRS, French Collaborative Institute on Migrations, Aubervilliers, France, ³French National Research Institute for Sustainable Development, Bondy, France, ⁴Université Paris Saclay, Paris, France, ⁵French Institute for Demographic Studies, Aubervilliers, France

BACKGROUND: Sub-Saharan African immigrants are particularly affected by HIV in France and social hardship is an indirect factor of HIV acquisition. To prevent new HIV transmission, biomedical HIV prevention tools are available. However, evidence suggests a lack of knowledge of these tools among immigrants from sub-Saharan Africa. We aimed to analyse the impact of social and health empowerment intervention on the knowledge of treatment as prevention (TasP), Pre Exposure Prophylaxis (PrEp) and Post Exposure Prophylaxis (PEP) among a population of precarious sub-Saharan immigrants.
METHODS: Data were collected in the Makasi social and health empowerment project. Participants were recruited in public places based on their precarious situations and followed during six months between 2018 and 2021. Following a stepped-wedge design, participants were randomised into two groups (intervention at recruitment in one group and 3 months later in the other). We described both groups and the knowledge of biomedical HIV prevention tools at each time point (0, 3, 6 months). We used random-effects logistic regression models to analyse booth the intervention effect and time effect on the level of knowledge of these tools. The study protocol was registered on Clinicaltrials.gov NCT04468724.

RESULTS: The majority of the participants were men (77.5%) and almost half of them arrived in France within 2 years prior to inclusion (49.3%). At the time of inclusion, 56% of participants knew about TasP, 6% knew about PEP and 4% knew about PrEP. Receiving the intervention increased the odds of knowing PEP (aOR=2.02 [1.09-3.75]; p<0.026). Intervention effect were observed for TasP and PrEP only after 6 six months. We observed significant time effect for PEP (at 3 months aOR=4.26 [2.33-7.80]; p<0.001; at 6 months aOR=18.28 [7.39-45.24]; p<0.001) and PrEP (at 3 months aOR=4.02 [2.10-7.72]; p<0.001; at 6 months aOR=28.33 [11.16-71.91]; p<0.001).
CONCLUSIONS: The Makasi intervention appeared to impact knowledge of biomedical HIV prevention tools. The effect of the intervention was relatively small compared to the effect of time. This suggests that exposure to the Makasi intervention and perhaps other sources of information together contributed to increase knowledge of biomedical HIV prevention tools among precarious sub-Saharan African immigrants.

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