Public Health Bulletin on HIV and STIs in Nouvelle-Aquitaine. December 2021.

Published on 30 November 2021

Key points

HIV/AIDS

Participation in the LaboVIH survey and accurate reporting of new HIV diagnoses via e-DO by clinicians and laboratory technicians are essential for producing reliable surveillance indicators. In 2020, due to the COVID-19 health crisis, participation in LaboVIH declined in the region (74% in 2020 compared to 79% in 2019).
A drop in HIV testing activity (-14% compared to 2019) was observed in 2020 due to the significant decline in testing during the first lockdown in the spring of 2020, with no corresponding increase in sales of self-tests. This decline in testing activity was accompanied by a decrease in the number of confirmed positive serology results (-24% compared to 2019).
The number of new HIV diagnoses was estimated at 44 per million inhabitants in 2020 (-37% compared to 2019 and -16% compared to 2018).
This decline in HIV infection diagnoses may be partly linked to reduced testing activity, lower exposure to HIV due to social distancing measures, or delayed diagnosis.
New HIV diagnoses primarily involved men who have sex with men (MSM) born in France (46%, stable), heterosexuals born in France (26.6%, up), and those born abroad (17.3%, down).
The decline in new HIV diagnoses in 2020 was more pronounced among people born abroad, particularly among heterosexuals, likely due to reduced migration flows and more difficult access to testing for this population amid the health crisis.
Among new HIV diagnoses, the increase in the proportion of people aged 50 and older observed since 2019 continues.

Bacterial STIs

In 2020, a decline in the rate of STI testing (for Chlamydia trachomatis, gonorrhea, and syphilis) was observed, particularly for Chlamydia trachomatis infections. This decline in testing led to a decrease in the number of diagnoses of these STIs.
Syphilis: In 2020, 198,860 syphilis tests were performed by private laboratories, a 5% decrease compared to 2019.
Gonococcal infections: In 2020, 167,600 tests for gonococcal infections were performed by private laboratories, a 5% decrease compared to 2019.
Chlamydia trachomatis infections: In 2020, 185,638 tests for Chlamydia trachomatis (Ct) infection were performed by private laboratories, a 7% decrease compared to 2019.
The number of visits to CeGIDD clinics dropped sharply in 2020 between March and May—during the first lockdown following the COVID-19 pandemic—with no recovery in activity for the remainder of the year.

Impact of the SARS-CoV-2 pandemic on HIV and bacterial STI testing

A decline in testing in 2020, observed for both HIV and bacterial STIs, raises concerns about delayed diagnosis and increased circulation of these infections. In the context of the COVID-19 pandemic, the public should be encouraged to utilize the healthcare system, particularly all available testing options, to ensure appropriate care.
Furthermore, it is essential to improve the completeness of surveillance data—which has deteriorated significantly over the past two years—in order to have robust indicators at the national and regional levels, which are indispensable for monitoring the 2017–2030 National Sexual Health Strategy.