The number of new HIV diagnoses in Paris decreased by 16% between 2015 and 2018, a "significant decline" attributed to screening and preventive treatment PrEP, announced Monday the city and health authorities. "In 2018, 906 Parisians and Parisians learned their HIV status, against 1.078 in 2015, a decline of 16%," said the city of Paris and the Regional Health Agency (ARS) of Ile-de-France in a joint statement.
According to the latest official national figures, published at the end of March, 6,400 people discovered their HIV status in France in 2017, a number that has not declined for several years. "The contribution of Paris to the fight against the HIV epidemic in France is fundamental because the capital concentrates a disproportionate share of the discoveries of seropositivity", continued the city of Paris and the ARS.
First reason given: PrEP
This drop is particularly marked among gay and bisexual men (or MSM, "men who have sex with men"), for whom it amounts to 22% (and even 28% when these men are born in France).
At the forefront of the reasons given, Paris and the ARS quote "the deployment of PrEP in the Parisian gay community". PrEP ("pre-exposure prophylaxis") consists of taking tablets of Truvada or its generics while being seronegative, to block the virus, while this drug was initially intended for HIV-positive people. France was the second country, after the United States, to authorize PrEP, and the first to repay 100%, from January 2016.
This treatment is aimed primarily at populations "at risk" (including homosexual men or prostitutes), for which it is recommended by the World Health Organization (WHO). It is accompanied by rigorous monitoring. Users must be screened every three months, including for possible other sexually transmitted infections (STIs), which PrEP does not protect.
An increase in screening coverage
Another reason put forward in Paris: "The increase in screening coverage, which may have contributed to an erosion in the number of people who are unaware of their HIV status". Once placed on antiretroviral therapy, HIV-positive people no longer transmit the AIDS virus to their sexual partners. According to the Public Health Agency France, the number of serologies performed by public and private laboratories in Paris increased from 493,600 in 2015 to 533,770 in 2018 (+ 8%).
However, "challenges remain", say Paris and the ARS. Thus, "the decline in new diagnoses hardly affects women, who account for 30% of discoveries of HIV in Paris in 2018". This argues, according to them, "for better access for women to new prevention strategies, including PrEP".
Similarly, "the decline is also not significant for people born abroad:" MSM born abroad represent more than 40% of Parisian MSM who discovered their infection in 2018. "These results were unveiled at the Fast Track Cities conference in London, which brings together cities involved in the fight against HIV worldwide.