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As victims begin to speak out and new surveys are conducted, a clearer picture of sexual violence against women is emerging. But little is known about how immigrant women are affected. Drawing on data from the Parcours survey, Julie Pannetier and her colleagues describe the sexual violence experienced by women from sub-Saharan Africa after arriving in France and explain the factors behind their vulnerability.

1Sexual violence against immigrant women is widespread but remains largely invisible in the public statistics of European countries (Box 1). While public awareness has been raised in transit countries, the issue receives much less attention once migrants have reached their destination. Yet even after migration, women are exposed to multiple forms of insecurity and sexual violence that are rarely recorded or analysed. Its effects on health are also largely undocumented.

Box 1. Sexual violence against immigrant women in Europe

Surveys of female refugees or asylum seekers, or of migrant women who are undocumented or facing housing insecurity, reveal very high levels of lifetime exposure to sexual violence: 1 in 4 or 5 women report experience of violence [2, 3, 4] occurring both before and after migration [2, 3]. These levels are much higher than among the general population. In the 2006 survey of French sexuality (Contexte de la sexualité en France), when asked the same question as in the Parcours survey, 7% of women reported lifetime experience of forced sexual intercourse [5]. In surveys based on representative samples of the general population in France, such as Baromètre santé 2010 (Health barometer, Santé publique France) or the Virage survey (INED), the lifetime frequency of forced sexual intercourse/rape is the same for women in the majority population and those from sub-Saharan Africa. The proportions are, respectively, 5% and 6% in Baromètre santé 2010, and after age-adjustment the probability of reporting forced sexual intercourse is not statistically different between the two populations. The most vulnerable women (exiled, undocumented and/or without stable housing) are absent from these large-scale surveys. Other surveys that include these women or target them specifically reveal much higher levels of sexual violence.

2The Parcours survey of immigrant women from sub-Saharan Africa was conducted in 2012–2013 in health facilities across the Paris region (Île-de-France). It sheds light on the risks of sexual violence incurred over the migration trajectory, the post-migration social contexts in which this violence occurs, and its consequences in terms of exposure to HIV infection (Box 2). Sub-Saharan Africans represent 13% of the immigrants living in France [1]. As HIV is particularly prevalent among the women in this population, the survey’s goal was to identify the factors that raise their infection risk.

Box 2. The Parcours survey: a study of HIV, hepatitis B, and health in the life trajectories of immigrant women from sub-Saharan Africa living in the Paris region [*]

The subjects eligible for inclusion in the random samples of the ANRS Parcours [**] survey were women aged 18–59 living in the Paris region (Île-de-France), born in sub-Saharan Africa, and with the nationality of a sub-Saharan country at birth, whatever their nationality at the time of the survey.
The study documents the life trajectories of 405 women who visited a health centre in the Paris region—either for the general public or specifically targeting vulnerable populations—and of 568 women receiving out-patient care for HIV infection at a Paris-region hospital (156 infected after migration and 391 before; for 21 women, infection could not be dated).
Eligible women were invited to take part in the survey by the consulting physician. They were then questioned by a specialized interviewer either after the consultation or at another agreed time. All information was collected anonymously.
The women’s life histories were recorded on an event history grid coupled with a questionnaire. All life events linked to living arrangements and housing since their arrival in France and to their administrative status (residence permits) were noted. Their romantic and sexual relationships were also recorded for each year since their arrival. Incidents of sexual violence were dated and entered on the grid to analyse, year by year, the social contexts in which this violence occurred.
The respondents were asked the following questions on sexual violence: ‘Has anyone ever forced you to have sexual intercourse against your will?’ And if the answer was yes: ‘Can you tell me at what moment(s) in your life this happened?’ The relevant year(s) are then noted on the grid.
To analyse the social context in which such violence occurred each year since migration, we used a structural equations model capable of handling longitudinal survey data. This enabled us to model the structure of the relationships between different variables [7]. The tested hypotheses are formulated a priori based on existing studies on the same topic (confirmatory analysis).
For more information (in French), see

Circumstances of migration and living conditions in France

3The survey was conducted in 74 health facilities. Two representative samples of immigrant women from sub-Saharan Africa were created: a first group of 405 women recruited in general health centres and a second group of 568 women living with HIV and receiving hospital out-patient care (Box 2).

4The first group had a median age of 26 years [1] when they arrived in France (Table), and 80% had a secondary or higher level of education. They migrated for a variety of reasons: to join a family member or their spouse (46%); to find a job and a better life (20%); to escape persecution in their home country (18%); to pursue their education (13%); or to obtain medical care (4%). On arrival in France, 54% had a partner and 33% had least one child under age 18. The median waiting time to receive a residence permit valid for at least a year was 3 years [1]. Many women faced residential and administrative insecurity after migration. One-fifth (21%) reported having to move frequently in the year following their arrival, more than half (54%) reported living in someone else’s home (partner, acquaintance, family member) for at least a year, and 43% of women reported living in France for at least a year without a residence permit.

Women seen in health centreHIV-positive women receiving hospital out-patient care
N = 405N = 568*
Median age at arrival (years)2628
Median time since arrival (years)1312
Distribution by educational level (%)
 Higher education2621
Reasons for migration (%)
 Employment / search for a better life2035
 Family reunification4639
 Persecution in home country1810
 Medical reasons48
Proportion with a partner at arrival (%)5445
At least 1 year without residence permit (%)4351
At least 1 year without stable housing (%)2130
At least 1 year in someone else’s home (%)5463
Sexual violence (%)
In lifetime1820
Forced sex before age 153.73.5
Forced sex after age 151417
Forced sex after age 15, of which
 Before migration11.310.5
 After migration3.57.2
Infected before migrationInfected after migration
n = 391n = 156
Proportion reporting forced sex since age 15 after migration3.54.215.1
tableau im1

5The women receiving out-patient hospital care for HIV infection have similar characteristics. On arrival in France, they were 2 years older on average (median age 28 years), less frequently had a partner (45%), but in half of cases already had a child (53%). They left their country slightly less often to escape persecution (10%) or to pursue their education (8%) and more often for medical reasons (8%). They much more frequently experienced residential and administrative insecurity after migration (Table).

Sexual violence after migration

6Around 1 in 5 women reported lifetime experience of sexual violence. This proportion is very high, comparable to that observed in other studies of immigrant women in France and Europe (Box 1).

7Limiting the study to violence experienced after migration and from age 15 (a separate survey would be needed to study sexual violence against girls under 15), 3.5% of the women recruited in a health centre reported experience of violence since age 15 versus 7% among those receiving care for HIV (Table).

8The women who left their country to escape persecution, regardless of whether they had obtained refugee status, reported experience of sexual violence more often than women who came to France to find work: 2.3 times more often before migration and 3.7 times more often afterwards. In other words, women who migrate to escape violence in their home country are more likely to also experience violence (this time sexual) at destination.

Residential and administrative insecurity increase exposure to sexual violence

9The living conditions that increase exposure to sexual violence after migration were identified using a model that takes account of both direct and indirect contributing factors (Figure).


10For women who make frequent changes of residence in a given year, with nights spent in emergency accommodation, in other people’s homes and/or in the street, the probability of experiencing sexual violence is higher than in years when they have independent housing. This residential instability is a direct factor of sexual violence.

11Periods in which women reported not having a residence permit are also those in which they cannot take up legal paid employment. They may have multiple sexual partners during such periods, and their likelihood of being raped is increased. Administrative instability is thus an indirect factor of sexual violence (Figure).

12When women share the homes of partners, acquaintances, or family members, the risk of sexual harassment and violence is increased. Being hosted by someone does not guarantee them protection. Surveys of sexual violence in France [5, 6] have clearly shown that such violence occurs mainly in the domestic or private sphere and is perpetrated by individuals known to the victims, such as partners, ex-partners, or family members. The mechanisms of appropriation of women’s bodies are reinforced by women’s dependence on men, including male partners, acquaintances, and family members. While these mechanisms are not specific to immigrant women, their power is clearly heightened by residential insecurity.

13Relational situations are themselves closely linked to women’s living conditions and to the sexual violence they experience. Some 2% of the women seen in health centres and 7% of those receiving HIV care reported having transactional sexual relations after arriving in France to obtain money or other necessities (see Figure), such as a place to sleep. These types of relationships are highly conducive to sexual violence. Women facing residential and administrative insecurity are thus at greater risk; these two forms of insecurity are direct and indirect factors of sexual violence.

Sexual violence after migration and the risk of HIV infection

14One-third of the HIV-positive women in the survey were infected after migration, i.e. they were diagnosed at least 11 years after their arrival, had a negative screening result in France, or began their sexual life after coming to the country. [2]

15Women infected with HIV after migration reported experience of forced sexual intercourse after migration 4 times more frequently than uninfected women (15% vs. 3.5%; see Table). While this finding does not signify that HIV infection is directly linked to sexual violence (a hypothesis impossible to prove), the study shows that for a share of women infected with HIV after migration, sexual violence is associated with situations of high HIV-transmission risk in an extremely insecure social environment.


17Efforts to combat gender violence must recognize and address the issue of violence against immigrant women living in precarious conditions. Their increased HIV infection risk testifies to the gravity of this issue. Insecurity and lack of access to basic rights are factors underlying the sexual violence perpetrated on these women. Access to stable housing and to resident status are essential preconditions for exercising the right to live without violence or risk to personal health.


  • [1]
    Half of the women were under age 26, and half were 26 or older.
  • [2]
    A mathematical model of biological data was also used to determine whether infection occurred before or after migration [8].

The Parcours survey conducted in 2012–2013 in health facilities across the Paris region (Île-de-France) sheds light on sexual violence experienced by immigrant women from sub-Saharan Africa after migration and the social contexts in which it occurs; residential and administrative insecurity are factors of increased risk. One-third of surveyed women with HIV were infected after migration, and they reported experience of forced sexual intercourse 4 times more frequently than uninfected women.

  • sexual violence
  • women
  • migration
  • France
  • immigrant women from sub-Saharan Africa
  • HIV infection
  • vulnerability
  • housing insecurity


  • Online
    Gosselin A., Desgrées du Loû A., Lelièvre E., Lert F., Dray-Spira R., Lydié N. et al., 2016, How long do sub-Saharan migrants take to settle in France? Population and Societies, 533, May.
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    Keygnaert I., Vettenburg N., Temmerman M., 2012, Hidden violence is silent rape: Sexual and gender-based violence in refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands, Culture, Health & Sexuality, 14(5), 505–520.
  • 3
    Chauvin P., Simonnot N., Vanbiervliet F., Vicart M., Vuillermoz C., 2015, Access to healthcare for people facing multiple health vulnerabilities in 26 cities across 11 countries: Report on the social and medical data gathered in 2014 in nine European countries, Turkey and Canada, Paris, Doctors of the World - Médecins du Monde International Network.
  • 4
    Andro A., Scodellaro C., Eberhard M., Gelly M. et l’équipe Dsafhir, 2019, Parcours migratoire, violences déclarées et santé perçue des femmes migrantes hébergées en hôtel en Île-de-France. Enquête Dsafhir, Bulletin épidémiologique hebdomadaire, 17–18, 334–341, 25 June.
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  • Online
    Pannetier J., Ravalihasy A., Lydié N., Lert F., Desgrées du Loû A. on behalf of the Parcours study group, 2018, 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, 3(1), e16–e23.
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    Desgrées du Loû A., Pannetier J., Ravalihasy A., Gosselin A., Supervie V., Panjo H. et al., 2015, Sub-Saharan African migrants living with HIV acquired after migration, France, ANRS PARCOURS study, 2012 to 2013, Eurosurveillance, 20(46), 31–38, 19 November.
Julie Pannetier
Cresppa-GTM (Université Paris 8, Université Paris Nanterre, CNRS)
Institut des Migrations
Ceped (Université Paris Descartes - IRD), ERL Inserm SageSud
Andrainolo Ravalihasy
Ceped (Université Paris Descartes - IRD), ERL Inserm SageSud
Institut de Recherche pour le Développement (IRD)
Annabel Desgrées du Loû
Institut des Migrations
Ceped (Université Paris Descartes - IRD), ERL Inserm SageSud
Institut de Recherche pour le Développement (IRD)
France Lert
Ceped (Université Paris Descartes - IRD), ERL Inserm SageSud
for the Parcours survey team
Nathalie Lydié
Santé publique France
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