Role of Community Associations in HIV, HBV and HCV Screening and Support for Migrant Populations in France: Results of the DéPAC Study

The majority of human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) infection diagnoses in France involve migrant populations, who face challenges in navigating healthcare systems. Community associations that liaise with migrant populations are well placed to screen for these viruses and provide post-screening support. This study aimed to evaluate the impact of community association-based HIV, HBV and HCV screening campaigns and support in migrant populations in France. The retrospective, observational DéPAC (DÉpistage Par des Associations Communautaires [Screening by Community Associations]) study evaluated data from 10 community associations primarily supporting Afro-Caribbean migrants based in Paris, Lyon and Marseille. The associations provided data from January to December 2023 on the number of point-of-care (POC) HIV, HBV and HCV tests performed, positivity rates, and follow-up support. The community associations performed 29,422 POC tests (HIV 10,293; HBV 9925; HCV 9204), of which 502 returned a positive result. Positivity rates were 1.3% for HIV, 2.8% for HBV and 1.0% for HCV; 78.3% of positive tests were from individuals with unknown viral status prior to the tests. Following a positive test result, referral for medical support was almost always offered and social support was frequently offered. Medical and social support were also offered following negative tests, but follow-up data were missing for many of the tests. High positivity rates for HIV, HBV and HCV were observed among migrants in France who underwent community-based testing. This suggests that such screening can effectively target this population and provide an opportunity to access appropriate support. Graphical abstract available for this article. Despite the availability of effective treatments in France, human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) infections affect large numbers of migrants (i.e. people born abroad), and many are unaware of their diagnosis and have limited access to healthcare. Community associations for migrants in France can offer rapid tests for these viruses and provide support once the test result is known. This study assessed the testing for HIV, HBV and HCV and support provided by community associations to migrants in three large French cities. Ten associations were involved; they provided information about how many HIV, HBV and HCV tests were taken, how many identified an infection, and the support offered following a positive and negative test for the infections during 2023. Of 29,422 tests conducted (10,293 for HIV, 9925 for HBV, 9204 for HCV), 502 showed a positive result. Positivity rates (1.3% for HIV, 2.8% for HBV, 1.0% for HCV) were higher than previously reported in other settings, and over three-quarters of positive tests were from people who had not known they had the infection. Following a positive result, medical and social support was frequently offered. Following a negative result, many individuals were also directed to healthcare centres for medication to prevent future HIV infection and vaccination against HBV, as well as social support. These results suggest community associations play an important role in assisting migrants to undergo HIV, HBV or HCV testing and obtain social and medical support after their test.