2024-11-22 18:09:00
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. 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 factors contributing to the plateau in new HIV infections in France despite the availability of prevention tools?
**Interview with Professor Yazdan Yazdanpanah on the Current State of HIV in France**
*Date: November 22, 2024*
**Interviewer:** Welcome, Professor Yazdan Yazdanpanah, director of the National Agency for AIDS Research-Emerging Infectious Diseases (ANRS-MIE). Thank you for joining us today.
**Professor Yazdanpanah:** Thank you for having me.
**Interviewer:** Recent reports from Public Health France indicate that nearly 5,500 new HIV diagnoses are expected in 2023, a concerning figure indeed. Can you elaborate on this estimate and what it implies about the current state of HIV infections in France?
**Professor Yazdanpanah:** Certainly. The figure is derived from correcting the reported cases, which initially stood at 3,877. This adjustment reflects the reality of under-reporting in our health system. It’s alarming that, despite having the necessary tools to prevent HIV transmission, the number of new infections has plateaued for several years now. This suggests we need to investigate and address the underlying factors contributing to this stagnation.
**Interviewer:** You mentioned the lack of decline in new infections. Could you expand on the reasons behind this phenomenon?
**Professor Yazdanpanah:** Yes, the reasons are complex. Factors such as social determinants of health, stigma associated with HIV, and disparities in access to medical care all play significant roles. Our recent recommendations, presented at the annual congress of the French Society for the Fight against AIDS, explore these areas in detail. It’s crucial that we not only provide medical solutions but also address these broader social issues to effectively reduce new infections.
**Interviewer:** What are some of the key recommendations that emerged from the recent congress regarding HIV care?
**Professor Yazdanpanah:** We laid out eleven comprehensive recommendations focusing on improving care access and tailoring our approaches to different populations. This includes enhancing educational campaigns, addressing stigma, and ensuring equitable access to testing and treatment services. We believe these steps are essential to reversing the trend of new infections.
**Interviewer:** As we look forward, what strategies do you believe will be pivotal in achieving a significant reduction in HIV transmissions in France?
**Professor Yazdanpanah:** It will require a multi-faceted approach. We must enhance public awareness about prevention tools available, like PrEP (pre-exposure prophylaxis), along with ongoing testing and treatment efforts. Engaging communities and ensuring that vulnerable populations are prioritized in our public health efforts are critical. We need a robust commitment from all societal sectors to make a real difference.
**Interviewer:** Thank you, Professor Yazdan Yazdanpanah, for shedding light on these pressing issues. We appreciate your insights and the vital work your agency is doing in the fight against HIV.
**Professor Yazdanpanah:** Thank you. It’s important that we keep this conversation going and work together to combat HIV in France effectively.