It is a paradox of the fight against HIV. Never has the arsenal of means of prevention been so rich and diversified. However, the number of new diagnoses of infection with the human immunodeficiency virus is not decreasing in France, notes Public Health France (SPF), in a document published Tuesday, November 29, on the occasion of World AIDS Day. , Thursday 1^er december.

From 2012 to 2019, HIV testing activity steadily increased from 5.3 million tests to 6.1 million per year. Then it fell between 2019 and 2020 (–13%), in connection with the Covid-19 epidemic. This decrease “has not been fully caught up in 2021 (+ 8%), hence a deficit in the use of screening”reports SPF.

As for the number of new diagnoses, it fell sharply between 2019 and 2020 (–22%). A fall “in connection with the decrease in screening activity, but probably also with a decrease in exposure to HIV linked to social distancing measures, and with the decrease in migratory flows, particularly from sub-Saharan Africa”SPF analysis.

In 2021, approximately 5,000 people discovered their HIV seropositivity, a stable number compared to 2020. A stability observed regardless of the mode of contamination or the place of birth: heterosexuals born abroad or in France, men with sex with men born abroad or in France, injection drug users, trans people.

Free screening without prescription

Also in 2021, 24% of diagnoses were made at an early stage of infection, “a proportion which tends to decrease”, notes Florence Lot, of the Infectious Diseases Department at SPF; 47% were at an intermediate stage, a proportion that is increasing; and 29% at an advanced stage (AIDS or CD4 lymphocyte count below 200 per mm³), “a fairly stable proportion in recent years”. The data for the year 2022 is not yet known.

“Improved screening is necessary to reduce late diagnoses and contamination”, observes SPF. ” Early detection makes it possible to benefit from antiretroviral treatment, to lower the viral load and, thus, to no longer transmit HIV., emphasizes Florence Lot.

However, a new device allows, since 1^er January, to be tested for HIV free of charge, without advance payment and without a prescription, in all laboratories in France. “This non-prescription screening is a very good measure, especially for the youngest and the oldest, who are under-screened”says Professor Gilles Pialoux, head of the infectious and tropical diseases department at the Tenon hospital in Paris.

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