Key Points

In 2017, 5.6 million HIV tests were performed by clinical laboratories. HIV testing activity increased by 12% between 2010 and 2017, but this increase was not accompanied by a rise in the number of confirmed positive test results, leading to a downward trend in the positivity rate (from 2.2 to 2.0 per thousand over the same period). This finding suggests that the increase in testing likely had little impact on the populations most at risk for HIV.

The number of new HIV diagnoses remained stable between 2010 and 2017. Approximately 6,400 people learned of their HIV-positive status in 2017, of whom 3,600 (56%) were infected through heterosexual intercourse, 2,600 (41%) through sex between men, and 130 (2%) through injection drug use.

While the number of new HIV diagnoses remained generally stable between 2010 and 2017 among MSM, differences were observed based on country of birth. The number of new HIV diagnoses remains stable among MSM born in France, while it has been steadily increasing among those born abroad, rising from 400 cases in 2011 (18% of new diagnoses among MSM) to 675 in 2017 (26%). This trend may be linked to an increase in the number of new infections, but also to greater use of screening.

Among HIV diagnoses among heterosexuals, 75% involve people born abroad. Among this group, the number of diagnoses remained stable over the entire 2010–2017 period. Among those born in France, the decline observed between 2010 and 2014 did not continue thereafter.

Nearly one-third of HIV diagnoses are still made too late: 30% of individuals were diagnosed in 2017 at an advanced stage of HIV infection (clinical stage of AIDS or CD4 lymphocyte count < 200/mm³ excluding primary infection). Half of all HIV diagnoses (52%) involved people who reported never having been tested before. In populations where regular screening is recommended—heterosexuals born abroad and MSM—this proportion is 68% and 33%, respectively.

In the context of diversified HIV prevention (condoms, pre-exposure prophylaxis -PrEP-, post-exposure prophylaxis -PEP-, "treatment as prevention" -TASP-), HIV testing must therefore be further intensified to reduce the number of people unaware of their HIV status and enable them to access antiretroviral treatment, for both individual and collective benefit.All of these measures will ultimately reduce the number of new HIV infections, which will then be followed by a decrease in the number of new HIV diagnoses.