2023-12-01 15:47:02
December 1, 2023
The progress made over many years in the fight against HIV/AIDS tends to trivialize the disease. World Wrestling Day, organized every year on December 1, is there to remind us that nothing has yet been won. The AIDES association points to screenings that are poorly targeted and still too late.
On this World AIDS Day, the AIDES association – which has been working in the fight against HIV/AIDS and hepatitis since 1984 – welcomes the encouraging resumption of screening but also warns of insufficient targeting.
She thus criticizes the State for its lack of ambition to end the epidemic by 2030, even though we have all the necessary tools: Prep (pre-exposure prophylaxis), Tasp (Treatment as Prevention; use of antiretroviral therapy to significantly reduce transmission of the virus), internal and external condoms, screening, PEP (Post-Exposure Treatment; administration of antiretroviral drugs within hours of suspected exposure to HIV) and community health centers.
At this rate, we won’t make it!
Between 4,200 and 5,700 people discovered their HIV status in 2022 in France.
Between 2012 and 2022, the reduction in the number of HIV discoveries is estimated between 11% and 21%. While this data represents good news, AIDES considers this result to be disappointing when put into perspective with the diversity and effectiveness of the prevention tools available in France and in comparison with other countries.
The association takes the example of the United Kingdom. In this country, between 2012 and 2018, the number of discoveries of new transmissions fell by 71.4% among men who have sex between men (MSM). In France, the drop was only 32% between 2012 and 2022.
6.5 million HIV serologies in 2022
HIV screening activity, which had decreased between 2019 and 2020 in connection with the Covid-19 epidemic, increased again to reach a level in 2022 higher than that of 2019 (+3%), notes Public Health France. But that is not enough. In fact, associations and public authorities had set themselves the objective that 95% of people living with HIV would know their serological status in the country, a prerequisite for the end of the epidemic.
One of the ways to achieve this is to strengthen screening among those most exposed to the risk of HIV transmission (MSM, injecting drug users, migrant populations, etc.).
Detect yes, but early
If screening needs to be intensified, the infection must still be discovered at an early stage. However, in 2022, 43% of HIV infections were discovered at a late stage (only 28% at the advanced stage). The fact that this figure does not decrease over the years is worrying, because it fuels the epidemic due to a risk of transmission of HIV to partners before starting antiretroviral treatment. This of course also constitutes a loss of opportunity for the infected individual. These late discoveries of infection are mainly found in foreign-born heterosexual men and foreign-born women.
The end of HIV transmission by 2030, many still believe in it
AIDES considers that the data from Public Health France remains insufficient to have the means to achieve its ambitions. To this end, the association is calling for the French Obligatory Declaration (DO) system to be optimized for HIV.
Good news: HIV should be included in the list of pathologies treated by the LABOé-SI information system for the epidemiological surveillance of prioritized pathologies. This is currently being deployed in France.
In this 1is December 2023, Professor Yazdan Yazdanpanah, director ANRS/Emerging infectious diseases, and Professor Patrick Yeni, president of the National Council for AIDS and Viral Hepatitis, estimate in a joint letter that “ end of HIV transmission by 2030 is possible ».
They nevertheless specify that “ the epidemic is not declining fast enough. Screening proposals must be earlier and repeated […] in the presence of signs of primary infection or immune alteration, but also systematically, in the presence of indicators of sexual exposure, STIs or at the time of abortion (voluntary termination of pregnancy), regardless of age , geographical origin or sexual orientation of people. The offer of HIV screening tests without advance payment and without prescription should help repeat screening of exposed people. »
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