Key points

HIV/AIDS

• The participation of biologists and clinicians in French Guiana in mandatory HIV reporting has been steadily declining since 2016: the completeness rate stood at 7% in 2021 in French Guiana. Consequently, the rate of new HIV diagnoses cannot be estimated based on the surveillance system.

• According to the LaboVIH survey, the rate of HIV serology tests performed was much higher in French Guiana compared to mainland France excluding the Île-de-France region (225 serology tests per 1,000 inhabitants in French Guiana versus 30 per 1,000).

• According to the LaboVIH survey, the rate of positive serology tests was also much higher in French Guiana, with 7.2 positive results per 1,000 tests performed, compared to 1 per 1,000 in mainland France excluding the Île-de-France region.

Impact of COVID-19 on screening for sexually transmitted infections

• A decline in STI testing (Chlamydia trachomatis, gonococcal infection, syphilis) was observed during the COVID-19 pandemic. A recovery was observed in 2021 in laboratories but not in CEGIDD centers, where the number of tests continued to decline.

Chlamydia trachomatis infection

• In 2021, the screening rate for Chlamydia trachomatis (Ct) infections was on the rise, reaching 114.6 per 1,000 inhabitants in French Guiana—nearly three times the national rate (41.8 per 1,000 inhabitants) for tests covered by health insurance.

• In French Guiana, 78.9% of those tested in 2021 were women; their high screening rate (172.4 versus 50.9 per 1,000 among men) can be explained by the HAS’s recommendation, in effect since 2018, for systematic opportunistic screening of women aged 15 to 25.

• In 2021, the rate of diagnosed and treated CT cases was 3.7 per 1,000 people aged 15 and older in French Guiana, which is twice as high as the national rate (1.7 per 1,000).

• At CeGIDD, screening rates were declining, but the positivity rate remained stable for both men and women.

• Among cases diagnosed at CeGIDD in 2021, women accounted for 60% and also constituted the majority of those tested. Approximately two-thirds of cases were under 26 years of age.

Syphilis

• Since 2020, an increase in cases of congenital syphilis has been observed in western French Guiana. More than half of the cases had an unfavorable outcome: fetal loss, spontaneous abortion, preterm delivery, and/or congenital syphilis. Cases of severe congenital syphilis were linked in all instances to a lack of follow-up or very delayed follow-up. An overview of the situation is presented on page 19 by Dr. Hcini, an obstetrician-gynecologist at CHOG.

• In 2021, approximately 26,459 people aged 15 and older were tested at least once for syphilis infection, representing a screening rate of 132.9 per 1,000 inhabitants in French Guiana—nearly three times the national rate (51.1 per 1,000 inhabitants) for screenings reimbursed by health insurance.

• In French Guiana, the majority of those tested were women (71.7%), whose screening rate was higher than that of men (181.8 versus 79.1 per 1,000 men); the lowest rate was observed among young men under 25, at 45.4 screenings per 1,000 inhabitants.

• In CeGIDD, testing rates were declining, but an increase in the positivity rate was observed among both men and women.

• Among cases diagnosed in CeGIDD in 2021, the majority were men (58.8%), although they were screened less frequently than women. Furthermore, two-thirds of cases were under 26 years of age, and the majority were born in France (69.0%).

• The majority of syphilis diagnoses at CeGIDD were made at the primary stage, and this proportion increased in 2021 (64.7% compared to 48.3% in 2018–2020).