With 5.7 million serologies for the human immunodeficiency virus (HIV) carried out in laboratories, 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 Covid-19 health crisis which had worried those involved in the fight against AIDS.

In 2021, screening has indeed started again. But it remained “below the level observed before the Covid-19 epidemic” (6.1 million), noted Public Health France.

However, the late detection of HIV status represents “a loss of chance” for the health of the person affected, but also a risk of increasing the spread of the disease.

In 2021, 29% of HIV infections were discovered at an advanced stage of infection, a proportion that has not decreased for several years.

However, “early detection makes it possible to benefit from antiretroviral treatment, to lower the viral load in the body and to no longer transmit HIV to its partners”, underlined Florence Lot, pilot of the HIV / AIDS unit, hepatitis B and C, STIs to Public Health France, during a press briefing.

The number of HIV positive findings stabilized in 2021, at 5,013 people. It had plummeted between 2019 and 2020 (-22%), with the drop in screenings but also “possibly” with less exposure to the virus linked to social distancing measures and border closures.

Heterosexuals (male or female) and men who have sex with men (MSM) remained the most affected categories, accounting for 51% and 44% of HIV findings respectively.

Faced with multiple “barriers to screening”, Public Health France is rebroadcasting a communication campaign with the slogan “Living with HIV is first of all living”, to raise awareness of the preventive effect of antiretrovirals and to fight against discrimination.

– “Virus hypercomplexe” – 

In addition to screening, pre-exposure prophylaxis (PrEP), a preventive pill for people at high risk of HIV, remains below expectations.

“The account is not there”, launched Gilles Pialoux, vice-president of the French Society for the fight against AIDS, during another press briefing from the ANRS / Emerging infectious diseases, evoking around 40,000 users in France .

PrEP “has not spread enough” beyond homosexuals, despite the possibility now of prescribing it in city medicine, according to this head of the infectious and tropical diseases department at Tenon hospital (AP-HP).

He notably pointed to an insufficient proportion of women or migrants among the beneficiaries of “this treatment which works extremely well” and “is not opposed to condoms”.

Beyond that, more than forty years after the first AIDS alert, there is still no vaccine.

HIV is “a really hypercomplex virus”, for which it is extremely difficult to find a vaccine that could work”, recalled Michaela Müller-Trutwin (Institut Pasteur).

There is no cure for HIV: HIV-positive people must be treated for life. “The very effective triple therapy has transformed a fatal disease into a chronic infection. But if we stop the treatment, the virus rebounds in a few weeks at the same level”, underlined this specialist.

Multiple studies include identifying new molecules to regulate dormant HIV in cells and boosting the immune response of people living with HIV, she said.

“We still hope to find a cure, we are not there yet,” lamented Emmanuel Bodoignet, member, for AIDES, of a group of associations fighting against AIDS.

In the meantime, he noted, “people with HIV still suffer a lot of discrimination” and remain vulnerable to different pathologies, such as with Covid or, more recently, monkeypox.

But research on AIDS continues and could also, in the long term, benefit from those on Covid-19, and vice versa, insisted the experts.