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 the current challenges in HIV prevention and treatment in France, as identified by healthcare experts?
**Interview with Professor Yazdan Yazdanpanah on the Current State of HIV in France**
**Interviewer:** Thank you for joining us today, Professor Yazdanpanah. Recent reports indicate that nearly 5,500 new HIV diagnoses will occur in France this year, a figure adjusted to reflect under-reporting. How do you interpret this data?
**Professor Yazdan Yazdanpanah:** Thank you for having me. The estimated 5,500 new cases of HIV in 2023 is troubling. This statistic highlights a stagnant trend in new infections, which we haven’t seen decline for several years despite the availability of effective prevention tools. It’s crucial to analyze why these infections are persisting and what barriers might be preventing people from getting tested and treated.
**Interviewer:** You mentioned the tools for prevention. Could you elaborate on what these are and why they aren’t being utilized effectively?
**Professor Yazdan Yazdanpanah:** Certainly. We have access to several effective methods for preventing HIV transmission, including pre-exposure prophylaxis (PrEP), regular testing, and education on safe practices. However, we face challenges such as stigma, lack of awareness, and social determinants that hinder access to these resources. These barriers disproportionately affect certain communities, contributing to the ongoing rates of infection.
**Interviewer:** On November 21, you presented new recommendations for HIV care at an annual congress. What are some of the key points covered in these recommendations?
**Professor Yazdan Yazdanpanah:** Our recommendations cover a range of critical issues. We focus on understanding the social determinants of infection, the importance of preventive treatments, and enhancing the diagnosis and monitoring processes for those living with HIV. We also address issues related to HIV in pregnancy and the need to adapt antiretroviral therapies to different populations and needs. Our goal is to create a more comprehensive care framework that responds effectively to the community’s needs.
**Interviewer:** You also mentioned that 43% of infections are discovered at a late stage. What implications does this have for treatment and public health policy?
**Professor Yazdan Yazdanpanah:** Discovering HIV at a late stage can significantly complicate treatment outcomes and increase the risk of transmission. This statistic underscores the necessity for improved testing efforts and education campaigns to encourage early diagnosis. Public health policies must prioritize outreach and accessibility to testing resources to ensure individuals are aware of their status sooner, facilitating timely intervention and care.
**Interviewer:** What message would you like to convey to our audience regarding HIV awareness and prevention?
**Professor Yazdan Yazdanpanah:** It is imperative to normalize discussions about HIV, reduce stigma, and encourage everyone to get tested regularly. Knowledge is power, and understanding one’s status is the first step toward prevention and care. We must all work together—healthcare providers, policymakers, and the community—to create an environment that supports these initiatives and responds effectively to the challenges we face regarding HIV.
**Interviewer:** Thank you, Professor Yazdanpanah, for sharing your insights on this important topic.
**Professor Yazdan Yazdanpanah:** Thank you for the opportunity to discuss these pressing issues.
