In 2016, 5.4 million of serology, HIV (human immunodeficiency virus) have been carried out in France by the laboratories of medical biology, of which 300
.000 anonymously. A considerable number, which has led to the discovery of about 6000 new infections.
A figure desperately constant over the past ten years. One of the explanation certainly comes from the hidden epidemic, that is to say, of the people infected (with hiv) without the knowledge. . They would be 25. .000 in France, according to a modeling of the Inserm.
There were still a lot in recent years about the arrival of new screening tools to reduce this home occult. Alas, neither the community screening possible since September 2011 in France by rapid test orientation diagnostic (Trod), 56. .300 made last year, or 75,000 of self-tests sold in pharmacy by 2016 (available from September 2015) do not have appreciably improved the situation. They have, nevertheless, the interest of reach a population that is particularly exposed to HIV, mainly men who have sex with men (MSM) and migrants.
These two groups accounted for two-thirds of those tested by rapid tests. “The more we know early his hiv status, the greater the benefit is great” François Bourdillon, the director-general of public Health France public Health experts in France, who have published a bulletin epidemiological weekly devoted entirely to the epidemic of HIV infection/aids, point to two public health issues: the delay in diagnosis and the dynamics of the epidemic in some population groups (MSM, migrants from sub-saharan Africa). The delay in diagnosis remains important, “the More one knows early on one’s hiv status, the greater the benefit is great, reminds François Bourdillon, the director-general of public Health of France. The benefit is individual, but also collective because of the risk of passing HIV to a partner for a treated individual with an undetectable viral load is almost zero. “Even in the group of MSM, yet the awareness of the HIV/aids and well-informed about the means of protection, such as PrEP (pre-exposure prophylaxis), only half of the infections are the subject of an early screening and 18 % of infections are discovered at an advanced stage. The majority of new infections will always be heterosexuals (3200), in front of the MSM (2600). However, the discovery of hiv are decreasing year by year (-9 % between 2013 and 2016) among heterosexuals, with a more marked decrease among men than among women, while it remains stable among MSM.
The vulnerability of migrant populations is well known. Moreover, the ANRS-Course released in 2015 showed that between 35 % and 49 % of migrants are contaminated had been after their arrival in France. The authors insisted on the need to better understand, in these groups, sexual behaviour in prevention and improve their information. Other reason of disappointment on, the PrEP is still little used (around 3000 people by the end of 2016). This strategy, which comes to supplement the range of preventive whose base remains the condom is for people who are not infected with HIV do not consistently use condoms when they have sex and are at high risk for the disease.
It consists of taking a combination of two antiretroviral drugs (Truvada) either continuously (1/j), or at the request, according to a particular protocol (multiple shots required between a day before and a day after the unsafe sex) depending on the sex considered.