Understanding the blended impacts of COVID-19 and systemic inequalities on sub-Saharan African immigrants in Canada.

The COVID-19 pandemic poses a grave health threat and has serious socio-economic implications for all. However, crises are not experienced equally; the pandemic has disproportionately affected immigrants in several countries, including Canada and the United States. The effects of COVID-19 have exposed the realities of societal and structural inequities, worsened the socio-economic status of many immigrants, and placed them at higher risks of poor health outcomes. Emerging research on COVID-19 and race in Canada addresses the structural inequities that shape the disproportionate harms of COVID-19 on immigrants. For sub-Saharan African immigrants, these inequities are worse due to the intersecting systems of race, gender, and class marginalization. They tend to be more exposed and less protected amid the pandemic. Given the lack of research on sub-Saharan African immigrants' experiences in Canada, this paper discusses how multiple axes of inequities shape their health and livelihood during COVID-19. The objective is to provide a broader scientific understanding of issues related to systemic inequities and health for sub-Saharan African immigrants in Canada and the related implications for public health advocates, policymakers, and the public.

RéSUMé: La pandémie de COVID-19 pose une grave menace pour la santé et a de graves conséquences socioéconomiques pour tous. Les crises ne touchent cependant pas tout le monde également; la pandémie a démesurément touché les immigrants dans plusieurs pays, entre autres au Canada et aux États-Unis. Les effets de la COVID-19 ont mis au jour la réalité des iniquités sociétales et structurelles, réduit le statut socioéconomique de nombreux immigrants et exposé ces immigrants à de plus grands risques de mauvais résultats cliniques. Des études émergentes sur la COVID-19 et la race au Canada abordent les iniquités structurelles qui déterminent les préjudices disproportionnés causés par la COVID-19 aux immigrants. Pour les immigrants d'Afrique subsaharienne, ces iniquités sont pires en raison de l'entrecroisement des systèmes de marginalisation fondés sur la race, le sexe et la classe sociale. Ces immigrants tendent à être plus exposés et moins protégés au milieu de la pandémie. Étant donné le manque d'études sur les expériences des immigrants d'Afrique subsaharienne au Canada, nous abordons ici l'influence des nombreux axes de l'iniquité sur leur santé et leurs moyens de subsistance durant la COVID-19. Notre objectif est de présenter une interprétation scientifique plus vaste des problèmes liés aux iniquités systémiques et à la santé chez les immigrants d'Afrique subsaharienne au Canada et des conséquences qui en découlent pour les défenseurs de la santé publique, les responsables des politiques et le grand public.

Deterioration of mental health and insufficient Covid-19 information among disadvantaged immigrants in the greater Paris area.

OBJECTIVES: The aim of this study is to provide information on changes in mental health among disadvantaged immigrants from Sub-Saharan Africa in the Greater Paris area and their level of information about Covid-19. METHODS: Prior to the Covid-19 epidemic, the Makasi community-based cohort followed 850 immigrants from sub-Saharan Africa in the Greater Paris area. Between the 1st of April and the 7th of June 2020, all participants scheduled for a follow-up survey were systematically included into an additional COVID-19-related wave of data collection (N = 100). We compared participants' type of housing, level of food insecurity, work and mental health (PHQ9) before and during the first COVID-19-related lockdown, using paired-Mc Nemar chi-2 tests. We next described their level of information on Covid-19 and policy measures, broken down by sex. RESULTS: Among the 100 participants, 68% had no legal residence permit. Food insecurity was more often reported during lockdown than before (62% vs 52%). 9% of participants had a score indicative of severe depression (PHQ9) before lockdown and 17% afterwards (p = 0.17). Only 51% knew about the possibility of asymptomatic transmission of the COVID-19 virus. CONCLUSIONS: This study brings original information on a hard-to-reach population group. Our results suggest that the lockdown had a detrimental impact on various economic and mental health aspects among disadvantaged migrants residing in the Greater Paris area.

HIV infection and COVID-19: risk factors for severe disease.

: We performed an observational prospective monocentric study in patients living with HIV (PLWH) diagnosed with COVID-19. Fifty-four PLWH developed COVID-19 with 14 severe (25.9%) and five critical cases (9.3%), respectively. By multivariate analysis, age, male sex, ethnic origin from sub-Saharan Africa and metabolic disorder were associated with severe or critical forms of COVID-19. Prior CD4 T cell counts did not differ between groups. No protective effect of a particular antiretroviral class was observed.