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. 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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How can community organizations play a crucial role in addressing the social determinants of health that affect HIV transmission rates in marginalized populations?
**Interview with Professor Yazdan Yazdanpanah, Director of the National Agency for AIDS Research-Emerging Infectious Diseases (ANRS-MIE)**
**Editor:** Thank you for joining us today, Professor Yazdanpanah. Recently, Public Health France estimated that nearly 5,500 new HIV diagnoses are expected in 2023. What are your thoughts on these numbers?
**Professor Yazdanpanah:** Thank you for having me. Yes, we do estimate around 5,500 new cases, which highlights a troubling trend in our fight against HIV. Despite having a range of effective tools for prevention and treatment, the number of new infections has not significantly declined over the past few years. This stagnation is concerning, and it’s essential we address the contributing factors.
**Editor:** You mentioned that there are tools available for prevention. Can you elaborate on what these tools are and why they aren’t reducing transmission rates effectively?
**Professor Yazdanpanah:** Certainly. We have various preventative measures, including PrEP (pre-exposure prophylaxis) for high-risk populations, routine screening, and public health campaigns to raise awareness about safe practices. However, the persistent issue seems to be related to social determinants of health, such as stigma, lack of access to healthcare services, and insufficient education about HIV prevention among certain communities. Our recent recommendations emphasize addressing these social determinants to create a more inclusive and effective approach to HIV prevention.
**Editor:** You recently presented new recommendations at the French Society for the Fight against AIDS congress. What are some of the key points discussed?
**Professor Yazdanpanah:** Yes, we laid out eleven new recommendations aimed at improving HIV care in France. These include enhancing access to HIV testing, particularly in vulnerable populations, increasing education efforts about PrEP, and improving support services for individuals diagnosed with HIV. We are also focusing on integrating mental health support with HIV care, recognizing that psychological well-being is crucial for managing long-term health outcomes.
**Editor:** There seems to be a significant emphasis on tackling the social determinants of infection. How do you propose to address these challenges?
**Professor Yazdanpanah:** Addressing social determinants requires a multifaceted approach. We aim to collaborate with community organizations to reach marginalized groups effectively, ensure that healthcare services are accessible and culturally sensitive, and advocate for policy changes that reduce stigma and discrimination. Education initiatives are vital, not only to inform about HIV but also to empower individuals to seek preventive measures and treatment without fear of judgment.
**Editor:** Thank you, Professor Yazdanpanah, for your insights. It’s clear that a comprehensive strategy tackling both medical and social factors is essential in reversing the trend of rising HIV infections in France. We appreciate your dedication to this important cause.
**Professor Yazdanpanah:** Thank you for highlighting these issues. It’s vital that we continue this dialog and work collectively towards a future with fewer new infections.
