Participatory development and pilot testing of the Makasi intervention: a community-based outreach intervention to improve sub-Saharan and Caribbean immigrants' empowerment in sexual health

Anne Gosselin, Séverine Carillon, Karna Coulibaly, Valéry Ridde, Corinne Taéron, Veroska Kohou, Iris Zouménou, Romain Mbiribindi, Nicolas Derche, Annabel Desgrées du Loû, MAKASI Study Group, Flore Gubert, Maria Melchior, Angèle Delbe, Jacques Ebongue, Fabienne El Khoury, Charles Gaywahali, France Lert, Belinda Lutonadio, Eve Plenel, Laura Maspeyrat, Patricia Mbiribindi, Thierry Miatti, Jean-Paul Ngueya, Andrainolo Ravalihasy, Faya Tess, Jean Voza Lusilu, Iris Zoumenou, And The Makasi Group Of Peers, Anne Gosselin, Séverine Carillon, Karna Coulibaly, Valéry Ridde, Corinne Taéron, Veroska Kohou, Iris Zouménou, Romain Mbiribindi, Nicolas Derche, Annabel Desgrées du Loû, MAKASI Study Group, Flore Gubert, Maria Melchior, Angèle Delbe, Jacques Ebongue, Fabienne El Khoury, Charles Gaywahali, France Lert, Belinda Lutonadio, Eve Plenel, Laura Maspeyrat, Patricia Mbiribindi, Thierry Miatti, Jean-Paul Ngueya, Andrainolo Ravalihasy, Faya Tess, Jean Voza Lusilu, Iris Zoumenou, And The Makasi Group Of Peers

Abstract

Background: Sub-Saharan and Caribbean immigrants are particularly affected by HIV in Europe, and recent evidence shows that a large portion of them acquired HIV after arrival. There is a need for efficient interventions that can reduce immigrants' exposure to HIV. We describe the pilot phase of a community-based empowerment outreach intervention among sub-Saharan and Caribbean immigrants in the greater Paris area aimed at 1) constructing the intervention, 2) assessing its feasibility, and 3) assessing the feasibility of its evaluation based on a stepped-wedge approach.

Methods: 1) To develop the intervention, a literature review was conducted on existing interventions and participatory approaches developed, including the constitution of peer groups. 2) To assess the intervention's feasibility, a pilot was conducted between April 2018 and December 2018. A daily register was used to collect data on sociodemographic characteristics of all persons who visited the mobile team to assess eligibility and acceptability. 3) To assess the feasibility of performing a stepped-wedge trial to evaluate the intervention, we compared eligibility, enrolment and retention at 3 months in two arms (immediate vs deferred). Chi-squared tests were used to compare reach and retention between the two arms.

Results: Intervention development. The Makasi intervention was designed as an outreach intervention that starts with the persons' capacities and helps them appropriate existing resources and information and obtain knowledge about sexual health, based upon motivational interviewing techniques. Intervention Feasibility. Between April 2018 and December 2018, a total of 485 persons were identified as eligible. Participation in the intervention was proposed to 79% of eligible persons. When proposed, the persons enrolled in the intervention with a response rate of 69%. Some were lost to follow-up, and 188 persons were finally included. Evaluation Feasibility. The proportions of eligible (45 and 42%) individuals and of enrolled individuals (65 and 74%) were similar and not significantly different in the immediate and deferred arms, respectively.

Conclusions: A community-based outreach intervention aimed at improving sub-Saharan and Caribbean immigrants' empowerment in sexual health is feasible. The pilot phase was key to identifying challenges, designing a relevant intervention and validating the stepped-wedge protocol for evaluation.

Keywords: Community-based research; Empowerment; France; Intervention; Migrants; Sexual health; Sub-Saharan Africa.

Conflict of interest statement

No conflict of interest to declare.

Figures

Fig. 1
Fig. 1
Makasi theory of intervention, 2019
Fig. 2
Fig. 2
Makasi theory of change, 2019
Fig. 3
Fig. 3
Flow chart of enrolment, Makasi pilot study 2018

References

    1. European Centre for Disease Prevention and Control, WHO Regional Office for Europe. HIV/AIDS surveillance in Europe 2018–2017 data. [Online, 18.11.2019]. Copenhagen: WHO Regional Office for Europe; 2018. Available at: .
    1. Santé Publique France. Point épidémiologique - Infection par le VIH et IST bactériennes [Internet]. 2017. Disponible sur:
    1. Alvarez-Del Arco D, Fakoya I, Thomadakis C, Pantazis N, Touloumi G, Gennotte A-F, et al. High levels of postmigration HIV acquisition within nine European countries. AIDS. 2017;31(14):1979–1988. doi: 10.1097/QAD.0000000000001571.
    1. Desgrees-du-Lou, Annabel, J. Pannetier, A. Ravalihasy, A. Gosselin, V. Supervie, H. Panjo, N. Bajos, F. Lert, N. Lydie, et R. Dray-Spira. « Sub-Saharan African migrants living with HIV acquired after migration, France, ANRS PARCOURS study, 2012 to 2013 ». Eurosurveillance. 2015;20(46):31–38. 10.2807/1560-7917.es.2015.20.46.30065.
    1. Gosselin A, Ravalihasy A, Pannetier J, Lert F, Loû AD du. When and why? Timing of post-migration HIV acquisition among sub-Saharan migrants in France. Sex Transm Infect. 2019;sextrans-2019-054080.
    1. Desgrées du Loû A, Pannetier J, Ravalihasy A, Le Guen M, Gosselin A, Panjo H, et al. Is hardship during migration a determinant of HIV infection? Results from the ANRS PARCOURS study of sub-saharan African Migrants in France. AIDS. 2016;30:645–656. doi: 10.1097/QAD.0000000000000957.
    1. Pannetier, Julie, Andrainolo Ravalihasy, Nathalie Lydié, France Lert, Annabel Desgrées du Loû, et Parcours study group. « Prevalence and Circumstances of Forced Sex and Post-Migration HIV Acquisition in Sub-Saharan African Migrant Women in France: An Analysis of the ANRS-PARCOURS Retrospective Population-Based Study ». The Lancet. Public Health. 2018;3(1):e16–23. 10.1016/S2468-2667(17)30211-6.
    1. Larsen C, Limousi F, Rahib D, Barin F, Chevaliez S, Peytavin G, et al. Infections VIH et VHB parmi les Afro-Caribéens d’Île-de-France : des prévalences élevées et des dépistages insuffisants. Bull Épidémiol Hebd. 2017:29–30.
    1. Rice BD, Elford J, Yin Z, Delpech VC. A new method to assign country of HIV infection among heterosexuals born abroad and diagnosed with HIV. AIDS. 2012;26(15):1961–1966. doi: 10.1097/QAD.0b013e3283578b80.
    1. Santé Publique France, Afrique Avenir. AFROBAROMÈTRESANTE 2016. In Paris; 2019.
    1. Carillon S. Médicamenter ou accueillir: L’approche de la prep pour les migrants en france est-elle pertinente ? AFRAVIH; 2018; Bordeaux.
    1. Loos J, Nöstlinger C, Reyniers T, Colebunders R, Jespers V, Manirankunda L, et al. PrEP for African migrants in Europe? A research agenda. The Lancet HIV nov 2016;3(11):e505–7.
    1. World Health Organization. Closing the gap in a generation. Health equity through action on the social determinants of health [Online, 18.11.2019]. 2008. Report No.: WHO/IER/CSDH/08.1. Disponible sur: .
    1. Gosselin A, Desgrées du Loû a, Lelièvre E, Lert F, dray-Spira R, Lydié N, et al. How long do sub-Saharan migrants take to settle in France ? Population and societies [Online, 18.11.2019]. 2016;(533).Available at: .
    1. Gosselin A, Loû AD d, Lelièvre E, Lert F, Dray-Spira R, Lydié N, et al. Understanding Settlement Pathways of African Immigrants in France Through a Capability Approach: Do Pre-migratory Characteristics Matter? Eur J Popul. 2018:1–23.
    1. Larchanché, Stéphanie. « Cultural Anxieties and Institutional Regulation: “Specialized” Mental Healthcare and “Immigrant Suffering” in Paris, France ». All These and Dissertations (ETDs), St Louis: Washington University; 2010.
    1. Larchanché S. Intangible obstacles: health implications of stigmatization, structural violence, and fear among undocumented immigrants in France. Soc Sci Med Mars. 2012;74(6):858–863. doi: 10.1016/j.socscimed.2011.08.016.
    1. Médecins du Monde. Rapport 2017 de l’Observatoire de l’accès aux droits et aux soins dans les programmes de Médecins du Monde France [Online, 18.11.2019]. 2018. Available at: .
    1. Mooney M. Structures de médiation et intégration des immigrants haïtiens à Paris. Revue européenne des migrations internationales. 2008;24(vol. 24-n°1):89–114.
    1. Brinbaum Y, Safi M, Simon P. Les discriminations en France: entre perception et expérience. In: Trajectoires et Origines Enquête sur la diversité des populations en France (Beauchemin, Hamel & Simon Eds). Ined. Paris; 2015.
    1. Wallerstein N, Duran B, Minkler M, Oetzel JG. Community-based participatory research for health: advancing social and health equity. San Francisco: John Wiley&Sons; 2017.
    1. Basu I, Jana S, Rotheram-Borus MJ, Swendeman D, Lee S-J, Newman P, et al. HIV prevention among sex workers in India. Journal of acquired immune deficiency syndromes (1999). 2004;36(3):845.
    1. Swendeman D, Basu I, Das S, Jana S, Rotheram-Borus MJ. Empowering sex workers in India to reduce vulnerability to HIV and sexually transmitted diseases. Soc Sci Med oct. 2009;69(8):1157–1166. doi: 10.1016/j.socscimed.2009.07.035.
    1. Romero L, Wallerstein N, Lucero J, Fredine HG, Keefe J, O’Connell J. Woman to woman: coming together for positive change--using empowerment and popular education to prevent Hiv in women. AIDS Educ Prev. 2006;18(5):390–405. doi: 10.1521/aeap.2006.18.5.390.
    1. Frye V, Henny K, Bonner S, Williams K, Bond KT, Hoover DR, et al. « Straight talk » for African-American heterosexual men: results of a single-arm behavioral intervention trial. AIDS Care. 2013;25(5):627–631. doi: 10.1080/09540121.2012.722605.
    1. Sánchez J, Serna CA, de La Rosa M. Project Salud: using community-based participatory research to culturally adapt an HIV prevention intervention in the Latino migrant worker community. Int Public Health J. 2012;4(3):301–308.
    1. Lamboy B. Synthèses de connaissances sur les interventions de prévention auprès des jeunes : enjeux et méthodes. Santé Publique. 2013;S1(HS1):9–11.
    1. Loewenson R, Laurell AC, Hogstedt C, D’Ambruoso L, Shroff Z, EQUINET (organization). Participatory action research in health systems: a methods reader 2014.
    1. Tremblay M-C, Parent A-A. Reflexivity in PHIR: let’s have a reflexive talk! Can J Public Health. 2014;105(3):e221–e223. doi: 10.17269/cjph.105.4438.
    1. Fête M, Aho J, Benoit M, Cloos P, Ridde V. Barriers and recruitment strategies for precarious status migrants in Montreal, Canada. BMC Med Res Methodol. 2019;19(1):41. doi: 10.1186/s12874-019-0683-2.
    1. Chen HT. Practical program evaluation: theory-driven evaluation and the integrated evaluation perspective. SAGE Publications; 2014. 465 p.
    1. Ninacs WA. Empowerment: cadre conceptuel et outil d’évaluation de l’intervention sociale et communautaire. Québec (Canada), La Clé [Online, 18.11.2019]. 2003; Available at: .
    1. Bacqué M-H, Biewener C. L’empowerment, une pratique émancipatrice? La découverte; 2015.
    1. Israel BA, Checkoway B, Schulz A, Zimmerman M. Health education and community empowerment: conceptualizing and measuring perceptions of individual, organizational, and community control. Health Educ Behav. 1994;21(2):149–170.
    1. Strehlau V, Torchalla I, Patterson M, Moniruzzaman A, Laing A, Addorisio S, et al. Recruitment and retention of homeless individuals with mental illness in a housing first intervention study. Contemp Clin Trials Commun. 2017;7:48–56. doi: 10.1016/j.conctc.2017.05.001.
    1. Cepeda A, Valdez A. Ethnographic Strategies in the Tracking and Retention of Street-Recruited Community-Based Samples of Substance Using Hidden Populations in Longitudinal Studies. Subst Use Misuse. 2010;45(5):700–716. doi: 10.3109/10826081003591282.
    1. Sadler GR, Lee H-C, Lim RS-H, Fullerton J. Research article: recruitment of hard-to-reach population subgroups via adaptations of the snowball sampling strategy. Nurs Health Sci. 2010;12(3):369–374. doi: 10.1111/j.1442-2018.2010.00541.x.
    1. Calsyn RJ, Klinkenberg WD, Morse GA, Miller J, Cruthis R, for the Hiv/aids Treatment Adherence HO et al. Recruitment, engagement, and retention of people living with HIV and co-occurring mental health and substance use disorders. AIDS Care. 2004;16(sup1):56–70. doi: 10.1080/09540120412331315286.
    1. Lankenau SE, Sanders B, Hathazi D, Jackson BJ. Recruiting and retaining Mobile young injection drug users in a longitudinal study. Subst Use Misuse avr. 2010;45(5):684–699. doi: 10.3109/10826081003594914.
    1. Redwood D, Leston J, Asay E, Ferucci E, Etzel R, Lanier AP. Strategies for Successful Retention of Alaska Native and American Indian Study Participants. J Primary Prevent. 2011;32(1):43–52. doi: 10.1007/s10935-010-0209-5.
    1. Bonevski B, Randell M, Paul C, Chapman K, Twyman L, Bryant J, et al. Reaching the hard-to-reach: a systematic review of strategies for improving health and medical research with socially disadvantaged groups. BMC Med Res Methodol. 2014;14:42. doi: 10.1186/1471-2288-14-42.
    1. Van Loon AJM, Tijhuis M, Picavet HSJ, Surtees PG, Ormel J. Survey Non-response in the Netherlands: Effects on Prevalence Estimates and Associations. Annals Epidemiol. 2003;13(2):105–110. doi: 10.1016/S1047-2797(02)00257-0.
    1. Lydié N, éditeur. Les populations africaines d’Ile-de-France face au VIH/sida, Connaissances, attitudes, croyances et comportements. Editions Inpes. 2007. (Etudes Santé).
    1. Fernández-Balbuena S, Fuente L de la, Hoyos J, Rosales-Statkus ME, Barrio G, Belza M-J, et al. Highly visible street-based HIV rapid testing: is it an attractive option for a previously untested population? A cross-sectional study. Sex Transm Infect. 1 mars. 2014;90(2):112–8.
    1. Franck KA, Paxson L. Women and Urban Public Space. In: Altman I, Zube EH, éditeurs. Public Places and Spaces [Internet]. Boston, MA: Springer US; 1989 [cité 3 oct 2019]. p. 121‑46. (Human Behavior and Environment). Disponible sur: 10.1007/978-1-4684-5601-1_6.

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