Spatial dynamics and epidemiology for AIDS in remote areas in French Guiana.

Although AIDS care is generally improving in French Guiana, disparities among regions and certain key populations remain significant. The purpose of this study was to describe the spatial and clinical characteristics of people living with HIV (PLHIV) in remote areas in comparison to those followed in hospitals on the urban coast of French Guiana. The data presented were obtained from outpatient on primary care centers located in rural regions away from the urban coast. Data were compared with that from medical records of PLHIV treated in French Guiana's urban care. The evolution of the annual rate of discovery of HIV seropositivity indicates a lag in remote areas as compared to urban and coastal areas. In recent years, the epidemic appeared as particularly active in rural areas among Brazilian patients. The median age of PLHIV in remote areas was 43.8 years, the sex ratio (M/F) was 0.93. Nearly 37% of PLHIV were discovered with advanced disease (<200 CD4/mm3). The percentage of virological success after six months of HAART was 80% and 88% in remote areas and urban area, respectively. Efforts must be made to control and halt the spread of the HIV epidemic, as these remote sites represent strategic points.

Hunger in French Guiana's Vulnerable Urban Neighborhoods: A Neglected Consequence of COVID-19.

BACKGROUND: In French Guiana, restrictions to control the spread of SARS-CoV-2 were put in place between March 2020 and March 2022. In vulnerable urban neighborhoods, during this period, requests for food assistance increased and fear of hunger overtook fear of being affected by COVID-19. OBJECTIVE: The objective of this survey was to describe food security during the COVID-19 pandemic in French Guiana and to study the relationship between the socioeconomic conditions of the study households and household hunger. METHODS: A multicenter survey was therefore conducted in mobile clinics and fixed structures providing care to at-risk urban populations. In a face-to-face interview, a community health worker asked participants questions about the sociodemographic and economic profile of the household, and about household food security (food consumption score, coping strategies in the face of food shortages, and household hunger index). Two hundred seventy-seven households were recruited in February 2021. RESULTS: According to the household hunger scale, 42.6% of households experienced moderate hunger and 23.8% of households experienced severe hunger in the month preceding the survey. Lack of residence permit, lack of social support, water insecurity, small housing, and lack of access to an urban garden were determinants related to the risk of household hunger. CONCLUSIONS: Food insecurity has affected a large majority of the households in this survey, and the immediate consequences for children's health were already apparent. These results draw attention to a neglected health problem in a socioeconomically vulnerable population during the COVID-19 pandemic.

Addressing sexuality and sexual health with migrants. Practice guidelines.

Sexual health is an integral part of overall health and should be discussed with all people who seek help. The Vaccination and Prevention working group of the French Infectious Diseases Society (SPILF) and the Migrant Commission of the French AIDS Society (SFLS) developed recommendations to address this issue with migrants presenting vulnerability factors. After defining sexual health and target migrants, practical recommendations were issued. Sexual health can be discussed simply with migrants or people with an immigrant background. Some migrants are exposed to sexual vulnerability due to their migration route, social isolation, administrative and housing insecurity, gender inequalities, and discrimination. Situations of sexual vulnerability, sexual violence, and female genital mutilation should be systematically identified and followed by appropriate care that respects the migrant's needs. Extended screening for HIV and sexually transmitted infections (STI) should be systematically offered as part of a "migrant health checkup" and completed, if necessary, with information on preventing tools for HIV, STIs, unwanted pregnancies, and sexual violence. In this population, it is important to check if vaccinations are up to date. Sexology and addiction counselling is sometimes useful. The specific needs of LGBTQIA+ people with an immigrant background should be taken into account.

Sexual and reproductive health of incarcerated women in French Guiana: a qualitative approach.

PURPOSE: Incarcerated women are a vulnerable population in terms of sexual and reproductive health. In French Guiana, most incarcerated women come from unsafe environments and are incarcerated because of drug trafficking. Medical follow-up processes used in prison (medical assessment on arrival, and then two half-days per week upon request but without an obstetrician-gynecologist) does not allow for a thorough assessment of the impact of incarceration on women prisoners' health to take place. In the absence of data, the purpose of this study was to describe incarcerated women's experiences in relation to sexual and reproductive health. DESIGN/METHODOLOGY/APPROACH: Semi-structured interviews were conducted among French-speaking adult women who had been incarcerated for at least four months in a French Guianan prison. Menstruation, contraception, pregnancy, abortion, sexually transmitted infections and sexuality were described by means of interpretative phenomenological analysis. FINDINGS: A total of 14 women were interviewed. They suffered from menstrual cycle disorders, poor hygiene and menstrual insecurity. They appeared to have emotionally disinvested sexuality. However, intra-prison sexual activity existed for some (masturbation, conjugal prison visits, homosexual intercourse between fellow prisoners). Homosexual relations were a source of discrimination. Being pregnant while incarcerated was viewed negatively. A lack of knowledge about sexual and reproductive health and high-risk behaviors such as piercing and tattooing practices were widespread. ORIGINALITY/VALUE: Incarceration is a vulnerable time for women's sexual and reproductive health. Sexual activity exposes women to risks and discrimination that should be taken into account in a multidisciplinary approach adapted to the prison environment.