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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How do social determinants such as stigma and access to healthcare impact HIV transmission rates in France, according to Professor Yazdanpanah?
### Interview with Professor Yazdan Yazdanpanah on HIV Trends and Recommendations in France
**Interviewer:** Thank you for joining us today, Professor Yazdan Yazdanpanah, director of the National Agency for AIDS Research-Emerging Infectious Diseases (ANRS-MIE). It’s concerning to hear that nearly 5,500 new HIV diagnoses are expected in France this year, especially given the stagnation in decreasing new infections. What do you think is driving this trend?
**Professor Yazdanpanah:** Thank you for having me. Unfortunately, the lack of decline in new HIV infections can be attributed to several factors. Despite the availability of effective prevention methods, there remains a significant gap in awareness and testing. Many individuals who are HIV-positive do not know their status, and up to 40% of new transmissions are from people unaware they are infected[[1](https://hivinfo.nih.gov/understanding-hiv/fact-sheets/hiv-testing)]. Furthermore, social determinants such as stigma, access to healthcare, and awareness of preventive measures play substantial roles.
**Interviewer:** You mentioned the importance of awareness and testing. What steps are being taken to address this issue?
**Professor Yazdanpanah:** In response to these challenges, we recently presented eleven new recommendations at the annual congress of the French Society for the Fight against AIDS, which focus on various critical aspects of HIV care[[1](https://hivinfo.nih.gov/understanding-hiv/fact-sheets/hiv-testing)]. This includes enhancing access to preventive treatments, improving diagnostic methods, and addressing the social determinants of health that contribute to the infection rates. For instance, it’s crucial to expand access to rapid HIV screening tests, which can significantly increase detection and treatment rates.
**Interviewer:** One alarming statistic is that 43% of infections are discovered at a late stage. What implications does this have for treatment and patient outcomes?
**Professor Yazdanpanah:** Discovering HIV at a late stage poses significant health risks both for the individual and public health overall. Late diagnosis can lead to severe health complications and reduces the effectiveness of treatment[[1](https://hivinfo.nih.gov/understanding-hiv/fact-sheets/hiv-testing)]. It is essential that we push for regular testing and greater awareness, especially among high-risk populations, to ensure earlier diagnosis and more effective management of the virus.
**Interviewer:** What role can community organizations and public health initiatives play in combating this stagnation in new cases?
**Professor Yazdanpanah:** Community organizations are vital in bridging the gap between healthcare services and at-risk populations. They can help raise awareness about the importance of regular testing and provide support for those living with HIV. Public health initiatives should focus on education, outreach, and ensuring that testing services are accessible and culturally sensitive. With the right resources and support, we can make significant strides toward reducing HIV infections in France.
**Interviewer:** Thank you, Professor Yazdanpanah, for sharing your insights and the necessary steps moving forward.
**Professor Yazdanpanah:** Thank you for the opportunity to discuss this important issue. Together, we can work towards a future where HIV is no longer a serious public health concern.
