Key Points

HIV Infection and AIDS

• The number of HIV serology tests performed by clinical laboratories continues to rise. In 2024, it is estimated at 8.5 million. Tests performed without a prescription and without upfront payment accounted for 20% of all tests conducted in 2024. Since the program was expanded to include STIs in September 2024, the monthly number of young people under 25 tested for HIV through this program has doubled.

• Approximately 5,100 people learned of their HIV-positive status in 2024. This number appears to be stabilizing following the increase observed between 2020 and 2023.

• More than half (56%) of those who learned of their HIV-positive status in 2024 were born abroad. Among them, 43% were infected after arriving in France. As with all HIV diagnoses, the trend in diagnoses among people born abroad was marked by a decline in 2020 followed by a resumption of the increase through 2023.

• The most common modes of transmission among people diagnosed in 2024 were heterosexual intercourse (53%), followed by sex between men (42%). Transgender people infected through sexual contact accounted for 2% of new diagnoses, and people who inject drugs (PWID) accounted for 1%. Mother-to-child transmission (1%) primarily involved children born in sub-Saharan Africa.

• Among MSM (men who have sex with men), the stabilization in the number of new cases since 2022 marks a break from previously observed trends, with a steady decline among MSM born in France and an increase among those born abroad.

• The epidemic remains marked by a particularly concerning situation in French Guiana, and to a lesser extent in Mayotte, the French West Indies, and the Île-de-France region.

• In 2024, 43% of HIV infections were diagnosed at a late stage, including 27% at an advanced stage. This proportion, although declining since 2020, particularly highlights missed opportunities for testing and initiation of treatment.

Significant progress has been made in the fight against HIV infection in France, as evidenced by the 2023 care cascade: 94% of people living with HIV (PLHIV) were diagnosed; of these, 96% were on antiretroviral therapy, with an undetectable viral load (at the threshold of 200/mm³) for 97% of them. However, the incidence of HIV infections is no longer declining and has stabilized at 3,400 cases since 2023. The number of people living with HIV who have not yet been diagnosed is estimated at approximately 9,700 in 2024, despite a decrease compared to 2023. These indicators underscore the need to continue efforts to better address the needs of the most vulnerable populations and regions by implementing combined prevention measures through a proportionate universal approach, in order to achieve the goal of eliminating HIV infection set by the national sexual health strategy.

Bacterial STIs

• In 2024, 3.4 million people were screened for Chlamydia trachomatis infection, 3.7 million for gonorrhea, and 3.7 million for syphilis, according to health insurance data. Additionally, 306,000 tests for Chlamydia trachomatis infection, 305,000 tests for gonorrhea, and 285,000 tests for syphilis were performed free of charge at CeGIDDs (free centers for information, screening, and diagnosis of sexually transmitted infections, including HIV). Screening rates for the three bacterial STIs continued to rise between 2022 and 2024 (+30% for Chlamydia trachomatis infections, +26% for gonorrhea, and +20% for syphilis), with a more pronounced increase among men (+34%, +37%, and +29%, respectively).

• In 2024, approximately 61,100 people were diagnosed with Chlamydia trachomatis infection, 25,800 with gonorrhea, and 6,500 with syphilis, according to health insurance data. In the CeGIDD centers, 22,200 Chlamydia trachomatis infections, 13,500 gonorrhea cases, and 2,500 syphilis cases were also diagnosed. The incidence rates of STI diagnoses have continued to rise since 2022, with:

  • for gonorrhea, a sharper increase (+35%), particularly among men (+40%);

  • for Chlamydia trachomatis, the incidence rate increased most sharply between 2023 and 2024 among young people aged 15 to 25 (+13% among women and +21% among men);

  • for syphilis (+12%), a sharper increase among women than among men (+24% vs. +10%).

• MSM continue to account for the majority of syphilis cases, but the increase in cases among women should raise concerns about the risk of mother-to-child transmission;

• These STI diagnoses were more common in the French overseas departments and regions (DROM), with particularly high rates in French Guiana, and more common in the Île-de-France region compared to the rest of mainland France.

Significant advances in screening in recent years—including reimbursement for PCR testing for major STIs, initiatives such as access to screening without a prescription, and off-site testing—have contributed to the rise in diagnoses. Nevertheless, the still very high estimates of the prevalence of these STIs from the PrevIST study confirm the imperative of regular screening and the use of condoms during sexual intercourse, which are essential measures for controlling the transmission of these STIs.