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 primary social determinants that Professor Yazdanpanah believes are impacting HIV prevention efforts in France?
### Interview: Understanding the Current HIV Landscape in France
**Interviewer:** Good evening, Professor Yazdanpanah, and thank you for joining us today. Your recent statements at the press conference highlighted a concerning trend in HIV diagnoses in France. Can you elaborate on the statistics released by Public Health France regarding new infections?
**Professor Yazdanpanah:** Thank you for having me. Yes, Public Health France has estimated that nearly 5,500 new people will be diagnosed with HIV in 2023, which is a significant number considering we also corrected earlier figures to account for under-reporting. This shows that despite having the necessary tools for prevention, we have not seen a decline in new infections over the past several years.
**Interviewer:** That’s quite alarming. You mentioned the various tools available for prevention. What do you think is causing this stagnation in the decline of new infections?
**Professor Yazdanpanah:** Several factors contribute to this situation. There are social determinants at play, such as access to healthcare, stigma, and education about HIV, which can significantly affect prevention efforts. Additionally, we need to improve the early diagnosis and monitoring of individuals living with HIV. It’s crucial for those who are infected to get the right treatment early to not only improve their health but also reduce transmission.
**Interviewer:** At the recent congress, you presented eleven new recommendations on HIV care. Can you highlight some of the key points discussed?
**Professor Yazdanpanah:** Absolutely. Our recommendations focus on various aspects of HIV care including the importance of understanding social determinants of health, enhancing preventive treatments, and ensuring effective diagnosis and monitoring of HIV. We also addressed specific issues such as HIV in pregnancy and the need to adapt antiretroviral treatments to meet the needs of diverse patient populations.
**Interviewer:** Speaking of diagnosis, you mentioned that 43% of new infections are discovered at a late stage. Why is this a significant concern?
**Professor Yazdanpanah:** This is a serious concern because late diagnosis often leads to worse health outcomes for individuals. When HIV is detected early, treatment can start sooner, which not only benefits the patient but also dramatically reduces the risk of transmitting the virus to others. Late diagnoses suggest we need to implement more effective screening strategies and raise awareness about the importance of regular testing.
**Interviewer:** Thank you, Professor. As we wrap up, what message do you want to convey to our viewers regarding HIV prevention and care?
**Professor Yazdanpanah:** I want to emphasize the importance of education, regular testing, and open conversations about HIV. Everyone can play a role in preventing new infections. By understanding the risks and engaging with available resources, we can work towards controlling this epidemic and providing better care for those affected.
**Interviewer:** Thank you, Professor Yazdanpanah, for sharing your insights and updates on the fight against HIV in France.
**Professor Yazdanpanah:** Thank you for having me.
