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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**Interview with Professor Yazdan Yazdanpanah on HIV Screening and Prevention in France**
*Date: November 22, 2024*
**Interviewer:** Good afternoon, Professor Yazdanpanah. Thank you for joining us today. Recent estimates from Public Health France suggest that nearly 5,500 new HIV diagnoses are expected this year. What are your thoughts on these figures?
**Professor Yazdanpanah:** Good afternoon, and thank you for having me. Yes, the number is concerning. It reflects a troubling trend: for several years now, we haven’t seen a reduction in new HIV infections, despite having the tools and knowledge necessary to prevent transmission effectively. The under-reporting of cases complicates our understanding, but it also highlights a critical issue in our public health response.
**Interviewer:** You mentioned that we possess the tools to prevent transmission. What specific strategies do you believe could be implemented to address this ongoing challenge?
**Professor Yazdanpanah:** We need to reconsider our screening strategies and enhance accessibility to testing. I advocate for routine, voluntary HIV screening as a standard practice across the population. For at-risk groups, more frequent testing can be crucial. Moreover, we should focus on the social determinants of health that contribute to higher rates of infection, integrating these factors into our prevention and care strategies.
**Interviewer:** During the recent congress of the French Society for the Fight against AIDS, eleven new recommendations were presented concerning HIV care. Can you highlight a few key points from these recommendations?
**Professor Yazdanpanah:** Certainly. The recommendations address several critical areas. We focused on improving access to preventive treatments and ensuring early diagnosis. For instance, we noted that 43% of infections are discovered at a late stage, which can significantly impact treatment outcomes. We also discussed the importance of tailored treatment regimens for specific populations, including pregnant individuals, and the need for ongoing support for those living with HIV.
**Interviewer:** What do you think is the biggest obstacle to better HIV management and care in France right now?
**Professor Yazdanpanah:** One of the largest obstacles is the stigma surrounding HIV. It can deter individuals from seeking testing and treatment. Additionally, we must improve public awareness about the importance of regular screening. Education on HIV transmission and management is vital. Only when we address these social factors can we hope to make significant progress in reducing diagnoses and improving the quality of life for those affected.
**Interviewer:** Thank you, Professor Yazdanpanah, for your insights. It’s clear that while there are challenges ahead, there are also targeted strategies that could lead to significant improvements in HIV prevention and care in France.
**Professor Yazdanpanah:** Thank you for having me. It’s a joint effort that requires collaboration between healthcare providers, policymakers, and the public. I’m hopeful that with the right actions, we can turn the tide against HIV in our communities.
