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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How do the new recommendations from the recent congress in Biarritz propose to address late-stage HIV diagnosis among individuals?
**Interview with Professor Yazdan Yazdanpanah on HIV Trends and New Recommendations in France**
**Interviewer:** Thank you for joining us today, Professor Yazdanpanah. Recent estimates suggest that nearly 5,500 new HIV diagnoses are expected in France this year. What do you see as the primary reasons for this ongoing trend of new infections?
**Professor Yazdanpanah:** Thank you for having me. It’s indeed concerning that the number of new HIV contaminations in France has plateaued. Despite having all the necessary tools for prevention, including widespread access to testing and effective antiretroviral treatments, many people are still becoming infected. Several factors contribute to this, including social determinants such as stigma, lack of awareness, and disparities in healthcare access that can prevent individuals from getting tested or seeking treatment early.
**Interviewer:** You mentioned these new recommendations presented at the recent congress in Biarritz. What are some of the key areas addressed in these recommendations?
**Professor Yazdanpanah:** The new recommendations focus on various critical aspects of HIV care. They emphasize the importance of addressing social determinants of health that affect the rates of infection. We’ve also highlighted the need for improved preventive treatments and better strategies for the diagnosis and ongoing monitoring of individuals living with HIV, including specific recommendations for pregnant women. Additionally, there are calls for adapting antiretroviral therapies to fit better into the lives of patients while ensuring efficient care.
**Interviewer:** It’s alarming that 43% of infections are discovered at a late stage. What does this mean for the individuals affected, and how can this be addressed?
**Professor Yazdanpanah:** Late-stage diagnosis considerably complicates treatment outcomes and increases the risk of transmission to others. For individuals, this often means a longer, more complicated treatment journey and a heightened risk of serious health issues associated with AIDS. To address this, we must enhance our public health messaging to encourage timely testing among at-risk populations. More accessible testing options and community outreach programs are essential to reduce the number of late diagnoses.
**Interviewer:** What message would you like to convey to our listeners, particularly those who might be at risk of HIV?
**Professor Yazdanpanah:** I encourage anyone who may be at risk or simply unsure of their status to get tested. Early detection is critical for effective management of HIV and greatly improves health outcomes. Additionally, it’s important to advocate for supportive environments where open discussions about HIV and sexual health can take place. There’s no shame in seeking help or knowledge; in fact, awareness and preventive measures are our best tools in the fight against HIV.
**Interviewer:** Thank you, Professor Yazdanpanah, for sharing your insights. It’s vital information that can help drive awareness and change in our communities.
**Professor Yazdanpanah:** Thank you for the opportunity to discuss this important issue.
