Gaining a Better Understanding of HIV Risk Among People Who Use Drugs

At the 9^th Scientific Conference on HIV, Marie Jauffret-Roustide (Cermes 3 at Inserm U988 – Santé publique France) and her colleagues at Santé publique France are presenting the results of their research on people who use drugs. To this end, the poster combines data from:

• HIV infection diagnoses in 2015 and estimates of the number of new HIV infections in 2012,

• the 2011–2013 ANRS Coquelicot study, which aimed to estimate the proportion of drug users infected with HIV and to understand the determinants of exposure to infectious risks. This study involved 1,718 IDUs and was conducted in 122 facilities located in Bordeaux, Lille, Marseille, Paris, Seine-Saint-Denis, and Strasbourg.

HIV prevalence remains high and incidence shows no sign of slowing

• HIV prevalence is 13% among drug users who have injected at least once in their lifetime. Marseille and Seine-Saint-Denis have the highest prevalence rates (20% and 21%), mainly due to the presence of older users

• The incidence of HIV among IDUs has not decreased since 2004. It stood at 86 new cases per 100,000 people in 2012 (versus 5 new cases per 100,000 among heterosexuals)

Behaviors that increase the risk of HIV transmission

• 26% of IDUs reported having shared a syringe at least once in the previous month, compared to just 13% in 2004

• 30% of drug users reported difficulties obtaining syringes, even in major cities like Paris

Late diagnoses

• IDUs are often diagnosed at an advanced stage of infection (38% of them in 2015), which delays their access to antiretroviral treatments that can control the infection and limit the risk of transmission.

"The Île-de-France region is among those where users are particularly vulnerable and face the greatest difficulties in obtaining syringes; they are therefore especially at risk of HIV transmission. The conditions that increase exposure to numerous infectious diseases, including HIV, are present. "France must remain particularly vigilant regarding this HIV epidemic affecting drug users, particularly by implementing harm reduction policies that focus more on the social and political factors linked to the infection," explains Marie Jauffret-Roustide. In this context, strengthening harm reduction policies—facilitating access to syringes and establishing safer consumption rooms—combined with measures enabling access to care and treatment, as well as improving the social situation for drug users, are essential to effectively reduce HIV risk exposure in this population.

The ANRS Coquelicot study was conducted by the Cermes3 research laboratory center of Inserm and Santé Publique France in collaboration with the National HIV Reference Center and the National Reference Center for Hepatitis B and C, and with financial support from the ANRS and the DGS. The first edition took place in 2004 and was repeated in 2011–2013.