December 1 is traditionally World AIDS Day (the last stage of HIV, the human immunodeficiency virus). In Mayotte, the cases are better known thanks to screening, “but there are still improvements to be made”.
Is the circulation of HIV increasing on the island?
“We have 400 patients in active line. Since 2019, the year I arrived, I have seen an increase. This year, for example, we have 80 new people screened. About twenty were already infected before arriving in Mayotte, ”says Doctor Mohamadou Niang, head of the infectious and tropical diseases department at the Mayotte hospital center (CHM). He sees “too much risky behavior and a lack of sex education. The notion of sex tourism is also important”. And even if the increase in cases is linked to better screening, “there are still improvements to be made”, nuance Marie-Eve Tremblay. A nurse in the HIV outpatient department, she works with Pauline Focant to monitor patients with HIV.
Are communities affected differently?
Doctor Niang estimates the proportion of patients in Mayotte at around 40% Malagasy. As the virus is particularly active in Africa, the Comorian or East African populations are also affected. “70% of patients need regularization. There is a lot of social work, it is a stakeholder in the care,” concedes Pauline Focant. Sex workers are a particularly watched public. The head of the service and the nurses deplore that the patients do not make themselves known at the last stage of HIV infection, that of AIDS.
What are the obstacles to screening?
This is a problem on the island, prevention is more difficult to carry out there than in mainland France, even if associations like Narike M’sada work locally for this. “We have a lot of screening in the event of pregnancy,” notes Marie-Eve Tremblay. Indeed, pregnant women being obliged to carry out checks, it is this public that is more easily monitored. Because, on the contrary, men do not have enough of the screening reflex and may very well have HIV without knowing it. “Some have never done medical tests,” fulminates the doctor, while he advocates screening “every three years”. Another obstacle, in Mayotte, the tests are generally more expensive than in mainland France. And “when you enter a pharmacy, you have to ask the pharmacists. In mainland France, you can buy a test directly on the shelves, ”adds the infectious disease specialist.
Can we get treatment in Mayotte?
This is the particularity of HIV, patients can live quite normally with the virus. Treatment in the form of triple therapy with one tablet per day is often administered. In the event of a deterioration in a patient’s condition, he can benefit from “multidisciplinary care” quickly on the spot. This Tuesday, for example, three people were hospitalized at the CHM. “We are between 85% and 90% of people carrying the virus, but who no longer transmit it. The World Health Organization has set a target of 95% in 2030,” argue the doctor and the two nurses.
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