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 challenges in routine HIV screening in France?
**Interview on HIV Screening and Infection Rates in France**
**Interviewer:** Today, we’re discussing the latest findings regarding HIV diagnoses and prevention efforts in France, which have recently shown alarming trends. Joining us is Professor Yazdan Yazdanpanah, the director of the National Agency for AIDS Research-Emerging Infectious Diseases (ANRS-MIE). Thank you for being here, Professor.
**Professor Yazdanpanah:** Thank you for having me.
**Interviewer:** You recently mentioned that nearly 5,500 new HIV cases are projected for 2023 in France. Can you explain the significance of this number?
**Professor Yazdanpanah:** Yes, this estimate highlights a serious concern. While 3,877 cases were recorded, the adjustment reflects an ongoing issue of under-reporting in our data collection. This number represents more than just statistics; it signifies real lives at risk and underscores the challenges we face in preventing new infections [[1](https://www.researchgate.net/publication/47545496_Routine_HIV_Screening_in_France_Clinical_Impact_and_Cost-Effectiveness)].
**Interviewer:** You’ve stated that the rate of new infections has plateaued despite the availability of prevention tools. Can you elaborate on why that is?
**Professor Yazdanpanah:** Absolutely. Our tools for prevention—including condoms, pre-exposure prophylaxis (PrEP), and widespread testing—are effective, yet there seems to be a gap in consistent public engagement and awareness. Many people remain unaware of their status, which plays a significant role in continued transmissions. We need to enhance our public health messaging and outreach to ensure everyone understands the importance of regular testing and preventive measures [[1](https://www.researchgate.net/publication/47545496_Routine_HIV_Screening_in_France_Clinical_Impact_and_Cost-Effectiveness)].
**Interviewer:** At a recent conference, the ANRS-MIE, the High Authority for Health, and the National AIDS Council released eleven recommendations focusing on various aspects of HIV care. What are some key points from these recommendations?
**Professor Yazdanpanah:** The recommendations emphasize several crucial areas, including addressing the social determinants of health that contribute to infection rates, improving access to preventive treatments, simplifying diagnosis and monitoring protocols, and adapting antiretroviral therapies to better meet the needs of individuals. We are also focusing on specific concerns such as HIV transmission during pregnancy. These recommendations aim to create a more comprehensive response to the HIV epidemic in France [[1](https://www.researchgate.net/publication/47545496_Routine_HIV_Screening_in_France_Clinical_Impact_and_Cost-Effectiveness)].
**Interviewer:** That’s a thorough approach. However, it’s concerning to hear that 43% of infections are diagnosed at a late stage. What can be done to improve early detection?
**Professor Yazdanpanah:** Increasing routine HIV screening is vital. Our studies show that many infections go undetected until they reach advanced stages. We must advocate for routine testing in healthcare settings and make it as accessible as possible. Educational campaigns can help destigmatize HIV testing and encourage more individuals to get screened [[1](https://www.researchgate.net/publication/47545496_Routine_HIV_Screening_in_France_Clinical_Impact_and_Cost-Effectiveness)].
**Interviewer:** Thank you, Professor Yazdanpanah, for these insights. It’s clear that while progress has been made, there’s much more work to do. We appreciate your time today.
**Professor Yazdanpanah:** Thank you for having me. It’s crucial that we continue this conversation and work together to combat HIV effectively.