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 main reasons for the stagnation in new HIV diagnoses despite the availability of preventive tools in France?
### Interview with Professor Yazdan Yazdanpanah on the Current State of HIV in France
**Interviewer:** Thank you for joining us, Professor Yazdanpanah. Your insights are invaluable, especially given the recent statistics regarding HIV diagnoses in France. Could you start by summarizing the key findings from the recent report by Public Health France?
**Professor Yazdanpanah:** Absolutely, and thank you for having me. In 2023, we estimate that nearly 5,500 individuals will be newly diagnosed with HIV in France. This number has been adjusted to account for previous under-reporting, which brought the actual count of diagnosed cases to around 3,877. This situation highlights a concerning trend: despite the availability of preventive tools, the number of new infections has stagnated over the past few years [[1](https://www.hiv.gov/hiv-basics/hiv-testing/learn-about-hiv-testing/hiv-testing-overview)].
**Interviewer:** In light of this stagnation, how do you interpret the fact that significant percentages of infections are discovered only at a late stage?
**Professor Yazdanpanah:** This is indeed a critical issue. We currently see that around 43% of new infections are identified at a late stage, which complicates treatment and management. This delayed diagnosis means that individuals have gone without necessary care, which not only affects their health but also increases the risk of further transmission to others. It underscores the urgent need for increased awareness and accessibility of HIV testing [[1](https://www.hiv.gov/hiv-basics/hiv-testing/learn-about-hiv-testing/hiv-testing-overview)].
**Interviewer:** During the recent congress of the French Society for the Fight against AIDS, you introduced eleven new recommendations on HIV care. What are some of the most vital points addressed in these recommendations?
**Professor Yazdanpanah:** The recommendations focus on several crucial aspects. We addressed social determinants of health that contribute to infection rates, emphasized the importance of preventive treatments, and proposed enhancements to the diagnosis and monitoring processes for those living with HIV. Additionally, we explored specific considerations for HIV and pregnancy, as well as the adaptation of antiretroviral treatments tailored to individual needs. The goal is to create a comprehensive approach to manage HIV effectively [[1](https://www.hiv.gov/hiv-basics/hiv-testing/learn-about-hiv-testing/hiv-testing-overview)].
**Interviewer:** It sounds like a holistic approach is being prioritized. What steps do you believe should be taken to reduce the number of new infections moving forward?
**Professor Yazdanpanah:** We need a multi-faceted effort. First, enhancing public awareness about HIV testing can help encourage individuals to get tested earlier. Second, integrating social services to address the broader health determinants is vital. Lastly, we must ensure that preventive treatments and education about HIV transmission are widely available and accessible to those most at risk. If we work on all these fronts simultaneously, we can make a significant impact [[1](https://www.hiv.gov/hiv-basics/hiv-testing/learn-about-hiv-testing/hiv-testing-overview)].
**Interviewer:** Thank you, Professor Yazdanpanah, for sharing your valuable perspective on this important issue. We hope to see progress in reducing HIV infections in France in the near future.
**Professor Yazdanpanah:** Thank you for having me. It’s imperative that we continue this conversation and work collaboratively to achieve better health outcomes for everyone.