Knowledge of HIV pre-exposure prophylaxis and antiretrovirals preventive potential of among migrant women in French Guiana

BACKGROUND: The use of antiretroviral drugs for prevention is a major progress in HIV prevention. French Guiana combines active immigration, precariousness and the highest HIV prevalence in France. We aimed to better understand the sexual health and knowledge of migrant women in French Guiana.
METHODS: A cross sectional study was conducted with a random sample of women attending the French Red Cross centers. Multilingual mediators conducted the interviews. The descriptive statistics and the multivariate stepwise logistic regression were performed using Stata 15.0.
RESULTS: Among the 429 women included, 69.6% were under 35 years of age, 71.6% were from Haiti and 56.3% did not know French well. Only 28.7% had ever heard of antiretroviral therapies, less often women from Haiti (19.9% vs 50.9%, p<0.001). Only 20.9% had ever heard of an emergency treatment that allows them to avoid catching HIV after unprotected sex (Post Exposure Treatment - PEP -), 13.6% among Haitian's women vs 39.2% among others (p<0.001). Only 15.4% knew what Pre-Exposure Prophylaxis for HIV - PrEP - was. Again, Haitian women had a lower level of information (9.3% vs 30.8%, p<0.001). Although few in number (n=22), the level of knowledge was significantly higher among women from the Dominican Republic, who were sex workers at 63.6%. Women (n=37) who self-identified as being at high risk for STIs were more aware of PrEP (52.8% vs. 11.9%, p<0.001). In the multivariate model, knowledge of prep was associated with sex work and high perceived risk of STIs, and was negatively associated with Haitian origin.
Only 4 women reported ever taking PrEP, and all discontinued due to adverse events or personal constraints. Once informed about PrEP, 18.3% said they were interested. In addition, 13 women reported have ever used PEP. Finally, 54.4% were interested in receiving a sexual health consultation (or had already received), both Haitian and non Haitian women (54.4% and 48.7%, p=0,30)
CONCLUSIONS: The level of knowledge about the preventive effects of HIV antiretroviral therapies and PrEP is extremely low among migrant women in French Guiana. Haitian women are largely unaware of biomedical prevention tools despite reported sexual health needs and deserves targeted interventions.

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