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 key factors contributing to the plateau of new HIV infections in France despite available prevention tools and treatment strategies?
**Interview with Professor Yazdan Yazdanpanah on HIV Trends and New Recommendations in France**
*Date: November 22, 2024*
**Editor:** Thank you for joining us today, Professor Yazdanpanah. Recent reports indicate that nearly 5,500 new cases of HIV are expected to be diagnosed in France this year. What does this data highlight about the current state of HIV infections in the country?
**Professor Yazdanpanah:** Thank you for having me. The projections for 2023, which show approximately 5,500 new diagnoses—an adjustment from the initially reported 3,877—are quite concerning. They underscore a troubling trend: the number of new HIV infections has plateaued in France despite the various prevention tools available, including effective treatment strategies and awareness campaigns. This indicates that we need to enhance our efforts in public health communication, testing, and treatment accessibility.
**Editor:** You mentioned the need for increased efforts in those areas. What specific initiatives were discussed during the recent congress of the French Society for the Fight against AIDS that could address these challenges?
**Professor Yazdanpanah:** At the congress, we introduced eleven new recommendations that focus on critical aspects of HIV care. These include tackling social determinants of health that affect infection rates, improving the diagnosis and monitoring of individuals living with HIV, and adapting antiretroviral treatments for better management of the virus. The aim is to create a holistic approach that considers not just medical treatment but also the social and environmental factors influencing health outcomes.
**Editor:** It is reported that 43% of new infections are discovered at a late stage, which raises alarms about access to testing. What strategies can be implemented to improve early diagnosis?
**Professor Yazdanpanah:** Increasing access to rapid HIV testing and encouraging routine screening are crucial. We also advocate for opt-out testing practices, which would make testing a standard part of routine healthcare appointments. This approach reduces stigma and increases the likelihood that individuals will get tested regularly. Additionally, public health campaigns that emphasize the importance of early detection can help raise awareness about the need for testing.
**Editor:** Lastly, what is your message to the public regarding HIV prevention and testing?
**Professor Yazdanpanah:** My message is clear: HIV is still a significant public health issue, and prevention is key. I urge everyone to get tested regularly, especially if they are in high-risk categories. Remember, early diagnosis saves lives, and effective treatment means that those living with HIV can lead normal, healthy lives. We have the tools—now it’s about utilizing them effectively in our communities.
**Editor:** Thank you, Professor Yazdanpanah, for sharing your insights on this pressing issue. It’s vital that we continue to foster awareness and action surrounding HIV prevention and care.
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This interview emphasizes the critical situation regarding HIV infections in France while also highlighting recent efforts and recommendations aimed at improving diagnosis and care for those affected.
