Pathways for sexual and gender-based violence migrant survivors in France: a single-center retrospective cohort study

Migrants often experience sexual and gender-based violence (SGBV) as they transition to and reside in the host country. In France, healthcare workers routinely use patient pathways to support migrants who migrated under difficult conditions involving violence, and who continue to struggle. This study investigated the Parcours unit located in north Paris and designed to specifically treat this demographic. A single-center retrospective cohort study was conducted between January 2018 and July 2021. The study explored social determinants, the frequency, and factors associated with violence as they travelled to and reside in the host country. The psychological, social, and clinical support post-intervention provided to migrants were comparatively analyzed while logistic regression was used to analyze potential associations between the social determinants. Eighty-nine people were included, mostly women (78%), from West Africa (10%), with the median migration pathway lasting 12 months, associated with violence for 68%. After a median of 19 months in France, only 37% had stable housing, 6% legal employment, 11% a residency permit, and 71% were isolated; 26% lived with HIV and 6% with HBV infections, 60% had experienced female genital mutilation (FGM), 67% post-traumatic stress disorder (PTSD) symptoms, and 23% experienced violence in France. Post-intervention measurements showed high levels (>75%) of psychological, social, and gynecological support, referrals to general practitioners and non-governmental organizations (NGOs) (51% and 85%, respectively), and an increase in stable housing (53%), legal employment (11%), and resident permit (30%). Violence during the migration journey, lack of stable housing or employment, and transactional sex seemed associated with an increased risk of violence in France. This study provides a preliminary analysis of the social determinants of the health of migrant survivors of violence, particularly GBV.