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“We risk losing years of efforts on HIV prevention and testing”

Françoise Barré-Sinoussi, at the Sidaction premises, in March 2020.

On the occasion of Sidaction, which takes place from March 25 to 27, its president, virologist Françoise Barré-Sinoussi, co-winner in 2008 of the Nobel Prize in Physiology or Medicine for the discovery of the AIDS virus (HIV) at the Institut Pasteur in 1983, evokes the concerns about prevention and screening which have declined since 2020, the therapeutic and vaccine prospects…

From the first months of the Covid-19 pandemic, you warned of its possible consequences for the fight against HIV. What about today ?

Our fears have been confirmed in terms of the impact of this epidemic on access to HIV testing, and its prevention through pre-exposure prophylaxis [PrEP]. In France, screening decreased by 14% in 2020, whereas it had been increasing for several years, and the drop was 17% for PrEP, when this strategy was already insufficiently developed.

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This trend is found internationally, as evidenced by recent reports from the Global Fund and the World Health Organization. [OMS] for 2020. About half of the countries in the world reported decreases in access to testing and prevention. The figures are quite alarming, since on a global scale the drop in screening is globally 22% and 11% for PrEP.

These data relate mainly to the year 2020. Since then, has there not been a catch-up?

These official figures, which are the most recent, are of course to be taken with great caution, but everyone agrees that there will inevitably be consequences on the number of HIV infections in the world, even on that of deaths, and also on other indicators such as mother-to-child transmission.

Regarding access to anti-HIV treatments, there was no significant impact at the start of the Covid-19 pandemic, but it is probably a little early to conclude. Indeed, with the decline in screening, we can predict that people will have later access to antiretrovirals. In this area, the damage can only be measured in the long term.

Access to prevention of mother-to-child transmission would have dropped by 4.5% with the health crisis, the disruptions being primarily on the African continent. We will have to see how this translates in terms of the number of children infected in the months to come.

In any case, the situation is worrying, because we risk wasting years of efforts on prevention and screening. It’s not just about HIV. We also have great concerns about tuberculosis, with the development of forms that are multi-resistant to treatments. There were also difficulties in screening and access to anti-tuberculosis drugs, and we know that drug interruptions are the source of resistance.

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