new recommendations to slow down transmissions which are no longer decreasing in France

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.

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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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What are⁢ some of the main factors contributing to the stagnation of new HIV infections in France despite available⁣ prevention tools?

**Interview with Professor Yazdan Yazdanpanah on HIV⁤ Trends and Care Recommendations in France**

**Interviewer:** Thank you for joining us, Professor Yazdanpanah. Recent reports indicate⁣ that ​nearly 5,500 new HIV diagnoses​ are expected in France this year. What do you think has contributed to the stagnation in the decline of new infections despite the ‌tools available for prevention?

**Professor Yazdanpanah:** Thank you for having ⁤me. Yes, the ⁤figures are concerning. Despite advancements in treatment and ‍prevention, we still see a plateau in new ​HIV infections. ‌This is primarily due to a combination of factors, including social determinants such as stigma, lack of awareness, and accessibility‌ of preventive measures. Many ​individuals may not be getting tested regularly or may⁣ not understand the ⁢importance of prevention options available to them.

**Interviewer:** You mentioned that 43% of infections are discovered at a late stage. How does late diagnosis impact the health outcomes for those living with HIV?

**Professor Yazdanpanah:** Late diagnosis significantly affects health​ outcomes. ⁢When people are ‌diagnosed later, they often have a weaker immune system, which​ can lead to more severe health issues and complications.​ Early ‌diagnosis is crucial; it ​allows for timely intervention, ‌better ⁢management of the virus, and ⁢the potential for a longer, healthier life.

**Interviewer:** At the recent congress in Biarritz, eleven new⁢ recommendations were presented.‍ Can ⁣you highlight some ⁣key areas these recommendations focus on?

**Professor Yazdanpanah:** Certainly. The recommendations address various critical ‍aspects of HIV care, including the social‍ determinants that contribute to infection rates. ⁣We also emphasize preventive treatments like PrEP (pre-exposure prophylaxis) and the importance of regular screening. ⁣Additionally, we are focusing on ‌the diagnosis and monitoring of people living with HIV, particularly in relation ‍to pregnancy and the adaptation ​of antiretroviral treatments ‍to improve patient outcomes.

**Interviewer:** Considering these insights, what should be the‌ next steps for individuals and healthcare ​providers ​in the fight against HIV?

**Professor Yazdanpanah:** It’s essential for individuals to stay ⁢informed about HIV prevention and to get tested⁢ regularly. Healthcare providers play a ‍critical role in educating patients about the resources available. We need to continue raising awareness and reducing stigma around HIV to encourage more people to‌ get tested and start treatment early. Collaboration among healthcare systems, governments, and educational institutions is vital for effective⁣ outreach and prevention efforts.

**Interviewer:** Thank you, Professor Yazdanpanah, for your⁣ valuable insights on this pressing ‌public health issue.

**Professor Yazdanpanah:** Thank ​you for having me. ⁤Let’s continue to work together to change the narrative around HIV in France and beyond.

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