HIV screening: although essential, there are still too few tests

In the fight against AIDS (acquired immunodeficiency syndrome), HIV screening has proven to be the most effective weapon for catching the virus unawares and starting antiretroviral treatment. The number of screenings had logically fallen in 2020 with the crisis linked to Covid 19, and it had started to rise again in 2021, but this year did not catch up with the delay linked to Covid. A “loss of chance” for some patients, according to Public Health France.

Screening stagnating in France

Thus, with 5.7 million serologies for the human immunodeficiency virus (HIV) carried out in the laboratory, screening began to increase again last year, by 8%, according to the annual report of the health agency. The number of these blood tests had fallen by 13% between 2019 and 2020, after six years of increase. A collateral effect of the health crisis. In 2021, screenings were more numerous, but they remained “below the level observed before the Covid-19 epidemic” (6.1 million), noted Public Health France. That same year, unfortunately 29% of HIV infections were discovered in “an advanced stage of infection” explains the study, noting a proportion that has not decreased for several years.

However, as Florence LOT, from the Infectious Diseases Department of Public Health France, recalls: “Knowing your serological status means being able to benefit from antiretroviral treatments allowing you to live like everyone else. Today, it is still essential to remember the importance of screening, in order to establish an early diagnosis for appropriate care. The earlier the HIV infection is diagnosed, the greater the benefits of the treatment, whether at the individual or collective level, thus making it possible to fight against the transmission of HIV..

The number of cases remains stable in the country

Other important information from this latest edition of monitoring: the number of HIV positive findings stabilized in 2021, at 5,013 people, whereas it had plummeted between 2019 and 2020 (-22%). There are two possible explanations for this: the fall in screenings, of course, but also a lower exposure to the virus linked to social distancing measures and border closures.

Among the population categories affected, heterosexuals (men or women) and men who have sex with men (MSM) remained the most affected, representing respectively 51% and 44% of HIV findings.

PrEP treatment is not widespread enough

In addition to screening, pre-exposure prophylaxis (PrEP), a preventive pill for people at high risk of HIV, exists. But according to the report, its use remains below expectations. “The account is not there”according to Gilles Pialoux, vice-president of the French Society for the Fight against AIDS, referring to around 40,000 users in France.

A reason seems to emerge for this: PrEP “has not spread enough” beyond homosexuals, whereas today there is the possibility of prescribing it in city medicine. An effort remains to be made to better supervise and prescribe this treatment to women, but also to migrants who are easy targets. The report reminds us: there is still no vaccine against AIDS and there is no cure for HIV.