Ethnic variations in sexual and preventive practices in France: first results from a community-based survey.

Aim: Afro-Caribbean populations bear a disproportionate burden of HIV infection in France. However, few data are available concerning their sexual and prevention practices. Using a community-based survey conducted among Afro-Caribbean populations in France, this presentation aims at characterizing sexual and preventive practices among these populations taking into account their ethnic diversity. Method / Issue: This presentation is based on the Afro-Baromètre 2011, first community-based survey among Afro-Caribbean populations in France. It was carried out in Paris and its surroundings in 2011 by Afrique Avenir, a community aids association. This survey recruited a sample of 4,044 male and female respondents of Afro-Caribbean origin. Respondents were mostly born in a sub-Saharan African country (55%), then in metropolitan France (22%), in the overseas departments (19%) and in the Caribean region (4%). Data were collected by a self-administred questionnaire in prevention sites of Afrique Avenir (night club, hair salon, community halls) frequented mostly by Afro-Caribbean populations. Mean duration to complete a questionnaire was 20 minutes. Of the 12,000 questionnaires distributed, 4044 were valide, or an exploitation rate of 34%. Results / Comments: Among sexually active respondents, a significant proportion reported concurrent sexual partnerships during the past 12 months, more often men than women (39 % vs 24 %). Condom use was frequent during the past 12 months (64 %), without differences between men and women. Respondents who reported concurrent partnerships were more likely to report condom use than respondents who reported only one sexual partner (86 % vs 39 %). Condom use was associated with region of birth for men but not for women : it was less frequent among men born in sub-Saharan Africa than among men born in metropolitan France (OR: 0,48; [0.24,0.95]). Sexual intercourse with same-sex partners during the past 12 months concerned a significant proportion of the sample(5 %), without differences between men and women. However, men were more likely than women to report only same-sex partners during the past 12 months (4 % vs 2 %). These proportions vary sharply according to region of birth. Respondents born in the Caribean region were more likely to report same-sex partners in the past 12 months than respondents born in an other region (14 % vs 4 %). Discussion: This methodology enabled us to obtain a diversified sample in terms of region of birth and sexual activity. Being born in sub-Saharan Africa is associated with less frequent condom use for men but not for women which suggests than women adopt more easily prevention practices in the French context. Moreover, these data confirm that same-sex partnerships exists among Afro-Caribbean population. The proportion is equivalent to that observed in the French general population except for migrants from the Caribean region. These results highlight the importance of taking into account the ethnic diversity of these populations and raise the question of how to reach people who have same-sex partners in order to make appropriate prevention.[résumé auteur]