2024-11-22 18:09:00
Rapid HIV screening test, June 2018. CLAUDIO REYES / AFP
In 2023, nearly 5,500 new people will be diagnosed with the human immunodeficiency virus (HIV) in France. This is an estimate from Public Health France (SPF) after correction of the raw number of seropositivity discovered (3,877 cases), in order to take into account the under-reporting of cases.
“For several years, the number of new HIV contaminations has no longer declined in France, even though we have all the tools to prevent transmission”lamented Professor Yazdan Yazdanpanah, director of the National Agency for AIDS Research-Emerging Infectious Diseases (ANRS-MIE), during a press conference on November 21.
That same day, eleven new recommendations on HIV care were presented at the annual congress of the French Society for the Fight against AIDS, in Biarritz (Pyrénées-Atlantiques). The three co-authors, the ANRS-MIE, the High Authority for Health (HAS) and the National AIDS Council (CNS), notably scrutinized several key points: social determinants of infection, preventive treatments, diagnosis and monitoring of people living with HIV, HIV and pregnancy, adaptation of antiretroviral treatments, etc.
43% of infections discovered at a late stage
Since 2012, the number of HIV discoveries has decreased by 10%. But if we except the year 2020, marked by a sharp drop linked to the Covid-19 pandemic, this number has stagnated since 2018 and has even rebounded since 2020. “ This increase particularly affects people born abroad”, note the experts, particularly women infected through heterosexual intercourse and men who have sex with men (MSM).
Another concern, in 2023, 43% of HIV infections were discovered at a late stage (between 200 and 350 CD4 cells per cubic millimeter of blood), including 27% at an advanced stage (AIDS stage), with less than 200 CD4 cells. per cubic millimeter of blood. Between contamination and diagnosis, the median time was 1.9 years for all people discovering their HIV status, and three years for heterosexual men born abroad. This delay is a loss of individual opportunity. It also increases the risk of viral transmission, an undiagnosed and untreated person being able to contaminate their partners. Conversely, “if the virus is undetectable in the blood, it is untransmissible, relève Yazdan Yazdanpanah. Screening therefore remains the primary prevention tool. »
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How does addressing social determinants of health, such as stigma and access to healthcare, play a role in HIV prevention efforts in France?
**Interview on the Current State of HIV in France**
**Host:** Welcome to our segment on public health, where we discuss important issues affecting our communities. Today, we are joined by Professor Yazdan Yazdanpanah, the director of the National Agency for AIDS Research-Emerging Infectious Diseases (ANRS-MIE). Professor Yazdanpanah, thank you for being here.
**Professor Yazdanpanah:** Thank you for having me.
**Host:** Let’s dive right in. Recent figures from Public Health France indicate that nearly 5,500 new HIV diagnoses are expected in 2023. This is quite a sobering statistic. What does this tell us about the current state of HIV transmission in France?
**Professor Yazdanpanah:** It’s indeed concerning. The fact that we are projected to see nearly 5,500 new cases indicates that, for several years now, the number of new HIV infections has plateaued. This stagnation occurs despite the availability of numerous prevention tools that we know can effectively reduce transmission, including PrEP and improved access to rapid testing.
**Host:** You mentioned that the numbers have not declined, which must be frustrating for public health officials. What are some of the factors contributing to this situation?
**Professor Yazdanpanah:** There are multiple factors at play. One key issue is under-reporting. The raw numbers from 2023 show just under 4,000 reported cases, which we know doesn’t reflect the actual situation due to unreported infections. Moreover, social determinants such as stigma, access to healthcare, and education also significantly impact how effectively we can control the spread of the virus.
**Host:** At the annual congress of the French Society for the Fight against AIDS, you presented new recommendations for HIV care. Can you elaborate on some of these recommendations?
**Professor Yazdanpanah:** Certainly. Our team focused on several crucial areas. We emphasized the importance of addressing social determinants of health that influence infection rates, such as economic disparities and access to healthcare. We also recommended scaling up community-based testing and outreach programs to increase awareness and reduce stigma surrounding HIV.
**Host:** It seems like a multi-faceted approach is essential. What role do you foresee for public education in combating HIV infections moving forward?
**Professor Yazdanpanah:** Education is absolutely critical. By improving public knowledge about HIV transmission, prevention options, and treatment, we can help reduce stigma and encourage those at risk to get tested and treated. The power of community engagement cannot be understated—it’s essential in building trust and promoting health-seeking behavior.
**Host:** Thank you, Professor Yazdanpanah, for your insights on this pressing issue. It’s clear that while we have the tools to combat HIV, we need a collective effort to utilize them effectively.
**Professor Yazdanpanah:** It was a pleasure to be here. I hope our discussion today encourages listeners to engage with this important public health issue.
**Host:** Absolutely! Let’s work together to educate and support our communities in the fight against HIV. Thank you for tuning in.
