Surveillance of bacterial STIs relies on several systems:

• The LaboIST Survey: This survey, conducted periodically among all clinical laboratories, aims to collect data on screening and diagnostic activity for the main STIs (gonorrhea, chlamydia, syphilis, and Mycoplasma genitalium infections) at the national and regional levels.

• The RésIST network: the network of volunteer clinicians known as “RésIST” contributes to the surveillance of early-stage syphilis (less than one year old and corresponding to the primary, secondary, or early latent stages) and gonorrhea.

• Consultation data from CeGIDDs (Free Centers for Information, Screening, and Diagnosis of HIV, Viral Hepatitis, and STIs): All CeGIDDs are legally required to participate in this surveillance, which covers HIV infection, viral hepatitis, syphilis, infections with Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium, genital warts, and genital herpes. The data transmitted make it possible to count the screenings and diagnoses performed in these facilities and thus calculate positivity rates. The sociodemographic characteristics of the cases are also collected, which allows for a fairly detailed description of the characteristics of the individuals concerned.

• Data from the National Health Data System (SNDS): enable the counting of screening tests performed by laboratories and reimbursed by health insurance. It is also possible to identify reimbursed antibiotic treatments. Combining the tests performed with antibiotic treatments allows for an estimation of diagnoses for certain STIs, as test results are not available in the SNDS data.

Surveillance of bacterial STIs, conducted by Santé publique France, also draws on the expertise of the National Reference Center (CNR) for Bacterial STIs, which coordinates, in particular, the LGV (venereal lymphogranulomatosis) network and the monitoring of antibiotic susceptibility in Neisseria gonorrhoeae and Mycoplasma genitalium.

The objective of epidemiological surveillance is to produce indicators that characterize the most at-risk populations and regions, in order to help guide and evaluate prevention efforts within the framework of the national sexual health strategy.

HIV surveillance is primarily based on:

• HIV testing activity: This surveillance relies primarily on the LaboVIH survey, conducted annually among all clinical laboratories, which collects data on the number of HIV serology tests and confirmed positive results. These data are supplemented by the number of self-tests sold in pharmacies. Rapid diagnostic tests (RDTs) performed by authorized organizations are also taken into account, with results compiled by the DGS.

• New HIV-positive cases: these data are available through mandatory HIV reporting, carried out in parallel by laboratory professionals and clinicians, who are required to report the cases they diagnose via a web application (e-DO). Mandatory HIV reporting is coupled with virological surveillance conducted by the National Reference Center for HIV (CNR), which involves performing a test for recent infection (a test that specifically identifies early-stage infections). AIDS diagnoses are also subject to mandatory reporting, carried out via e-DO by clinicians.

The Santé publique France Health Barometer

In partnership with numerous healthcare stakeholders, Santé publique France conducts a series of surveys known as the “Health Barometer,” which examine the various health behaviors and attitudes of the French population. The purpose of these surveys is to gain a better understanding of the population’s health attitudes and behaviors.

The Santé publique France Health Barometer is based on surveys of representative samples of the population, conducted using a computer-assisted telephone interviewing system.

The 2016 Health Barometer focused specifically on topics related to sexual health and infectious diseases.

Data collection took place from January 8 to August 1, 2016, in metropolitan France, among 15,216 people aged 15 to 75. Landline and mobile
phone numbers were randomly generated from the prefixes assigned by the French Regulatory Authority for Electronic Communications and Postal Services (ARCEP), specifically to obtain numbers of households not listed in telephone directories. To be eligible, a household had to include at least one person aged 15 to 75 who spoke French. Respondents were selected by random drawing from among eligible household members for landline calls and from among regular mobile phone users for mobile calls.

The survey took an average of 37 minutes to complete. It explored the following topics in particular:

• The circumstances and characteristics of the first sexual encounter

• Sexual behaviors over the course of one’s life (number and gender of partners, characteristics of the current partner, etc.)

• Condom use (over a lifetime, in the past 12 months, with a new partner);

• Contraception, including emergency contraception: knowledge and use

• Sexual violence

• Unplanned pregnancies

• Abortions

• Screening for hepatitis and HIV

Major surveys on the sexual behavior of the French

Santé publique France’s outreach to the general public also draws on the results of major surveys on the sexual behavior of the French population. The latest edition, titled “Context of Sexuality in France” (CSF), was conducted in 2006 under the leadership of Nathalie Bajos (Inserm) and Michel Bozon (INED). It has been the subject of numerous publications, including a report published by Éditions de la Découverte.

A new edition titled “E3S: Survey on Sexuality and Sexual Health” will be conducted in 2022–2023 under the scientific leadership of Nathalie Bajos (Inserm), Armelle Andro (University of Paris 1 Panthéon-Sorbonne), and Caroline Moreau (Inserm).

Objective: to study the sexual and preventive practices of the general population in France, aged 15 to 89, in relation to the societal changes and public policies that have marked the last decade.

To this end, 37,000 people will be surveyed by telephone and online in mainland France and in the DROM (Martinique, Guadeloupe, French Guiana, and Réunion). The survey will collect information on sociodemographic characteristics, perceptions related to sexuality and gender, sexual initiation, sexual practices over the course of one’s life and in the past 12 months, the most recent sexual encounter, digital sexuality, pornography use, paid sexual encounters, sexual harassment and violence, sexuality related to pregnancy, sexual health, and several general health indicators (weight, height, chronic disease, disability, mental health).

Survey data will be supplemented by a biological component (PrévIST) offered to individuals aged 18 to 59 who have already had sexual intercourse, which will allow for the estimation of the prevalence of three sexually transmitted bacterial infections (Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium) and human papillomavirus (HPV) carriage in relation to risky behaviors, screening frequency, and HPV vaccination coverage. This biological component is overseen by the Infectious Diseases Directorate of Santé publique France.

Santé publique France does not conduct specific studies on the sexual health of young people. However, young people may be surveyed as part of large-scale surveys, as was done in 2016 in the Health Barometer on infectious diseases and sexual health, which included respondents aged 15 and older. This survey allowed for questions to be asked of young people regarding their sexual debut (age at first sexual intercourse, characteristics of the partner, etc.), the use of protection, and experiences of sexual violence.

Santé publique France also participates in several initiatives surveying this population, including:

• The EnCLASS Project: National Survey of Adolescents in Middle and High Schools on Health and Substance Use This survey is the result of a collaboration between the research teams of the Health Behaviour in School-aged Children (HBSC) and European School Project on Alcohol and other Drugs (ESPAD) surveys, which have been working for the past 10 years to improve the monitoring system for adolescent health and behavior in France. It surveys school-aged youth by randomly selecting several classes. The questionnaire is completed online in the schools’ computer labs.

• The ENVIE Study: This study is led by INED. Marie Bergström serves as the principal investigator for this project. The ENVIE study focuses on the lifestyles of 18- to 30-year-olds. The study is conducted by telephone and is based on an anonymous questionnaire. A total of 10,000 people will be surveyed during 2022.

Santé publique France coordinates several survey programs targeting men who have sex with men (MSM) to improve understanding of the dynamics of the HIV epidemic and other sexually transmitted infections (STIs), with a particular focus on sociodemographic factors, lifestyles, sexual trajectories, and risk behaviors.

The Presse-Gays Survey

Since 1985, the Presse-Gays Survey has been collecting data on the lifestyles, sexual and preventive practices of MSM, as well as HIV and STI testing practices, on a voluntary basis. Initially distributed through the gay press, the self-administered and anonymous questionnaire has also been available online since 2004 via news and gay dating websites. Over the course of the survey’s 13 editions, more than 38,800 MSM have responded.

The latest edition of the survey, renamed the Gay and Lesbian Press Survey, took place in 2011 and, for the first time, included a questionnaire dedicated to women who have sex with women (WSW), distributed via community websites. In total, 10,587 MSM and 3,662 WSW participated.

PREVAGAY

In 2009, the first HIV seroprevalence survey among men who have sex with men (MSM) frequenting gay social venues (bars, backrooms, and saunas) in Paris was initiated by the InVS. In 2015, Prévagay was repeated in gay social venues in five cities: Lille, Lyon, Nice, Montpellier, and Paris. This survey combined the collection of blood samples on filter paper with the collection of behavioral data via an anonymous, self-administered questionnaire on a tablet. In this latest edition, 2,646 MSM who frequented the 61 venues surveyed participated.

Sexual Behavior Survey – ERAS

With the aim of assessing the adoption of various prevention methods by men who have sex with men (MSM), the Sex Survey (ERAS) was launched by Santé publique France in 2017 with the support of the National Agency for the Fight Against HIV (ANRS). This is a voluntary survey that distributes a self-administered questionnaire via social media, online gay dating sites, and geolocation-based dating apps. The first edition took place from February to March 2017, with 18,000 MSM responding. In 2019, a second edition recruited more than 24,000 MSM. In 2020, a special COVID-19 edition was conducted from June 30 to July 15, with over 8,000 MSM participating. The most recent edition took place from February 26 to April 11, 2021, with nearly 15,000 MSM responding.

European MSM Internet Survey

Santé publique France participates as the French institutional representative in the EMIS (European MSM Internet Survey) on knowledge, attitudes, needs, and behaviors regarding HIV and STI transmission among gay, bisexual, and men who have sex with men (MSM). The first edition of the survey took place in 2010. Recruitment was conducted via an anonymous, self-administered online questionnaire available in 25 languages, accessible through banners placed on the most-visited gay websites in Europe. In 2017, this survey was repeated in 50 countries, including France. More than 10,000 MSM residing in France participated in this latest edition. Principal investigators: Axel J. Schmidt and Peter Weatherburn of Sigma Research at the London School of Hygiene and Tropical Medicine (LSHTM).

Other Research

The Sexual Health Unit team is involved in other research through its participation in the following committees:

• Scientific Advisory Board of the ANRS Prévenir trial (HIV Prevention in the Île-de-France region). The ANRS Prévenir study aims to assess the public health impact of the rollout of Pre-Exposure Prophylaxis (PrEP) in the Île-de-France region. It seeks to reduce the number of new infections, primarily among the population most at risk of HIV. It also allows for the evaluation of the impact of personalized support provided by community-based organizations and coordinated by AIDES, as well as the prevention and management of other sexually transmitted infections (STIs), with the goal of improving the sexual health of vulnerable individuals. Principal Investigator: Professor Jean-Michel Molina, Saint-Louis Hospital, AP-HP, Paris Diderot University, INSERM U941.

• Trust Research Steering Committee: Respondent-Driven Sampling (RDS) survey among young (18–25 years old) men who have sex with men at high risk of HIV infection: enrollment in combined prevention programs, including Pre-Exposure Prophylaxis (PrEP). The main objective of the research is to characterize the population of young MSM at high risk of HIV infection, their practices, and their sexual and social networks, and to facilitate their entry into combined prevention programs, including PrEP. The use of the targeted sampling method, developed to reach hard-to-reach populations, is innovative in France among MSM. Principal Investigator: Tristan Delory, Pierre Louis Institute of Epidemiology and Public Health (iPLESP) INSERM 1136.

• Ganymede Project Steering Committee: HIV acquisition and life trajectories of men who have sex with men (MSM) born abroad and living in the Île-de-France region. The Ganymede survey aims to determine the proportion of foreign-born MSM living in the Île-de-France region who are HIV-positive and were infected after arriving in France. It will identify the vulnerability factors among these patients, both before and after their arrival in France, that could explain their high exposure to HIV. These factors may be contextual (related to the country of origin) or individual (behavioral, related to sexual life or migration history, for example). Principal Investigator: Romain Palich, Pierre Louis Institute of Epidemiology and Public Health (iPLESP) INSERM 1136.

• Steering Committee for the VacciGay Project: Perceptions and Practices Regarding Vaccination Among Men Who Have Sex with Men in France. The main objective of this project is to better understand the barriers and drivers of vaccination uptake among men who have sex with men in France. This project focuses more specifically on three vaccine-preventable sexually transmitted infections for which MSM are subject to specific vaccination recommendations in France: hepatitis B virus (HBV), hepatitis A virus (HAV), and human papillomavirus (HPV) infections. Principal Investigator: Pierre Verger, Provence-Alpes-Côte d’Azur Regional Health Observatory (ORS PACA).

The AfroBarometer

This is a survey program designed to track changes in the behaviors of Afro-Caribbean populations living in the Île-de-France region. These surveys are conducted in partnership with the Afrique Avenir association. The first edition took place in 2011 in nightclubs, hair salons, and party venues primarily frequented by these populations. More than 4,000 questionnaires were collected between August 1 and November 15, 2011. The second edition of the AfroBarometer took place in 2016.

Objective: to describe the sexual and preventive behaviors of Afro-Caribbean populations living in Île-de-France and to measure the observed prevalence of HIV and HBV infections in these populations.

This cross-sectional survey, combining self-collection of blood on filter paper and a self-administered questionnaire on a tablet, was conducted between May and June among 1,283 people at 33 community sites where the Afrique Avenir association typically operates: in open settings (train and metro station exits, markets) or enclosed spaces (nightclubs, community halls, hair salons, places of worship).

The Parcours Survey

Santé publique France was involved in the Parcours survey conducted among immigrants from sub-Saharan Africa. This survey traced the migratory, social, administrative, and health trajectories of these immigrants in 2012–2013. More than just public health research, Parcours is a study of immigration from this region of the world—immigration marked by years of administrative instability and daily insecurity. It highlights the structural factors that weigh heavily—often in a lasting way—on immigrants’ settlement in France and increase their risk of HIV infection once they arrive. It also demonstrates the importance of systems that implement the principle of universal access to healthcare (AME, PASS, humanitarian organizations) and the need to ensure these systems remain in place.

• To learn more about this study: https://www.ceped.org/parcours/

Other Projects

The Sexual Health Unit team is involved in other initiatives through its participation in the following committees:

• Scientific Committee of the Makasi Project. The Makasi project involves organizing and evaluating an innovative intervention carried out on the street and in high-traffic areas (train stations, subway exits, etc.) to help people from sub-Saharan Africa or the Caribbean who are in precarious situations learn about and use available social and health resources. Scientific Director: Annabel Desgrées du Lou, IRD, CEPED, Institute of Migration.

• Scientific Committee of the PARTAGE Project: Prevention, Access to Rights, Vaccination Catch-up, Treatment of Conditions During Pregnancy and for Children: Acceptability and Determinants of a Prenatal Consultation for Men. This is an interventional study aimed at implementing a prenatal consultation program for all fathers of unborn children. Principal Investigator: Pauline Penot, CHI André Grégoire, Montreuil.

• Steering Committee for the MSF PREVAL Project: A pilot study to assess the prevalence of female genital mutilation in France. Principal Investigators: Armelle Andro, University of Paris 1; Marie Lesclingand, University of Côte d’Azur.

• Steering Committee for the Ganymede Project: HIV acquisition and life trajectories of men who have sex with men (MSM) born abroad and living in the Île-de-France region. The Ganymede survey aims to determine the proportion of foreign-born MSM living in the Île-de-France region who are HIV-positive and were infected after arriving in France. It will identify the vulnerability factors among these patients, both before and after their arrival in France, that could explain their high exposure to HIV. These factors may be contextual (related to the country of origin) or individual (behavioral, related to sexual activity or migration history, for example). Principal Investigator: Romain Palich, Pierre Louis Institute of Epidemiology and Public Health (iPLESP) INSERM 1136.

The 2016 Health Barometer survey included, for the first time, a biological component called BaroTest.

Following the telephone survey, respondents were offered the option to receive a self-collection kit for combined screening for hepatitis B, C, and HIV.

This offer was motivated by the fact that, despite extensive screening for HIV and hepatitis B and C viruses in France, many people remain undiagnosed.

Objectives:

• to assess the acceptability and feasibility of this new screening offer;

• to estimate, if possible, the prevalence of HBV, HCV, and HIV infections in the general population.

In practice, participation involved receiving a self-collection kit by mail. The kit contained all the necessary materials for the person to prick their fingertip and place a few drops of blood on a filter paper (five spots, each 6 mm in diameter). After the blood dried, the participant mailed the filter paper to the National Reference Center (NRC) for Hepatitis B, C, and D, which in turn sent two spots to the NRC for HIV for HIV testing. Once the tests were completed, the NRC for Hepatitis was responsible for informing the participant and their doctor of all the results.

See:

• BaroTest 2016 Protocol in English: Lydié N, Saboni L, Gautier A, Brouard C, Chevaliez S, Barin F, Larsen C, Lot F, Rahib D. Innovative Approach for Enhancing Testing of HIV, Hepatitis B, and Hepatitis C in the General Population: Protocol for an Acceptability and Feasibility Study (BaroTest 2016). JMIR Res Protoc 2018,7(10):e180.

• Protocol abstract: Innovative approach to enhance testing for HIV, hepatitis B, and hepatitis C in the general population: protocol for an acceptability and feasibility study (BaroTest 2016) (PDF - 148 KB)

You can view the results of this pilot study here.

Chlamydia trachomatis (Ct) infection is the most common bacterial sexually transmitted infection in the general population. The Natchla survey, conducted in 2006, showed that the prevalence of Ct was 1.6% among women aged 18 to 44 and 1.4% among men. The highest rates were recorded among young adults aged 18 to 24, with prevalence rates of 3.6% among women and 2.4% among men. This infection, which is most often asymptomatic, can lead to serious complications (ectopic pregnancy, tubal infertility), whereas early screening allows for effective antibiotic treatment within a few days.

Given the significance of this infection in France and the positive evaluation of self-collection screening kits promoted abroad, a pilot program offering access to this screening method was launched in 2012.

Objective: To assess the extent to which offering home self-collection kits via the Internet could increase the uptake of Chlamydia trachomatis screening among the French population aged 18 to 24, compared to providing information and referral to traditional screening systems.

The Chlamyweb study took the form of an individually randomized controlled trial. It relied on a website providing information on sexually transmitted infections and a communication campaign promoting it among young people.

In the “intervention” arm, participants were offered a home self-collection kit. In the “control” arm, they received comprehensive and detailed information about Ct infection and were referred to screening facilities (screening centers as well as gynecologists and general practitioners). The project was carried out in collaboration with the National Reference Center (CNR) for Chlamydia in Bordeaux, which performed the Ct tests and directly informed participants of their results.

You can view the results of this pilot study here.

Based on this pilot study, the French Health Insurance Agency, as part of its 2019–2022 youth prevention strategy, plans to promote access to Chlamydia trachomatis screening via at-home self-collection.

Memo on Testing: An Initiative to Promote Repeated Testing for HIV and Other STIs Among Men Who Have Sex with Men

Despite the efforts of various stakeholders, the uptake of HIV and other STI testing remains insufficient among men who have sex with men (MSM). Consequently, the time between infection and diagnosis is estimated at 2.8 years, which is far too long to control the HIV epidemic in this population. While the French National Authority for Health (HAS) recommends quarterly HIV testing for men who have sex with men (MSM), behavioral surveys conducted by Santé publique France show that only a minority of MSM (around 20%) adhere to these recommendations. Taking note of these data and recommendations, Santé publique France launched the MémoDépistages pilot program in 2018.

Objectives:

• to evaluate the effectiveness of a program encouraging quarterly HIV testing based on the development of a personalized solution that is adaptable over time and draws on the full range of testing options and the preferences of MSM with multiple partners;

• to evaluate the acceptability and feasibility of combined testing for HIV, hepatitis B and C, syphilis, Chlamydia trachomatis, and Neisseria gonorrhoeae via at-home self-collection.

This multicenter interventional study targeted MSM residing in the Île-de-France, Auvergne-Rhône-Alpes, Provence-Alpes-Côte d’Azur, or former Languedoc-Roussillon regions. MSM were recruited online. Upon enrollment, eligible men were offered the option to receive a self-collection kit for combined screening for HIV and other STIs and to enroll in a personalized follow-up program for a period of 18 months. Each quarter, participants could choose their preferred screening method (self-collection, self-test, rapid diagnostic test, consultation at a CeGIDD, etc.).

The self-collection kits, which were not available outside the study, enabled testing for HIV, hepatitis B, hepatitis C, and syphilis using a blood sample collected by the participant, and for Chlamydia trachomatis and gonococcal infections using urine, oral, and anal samples.

This pilot program ran from April 10, 2018, to December 31, 2019.

The results of this pilot program are available here.

QuestionSexualité is a social marketing initiative focused on sexual health aimed at the general public.

Objective: to provide access to reliable sexual health information to as many people as possible.

The QuestionSexualité initiative was launched in May 2021; it aggregates content from the now-defunct thematic websites info-ist.fr and choisirsacontraception.fr.

It consists of:

• A website: questionsexualite.fr.

• A “publications” section (brochures, posters, videos, etc.) available for order. The “publications” section includes a “Pour comprendre” collection designed to make health information accessible to the entire adult population. It is specifically designed to be accessible to audiences with low health literacy or disabilities.

• A “campaigns” component: several annual campaigns complement this initiative by promoting key messages on sexual health to the general public

An initiative rooted in a national public health framework

The QuestionSexualité initiative is part of the “National Sexual Health Strategy – Agenda 2017–2030,” whose overall objective is to ensure “a state of physical, emotional, mental, and social well-being related to sexuality, from birth through old age, for the entire population.”

This general objective can be broken down into thematic areas that the website aims to address:

• promoting reproductive health (contraception, abortion, and prevention of unwanted/unplanned pregnancies);

• combating discrimination based on sex, sexual orientation, or gender identity;

• prevention of sexual violence;

• prevention through HBV and HPV vaccination, screening, and management of STIs, including HIV and viral hepatitis;

• information on sexual dysfunction and disorders, their prevention, screening, and management.

Content based on scientific literature

The program’s content is based on national and international scientific data. In particular, it draws on the results of major surveys on sexuality in which Santé publique France participates.

Sexosafe is a social marketing initiative focused on sexual health for men who have sex with men (MSM).

Objective: to improve the sexual health of MSM and increase their use of protection against HIV and STIs.

In addition to providing reliable, comprehensive, and practical information, the initiative aims to make it easy and quick to take action (getting tested, scheduling an appointment for PrEP, contacting organizations, etc.).

The Sexosafe initiative consists of:

• An online component:

  • A website: sexosafe.fr

  • A Sexosafe Facebook page

  • A Sexosafe Instagram account

• An events component: Sexosafe is on the ground at festive, sporting, and cultural community events in partnership with LGBT organizations or groups fighting HIV.

• A print component (brochures, postcards, flyers, posters, etc.) distributed through community and affinity-based information and social networks.

• A “campaigns” component: several annual campaigns complement this initiative by promoting key messages on sexual health to this target audience

A program rooted in a national public health framework

The rollout of the Sexosafe initiative is part of several national action plans:

• The National Sexual Health Strategy, specifically its Axis 4, Objective 1:

  • Strengthen prevention, screening, access to rights, and care for populations most at risk of HIV, hepatitis, and STIs.

• The National Action Plan for Equal Rights and Against Anti-LGBT+ Hate and Discrimination 2020–2023, specifically its Priority 3:

  • Ensure access to healthcare for LGBT+ individuals, combat discrimination based on health status, and evaluate the conditions for blood donation by men who have sex with men

Content based on scientific literature

The program’s content is based on national and international scientific data. In particular, it draws on the results of the “Rapport au sexe” surveys, for which Public Health is responsible.

OnSEXprime is Santé publique France’s social marketing initiative on sexual health aimed at teenagers.

Objective: to promote a positive start to sexual activity in order to maintain good sexual health throughout life.

It consists of:

• An online component:

  • a website: OnSEXprime.fr

  • An online component:

    • a website, OnSEXprime.fr,

    • social media accounts (TikTok, Snapchat, Instagram, Facebook, and YouTube)

• A “publishing” component providing teenagers with informational brochures, also distributed by our partners such as the French Ministry of National Education, the Ministry of Youth and Sports, and associations working in schools such as CRIPS or Family Planning; at sexual health centers such as sexual health clinics (formerly CPEF) and, finally, at general youth centers (BIJ, CRIJ, etc.).

• A “campaigns” component: several annual campaigns complement this initiative by promoting key messages on sexual health to this target audience, such as the #GênantOupas, Réso Tuto, Sexo Tuto, Askip, and Ok/Pas OK campaigns.

An initiative rooted in a national public health framework

The rollout of the OnSEXprime initiative is part of several national action plans:

• The national health strategy emphasizes the importance of promoting sexual health through a comprehensive and positive approach, particularly among young people, as one of its priorities.

• The national sexual health strategy sets the following objectives:

  • to improve knowledge and acceptance of prevention among young people entering sexual activity;

  • to promote equality between men and women, self-respect and respect for others, the fight against sex- and gender-based discrimination, the fight against violence, the prevention of STIs (including HIV) and unintended pregnancies,

  • to continue promoting contraceptive choices tailored to each individual’s situation.

• The 30 Measures Against Violence Against Women (Secretariat for Women’s Rights) emphasizes education on non-violence and the promotion of gender equality.

• The National Action Plan for Equal Rights, Against Hate and Anti-LGBT+ Discrimination 2020–2023 highlights the importance of raising awareness among young people about homophobic and transphobic violence and harassment (through Action 18 in particular).

Content Based on Scientific Literature

The program’s content is tailored to the concerns and maturity level of adolescents. Its design is based on UNESCO’s International Guidelines on Sexuality Education. Drawing on recent scientific data and international best practices in sexuality education, this framework defines the knowledge, skills, and attitudes to be acquired by age group.

What is the purpose of sexuality education?

Sexuality education is often the subject of much debate. There is, however, significant evidence demonstrating the impact of sexuality education. This evidence highlights the fact that:

• sex education has positive effects; young people who receive it have, in particular, more knowledge and a better attitude toward sexual and reproductive health and behaviors than others;

• Sex education does not increase sexual activity, risky sexual behaviors, or rates of STI/HIV infection;

• programs that promote abstinence as the only option are not effective in delaying sexual debut, reducing the frequency of sexual intercourse, or reducing the number of sexual partners;

• Programs that address gender issues are substantially more effective than those that do not;

• The impact of sexuality education is greatest when school-based programs are complemented by the involvement of parents and teachers, training institutions, and youth-focused services.

The initiative is based on:

• A partnership with Africa Radio: every Thursday from 9:30 a.m. to 10:00 a.m., Africa Radio and Santé publique France present a health program and a video posted on Facebook to raise awareness among people of Sub-Saharan African origin living in France. A wide range of prevention topics are covered, including sexual health. The programs are available as podcasts. Every Tuesday, a video is also posted on Facebook featuring a health expert (a professional, community leader, or specialist) discussing a prevention topic in a clear and straightforward manner.

• Tools for health and social services professionals who care for migrants and foreigners in vulnerable situations, such as bilingual health booklets available in 16 languages.

  • Learn more: “Bilingual Health Booklets,” tools to bridge the gap between migrants and health or social service professionals.

• Thematic resources for healthcare professionals, such as the brochure developed in collaboration with the French Society for the Fight Against AIDS (SFLS) and the French-Speaking Society of Infectious Diseases (SPILF), which compiles practical guidelines for addressing the topics of sexuality and sexual health with migrants who face vulnerability factors.

  • Learn more: discussing sexuality and sexual health with migrants.

A program rooted in a national public health framework

The program for migrants is part of the “National Sexual Health Strategy,” specifically its Axis 4, Objective 1: “strengthen prevention, screening, access to rights, and care for populations most at risk of HIV, hepatitis, and STIs.”

Content based on scientific literature

The program’s content is based on national and international scientific data. In particular, it draws on the results of surveys conducted by Public Health and its partners.