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 Trends in France**
**Host:** Welcome, Professor Yazdanpanah. Thank you for joining us to discuss the current state of HIV in France, particularly in light of the recent alarming statistics released by Public Health France.
**Professor Yazdanpanah:** Thank you for having me. It’s a crucial topic that needs more attention.
**Host:** You mentioned at a recent press conference that nearly 5,500 new cases of HIV are expected this year. What does this tell us about the state of HIV transmission in France?
**Professor Yazdanpanah:** The estimate of 5,500 new diagnoses in 2023, adjusted for under-reporting, underscores a troubling trend: for several years, new HIV infections have stagnated, indicating that despite the availability of effective prevention tools, we are not making the progress we hoped for in reducing transmissions.
**Host:** You pointed out that social determinants play a significant role in this. Can you elaborate on that?
**Professor Yazdanpanah:** Absolutely. Social determinants such as access to healthcare, education, and socioeconomic status greatly influence the rates of HIV transmission. Populations that face barriers in these areas are at a higher risk, which is why our new recommendations emphasize tailored approaches to prevention and care that address these issues.
**Host:** At the recent congress, eleven new recommendations for HIV care were introduced. What are some of the key points these recommendations address?
**Professor Yazdanpanah:** The recommendations cover a wide range of topics, including improving the diagnosis and monitoring of people living with HIV, better access to preventive treatments, and specific guidelines for managing HIV during pregnancy. They also call for a closer inspection of the appropriateness of antiretroviral treatments currently in use.
**Host:** You also mentioned that a significant portion of new infections, about 43%, are diagnosed at a late stage. Why is this particularly concerning?
**Professor Yazdanpanah:** Late-stage diagnoses are concerning because they often indicate a lack of access to healthcare or testing. Individuals diagnosed late are at a higher risk for serious health complications, and it also increases the likelihood of transmission to others. This is why early testing and continuous monitoring are pivotal in our fight against HIV.
**Host:** As we look forward, what steps can be taken to reverse these trends and improve the situation?
**Professor Yazdanpanah:** We need to enhance awareness and accessibility of HIV testing and prevention methods. Greater investment in community-based health initiatives can improve education and outreach, particularly for at-risk populations. Collaboration among health authorities, NGOs, and communities is essential to ensure everyone has access to the necessary resources to prevent and manage HIV effectively.
**Host:** Professor Yazdanpanah, thank you for sharing these important insights. It’s clear that ongoing effort and innovation will be needed to tackle the challenges ahead in the fight against HIV in France.
**Professor Yazdanpanah:** Thank you. Raising awareness about these issues is a significant step in making progress.
**Host:** Thank you for joining us today.
