Key Points

HIV Infections and AIDS

• Significant increase in the HIV testing rate, particularly among those aged 50 and older, with a major contribution from the VIHTest program

  • Significant HIV testing activity in the region, with rates higher than the national average (excluding the Île-de-France region) and an increasingly higher testing rate among women under 50

  • Disparities across departments, with lower rates in the northeastern part of the region

  • Doubling of the testing rate among those aged 50 and older (men and women) between 2021 and 2023

  • Significant increase in the uptake of the VIHTest program in 2023, with over 150,000 people in the region using VIHTest, more than half of whom (52%) were aged 50 and older; Nouvelle-Aquitaine is one of the regions with the highest number of VIHTest users

• Increase in new HIV diagnoses since 2021, particularly among heterosexuals born abroad, who now account for 31% of new diagnoses

  • Nearly 300 people living in the region learned they were HIV-positive in 2023

  • A sharp increase in new diagnoses (+52%) among heterosexuals born abroad between 2021 and 2023

  • A trend toward stabilization among men who have sex with men (MSM) between 2021 and 2023, whether born in France or abroad

  • Rate of new diagnoses lower than the rate observed in mainland France excluding the Île-de-France region (47 vs. 50 per million inhabitants)

  • Stability in the proportion of cases diagnosed at an advanced stage (AIDS stage, CD4 < 200/mm³) (26%)

• Regional estimates of HIV incidence and the size of the undiagnosed population

  • The number of new HIV infections in 2023 in the region was estimated at 171 (95% CI: [102–240]), representing an overall stable incidence since 2021, following a decline observed between 2017 and 2021 linked in part to the decrease in infections among MSM born in France

  • Approximately 500 people living with HIV are estimated to be undiagnosed in the region as of late 2023

  • One-third of people born abroad who discovered their HIV-positive status in the region were infected in France

Bacterial STIs

• Increase in testing for all bacterial STIs: +15% for syphilis, +25% for gonorrhea, and +27% for Chlamydia trachomatis between 2021 and 2023

  • The increase in testing is significant among those aged 50 and older

  • The screening rate remains higher among women, regardless of the STI

  • Screening rates are highest in Gironde, Landes, Pyrénées-Atlantiques, and Charente

• Increase in diagnoses of Chlamydia trachomatis, gonorrhea, or syphilis infections, with estimated numbers of 4,800, 1,600, and 500, respectively, in 2023 in the region. Between 2021 and 2023, the incidence rate of diagnoses:

  • for Chlamydia trachomatis increased among men, particularly among men aged 50 and older (+49%)

  • for gonorrhea rose sharply across all age groups, regardless of sex, with a more pronounced increase among men and women aged 50 and older (+97% and +90%) and among men aged 26–49 (+66%)

  • Syphilis diagnoses increased among those aged 50 and older, regardless of sex (+71%)

• The increase in gonococcal diagnoses between 2021 and 2023 is significantly greater than the increase in gonococcal testing, which supports an increase in gonococcal incidence among both men and women. This trend is also visible for syphilis to a lesser extent, with much lower diagnosis rates