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For the first time, data show a decline in the HIV epidemic in France and Auvergne-Loire. An encouraging result to put into perspective compared to the last few months, explains Christine Jacomet, president of the coordination committee for the fight against sexually transmitted infections and the human immunodeficiency virus (Corevih) Auvergne-Loire.
What is the situation with HIV today?
In 2019, the data show a decrease in incidence in Auvergne and the Loire with 64 discoveries with hospital treatment (compared to 90 in 2018, a decrease of 30%).
Do you know the reasons for this decline?
These figures reflect the effectiveness of the outbreak control strategy. Prevention programs, the development of access to PrEP (pre-exposure drug prophylaxis) which is administered continuously or on demand to people who take many risks, the intensification and re-screening of HIV and infections sexually transmitted (STI), particularly among the most exposed populations, the rapid and effective treatment of all those who have tested positive for HIV or are carriers of an STI… are starting to bear fruit. However, to improve epidemic control and further reduce contamination, these efforts must be maintained.
That is?
By screening. The problem is that the crisis has put an end to this dynamism. Between the end of March and the beginning of May, the use of laboratory screening tests dropped from -30 to -40% according to Public Health France.
It is estimated that around 647,000 HIV tests were not performed in France from mid-March to mid-October compared to last year.
After the deconfinement, there was in fact a resumption of tests but at a much lower level than hoped and we are still at -15% compared to the previous year.
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A worrying situation …
Yes, because we can expect subsequent discoveries of seropositivity and therefore cascading contaminations due to the lack of diagnosis and therapeutic management of newly infected people. You should know that, when infected people take treatment, they do not transmit the virus to their sexual partners (in Auvergne and Loire, 94% of people on antiviral treatment have an undetectable viral load, which ensures their infection is controlled. a satisfactory state of health). This lack of access to screening is also partly one of the reasons for the growing rise in STIs in France. We therefore hope that things do not last.
“People need to get back into the habit of getting tested like in 2019 and make sure 2020 is just a parenthesis. The message is clear: test yourself! “
Doctor christine jacomet (President of the Corevih Auvergne-Loire)
How has the Covid-19 crisis affected HIV treatment?
People have had fewer encounters with health professionals who have been overwhelmed by the crisis, less information, less medical prevention. Today, in terms of prevention, condoms remain the essential means of protecting yourself from HIV and STIs. However, in recent years, biomedical prevention has been offered with treatments that help prevent HIV. Before taking a risk, there is PrEP (pre-exposure drug prophylaxis). When we have taken a risk, we can go within 48 hours to all emergencies in France to have access to preventive treatment (TPE) for one month to avoid contamination. These preventions decreased because there were fewer offers of care, particularly from Free Centers for Information, Screening and Diagnosis (CeGIDD) which had been closed during childbirth.
The worrying rise in sexually transmitted infections in Auvergne (April 2019)
Hence your desire to develop access to these treatments?
Today, biomedical prevention means are only available in hospitals or CeGIDDs. It is very restrictive. We would like to give a greater role to general practitioners as a central actor in prevention, to very well distributed pharmacists who could do Trods (rapid screening tests), and to laboratories that could offer HIV tests, free of charge. and without prescription. Following the Covid experience, which has mobilized all these stakeholders, we would like the Ministry of Health to seize the opportunity to expand access to screening and prevention for HIV and STIs.
Text: Maud Turcan
Photo: Thierry Lindauer and Rémi Dugne
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