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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**2. How can community-based programs improve awareness and testing for HIV among at-risk populations in France?**
**Interview with Professor Yazdan Yazdanpanah on HIV Trends in France**
**Interviewer:** Thank you for joining us today, Professor Yazdanpanah. Recent estimates indicate that nearly 5,500 new HIV diagnoses will occur in France in 2023. Can you explain the significance of this figure, especially in the context of the 3,877 cases initially reported?
**Professor Yazdanpanah:** Thank you for having me. The figure of 5,500 cases represents a critical update informed by investigations into under-reporting of HIV infections. The raw numbers are concerning, particularly because they suggest a stagnation in reducing new HIV infections, despite the availability of effective prevention and treatment tools.
**Interviewer:** You mentioned during a recent press conference that the number of new HIV cases in France has not declined for several years. What are some of the barriers to progress in combating this epidemic?
**Professor Yazdanpanah:** There are several barriers we need to consider. Social determinants of health play a significant role, including access to healthcare and education about prevention methods. There’s also the stigma associated with HIV that can deter individuals from getting tested or seeking treatment. These factors contribute to the troubling statistic that approximately 43% of infections are discovered at a late stage, which can complicate treatment outcomes.
**Interviewer:** At the annual congress of the French Society for the Fight against AIDS, new recommendations on HIV care were presented. Could you share some key points from those recommendations?
**Professor Yazdanpanah:** Certainly. The recommendations focus on several crucial areas, including enhancing preventive treatments, improving the diagnosis and monitoring processes, and addressing the needs of pregnant individuals living with HIV. We also emphasized the need for adapting antiretroviral therapies to optimize their effectiveness for different populations. The goal is to create a more comprehensive and inclusive approach to HIV care.
**Interviewer:** With the tools available, what specific actions can be taken to promote awareness and facilitate earlier diagnosis among at-risk populations?
**Professor Yazdanpanah:** Education and outreach are fundamental. We need to invest in community-based programs that provide resources and information about HIV transmission and testing. Increasing access to rapid screening tests can also encourage more individuals to know their status. Moreover, collaborating with social services to address the broader determinants of health will help us reach those who are currently underserved.
**Interviewer:** Thank you, Professor Yazdanpanah, for your insights on this pressing public health issue. It’s clear that while we have the resources to combat HIV, there’s still work to be done.
**Professor Yazdanpanah:** Thank you. It’s a complex issue, but with commitment and collaboration, I believe we can make significant strides in reducing new infections and improving the lives of those affected by HIV.
