Public Health France Mayotte has transmitted its latest figures on HIV and sexually transmitted infections for the year 2023. If the number of people diagnosed with HIV has fallen slightly, this decline in indicators should be put into perspective, given the fact that Mayotte remains the second department in France most affected by HIV.
A very relative drop in indicators
Epidemiologists are unanimous: if all the indicators making it possible to monitor the activity of HIV and STIs in the territory have decreased in 2023 compared to the year 2022, this slight decrease must nevertheless be put into perspective. “Mayotte is still in second position behind Guyana due to the high number of HIV discoveries in the territory and the number of serologies which turned out to be positive,” comments Youssouf Hassani, Head of the Mayotte Cell of Public Health France.
“We do not know the proportion of rapid tests that result in serologies”
Furthermore, if the number of positive HIV serologies has decreased slightly, it does not reflect a perfect exhaustiveness of the overall HIV screening carried out on the island, given the importance of the rapid screening tests carried out by the Mahorese associations. In 2023, 110 HIV screening tests were carried out per 1,000 inhabitants. In 2022, this figure was 114 per 1,000 inhabitants. “This drop must be put into perspective because there is a relatively large screening offer in Mayotte thanks to associations which carry out numerous rapid screening tests. This slightly lowers the level of serologies. We do not know the proportion of rapid tests that result in serologies. » Same thing for diagnosis, the indicators of which are also decreasing. In 2023, the proportion of positive serologies was estimated at 3.1 per 1,000 serologies carried out, representing a drop of 24% compared to the year 2022 (4.3 positive serologies/1,000 carried out). However, epidemiologists wish to remain cautious: “This figure remains very high because Mayotte is located just behind Guyana, whose rate of positive serologies is the highest of all the departments (4.5 positive serologies/1,000 carried out).
A significant number of HIV positive people
Furthermore, the number of HIV seropositivity discoveries was 92 in 2023, or 296 per million inhabitants. For comparison, in mainland France excluding Île-de-France, this rate was 50 per million inhabitants. Mayotte remains the French department with the highest rate of HIV discoveries, after Guyana, especially if we compare this rate to the number of inhabitants in Mayotte, equivalent to 320,901 inhabitants according to INSEE data. .
More than half of HIV-positive people are women
In 2023, of all people living with HIV, 64% were women. For Youssouf Hassani this is explained by the fact that HIV screening is systematically carried out as part of research or pregnancy monitoring. In 2018-2022, 56% of people with HIV were women. Among these HIV-positive people, the majority are people born abroad. 64% of people diagnosed positive for HIV come from Madagascar, Comoros, Seychelles, and Mauritius, compared to 59.7% in 2022. 21.8% come from sub-Saharan African countries. On the other hand, the number of HIV-positive people is decreasing among people born in France. In 2023, they represented 14%, compared to 20% between 2018 and 2022.
The incidence rate calculated for the first time
the LaboVIH survey.
In order to estimate the incidence in Mayotte, it was first necessary to estimate the share of people born abroad who were contaminated in France and exclude people contaminated before their arrival in the territory. Thus, the incidence of HIV in Mayotte was estimated at 37 in 2023, representing an incidence rate relative to the population of 11.9 per 100,000 inhabitants, equivalent to the incidence rate in Île-de-France. Furthermore, the number of people living with HIV in Mayotte without knowing their HIV status was estimated at 139 for the year 2023. In 2023, 8 people were diagnosed at the AIDS stage, compared to 15 in 2022. Of these people , five were women and three were men. Their average age was 40 years old. According to Public Health France, only three of these people were aware of their HIV status beforehand. None had received antiretroviral treatment at least 3 months before AIDS.
Effective monitoring
To monitor this sexually transmitted disease, epidemiologists and laboratory technicians work hand in hand to ensure that the screenings carried out are followed up. Public Health France welcomes this mutual work “which works very well”: “Regarding mandatory declarations, doctors and biologists report everything to us. The completeness is 100%,” specifies Youssouf Hassani.
Mathilde Hangard
