Île-de-France concentrates around 40% of HIV cases in France, although it only represents 18% of the population. In 2023, there were another 2,140 new HIV diagnoses in Île-de-France, out of 5,500 nationally.
The last ten years have been marked by an overall decline in new infections in Île-de-France. The actions deployed have greatly contributed to this: increased use of screening in its various modalities, increasing use of pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM), increasing effectiveness of treatment. responsibility for those affected.
These figures have allowed Île-de-France to get closer to the UNAIDS objectives known as “95-95-95”:
- 95% of people living with HIV know their serological status: this is today the case for 94% of them in Île-de-France, with a noted drop in the number of undiagnosed HIV-positive people (estimated by Santé public France at 4,104 – 95% CI 3855-4365);
- 95% of these people are taking antiretroviral treatment: this is today the case for 96% of them;
- 95% of people on treatment have an undetectable viral load: this is the case for 96% of them, for whom the viral load is less than 200 copies/ml (sustainably undetectable threshold).
However, new contaminations still occur, every day. For Public Health France, 1,456 people were newly infected with HIV in 2023 in Île-de-France (for a 95% confidence interval between 1279 and 1632).
After the health crisis, an increase in cases discovered in people born abroad was noted among both women and MSM, while the decrease observed among MSM born in France before 2020 did not increase. In 2023, 43% of findings involve foreign-born heterosexual men and women and 19% involve men having sex with foreign-born men.
These indicators underline the importance of continuing and intensifying combined prevention, of defining interventions adapted as closely as possible to the populations most exposed today in the region to achieve the elimination of HIV transmission in 2030.
ARS Île-de-France devotes 32 million euros annually to supporting associations and stakeholders (particularly health establishments) engaged in prevention, screening and monitoring of people exposed to or living with HIV.
The ARS also fully supports the efforts of communities committed to the fight against HIV, in particular the Île-de-France Regional Council, within the framework of the convention “For an Île-de-France region without AIDS” , and “Towards Paris without AIDS”, the association supported by the City of Paris.
The “Zero HIV in Île-de-France” program: regional mobilization to eliminate HIV transmission in the region
Among the actions and systems financed by the ARS, the “HIV Zero in Île-de-France in 2030” program, in partnership with the ANRS Emerging Infectious Diseases, is based on collective commitment and concrete actions. By mobilizing all resources and acting on social and territorial disparities, the two institutions today reiterate their common commitment to meet this major public health challenge.
Following collaborative work bringing together stakeholders involved in the fight against HIV in Île-de-France (associations, caregivers, researchers, local authorities), 25 new proposals were formulated. Some will be able to be deployed quickly, others still need to be the subject of additional work. Some strengthen existing systems, while others introduce innovative approaches aimed at training and expanding the network of health professionals and services involved in the combined prevention offer. They are deployed on three priority axes:
- Expand access to PrEP. Although the number of PrEP users doubled between 2020 and 2023 to reach 22,353 people, its use remains too restricted to MSM residing in the center of the region. Access to PrEP remains insufficient for certain socially diverse groups, with varied behaviors and sometimes living far from specialized health services, concentrated in urban centers. To compensate for these inequalities, several initiatives have been put in place: offer PrEP in the premises of community associations, develop teleconsultations, implement cooperation protocols between doctors, midwives and nurses, extend these protocols to women attending PMIs or general health centers.
- Strengthen local understanding of the epidemic. To enable stakeholders and decision-makers to improve territorial action, it is essential to provide them with precise and appropriate information. The COINCIDE program, with the support of the Île-de-France Regional Health Observatory (ORS), has mapped the epidemic in detail and accessible to all. The interactive maps tool, Cartoviz COINCIDE Since April 2024, it has been possible to visualize the HIV epidemic on a fine territorial scale. From now on, local actors (associations, CeGIDD) with the support of regional sexual health coordinations (CoReSS), will be able to support in each territory the understanding of local epidemic dynamics, and the mobilization of resources;
- Maximize the impact of screening and treatment. To better organize regional screening resources and reach populations far from healthcare, precise mapping will be carried out to list screening locations, their schedules, the services offered and the targeted audiences (primary care, CeGIDD, community teams, protection services maternal and child [PMI]former CePF sexual health centers). Departmental meetings will make it possible to adjust actions, in particular those carried out outside health structures (public, community or socializing places). These efforts aim to bring screening closer to populations far from care, in particular through an expanded offer of rapid diagnostic orientation tests (TROD).
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