Sexual health of migrant women attending French Red Cross Health Prevention Centers in French Guiana, in 2021

BACKGROUND: French Guiana is experiencing significant demographic and migration challenges (38% of the current population is foreign born). It's the French region with the highest HIV prevalence (1.18 - 1.35% in 2016). In this context, women''s health must be considered. The main objective of the study is to describe situations of sexual vulnerability among migrant women in French Guiana.
METHODS: A cross-sectional survey with a mixed methodology was conducted from April to August 2021 and includes :
- a descriptive cross-sectional epidemiological study, using questionnaires administered in French, Haitian Creole, Spanish or Portuguese, to a random sample of foreign-born women over 18 years old attending the Red Cross Health Prevention Centers in the two main cities.
- a qualitative exploratory study, through semi-directive interviews conducted with caregivers working in these centers.
RESULTS: A total of 382 women were included, mainly from Haiti (80.4%), Suriname (8.9%) and the Dominican Republic (5.7%). Median age was 31 years and 71.2% were in an irregular situation. Twelve semi-directive interviews were performed among health workers of these prevention centers. A significant exposure to sexual violence and transactional sex was reported. Among the 382 women interviewed, 19.9% reported rape at least once in their lifetime, 27.7% had traded sex for money and 27.6% had been physically abused. Health care teams reported mental health effects in women: anxiety and depressive disorders were frequently found in the epidemiological section : 24,3% had severe psychological distress (PHQ4 score).
An important vulnerability was reported : 76.7% of the respondents described a difficult financial situation and 55.5% were exposed to severe hunger. Social isolation was also a major finding, as 72.5% of women said they had noone to shelter them in case of need.
Menstrual precariousness was also significant, as 73.7% of the women reported a lack of sanitary protections in the last few weeks.
CONCLUSIONS: Sexual vulnerability of migrant women in French Guiana is a cause of concern and appears to be linked to poverty. Emergency measures (food aid, free sanitary protection, etc.) and medium-term measures (social and community interventions to reduce sexual risks, psychological care) need to be reinforced.

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