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Factors Associated with Virological Rebound in HIV-Positive Sub-Saharan Migrants Living in France After Traveling Back to Their Native Country: ANRS-VIHVO 2006–2009 Study

Authors :
Jean-Médard Kankou
Olivier Bouchaud
Maria Patrizia Carrieri
Sophie Abgrall
Bruno Spire
Nathalie Lele
Marguerite Guiguet
Hôpital Avicenne [AP-HP]
Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Parcours santé systémique (P2S)
Université Claude Bernard Lyon 1 (UCBL)
Université de Lyon-Université de Lyon
Service des maladies infectieuses et tropicales
Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris 13 (UP13)
Université de Lyon
Université Paris 13 (UP13)
Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP)
Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Sorbonne Université (SU)
Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD)
Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Aix Marseille Université (AMU)
ORS PACA
Hôpital Antoine Béclère
Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)
Centre de recherche en épidémiologie et santé des populations (CESP)
Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)
Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP]
Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)
Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)
Gestionnaire, Hal Sorbonne Université
Source :
Journal of Immigrant and Minority Health, Journal of Immigrant and Minority Health, Springer Verlag, 2019, ⟨10.1007/s10903-019-00864-y⟩
Publication Year :
2019
Publisher :
Springer Science and Business Media LLC, 2019.

Abstract

International audience; In France, around 25% of the estimated number of people living with HIV are migrants, of whom three quarters are from sub-Saharan Africa (SSA). Our objective was to determine factors associated with virological rebound (VR) at the occasion of a transient stay to the country of origin. HIV-positive migrants from SSA participating to the ANRS-VIHVO adherence study between 2006 and 2009, on effective ART with controlled pre-travel HIV-1 plasma viral load (VL), were included. Outcome was VR, defined as VL ≥ 50 copies/ml at the post-travel visit during the week following the return to France. Among 237 persons (61.6% female, median age 41 years (IQR, 35–47), median time on ART 4.2 years (IQR, 2.2–7.1), 27 (11.4%) experienced VR. The main purpose of the travel was to visit family and median time spent abroad was 5.3 weeks (IQR, 4.1–8.8). The travel was extended longer than anticipated by at least 1 week in 42 individuals (17.7%). In multivariable logistic model, risk factors for VR were male sex [adjusted OR (aOR) 5.1; 95% CI 1.6–16.2)], no employment in France (aOR 2.0; 1.2–3.5), self-reported non-adherence during the trip (aOR 14.9; 4.9–45.9) and PI-containing regimen (aOR 4.6; 1.2–17.6). In another analysis not including self-reported adherence, traveling during Ramadan while respecting the fast (aOR 3.3; 1.2–9.6) and extension of the stay (aOR 3.0; 1.1–7.8) were associated with VR. Virological rebound was partly explained by structural barriers to adherence such as extension of the travel and inadequate management of Ramadan fasting. Individuals’ journeys should be carefully planned with health care providers.

Details

ISSN :
15571920 and 15571912
Volume :
21
Database :
OpenAIRE
Journal :
Journal of Immigrant and Minority Health
Accession number :
edsair.doi.dedup.....f977d11dd74987285c6e8113f0c8ccfe
Full Text :
https://doi.org/10.1007/s10903-019-00864-y