Key points

HIV/AIDS

• In 2021, the decline in participation rates in LaboVIH in the region continues (<70%), while the completeness of the DO is increasing (88%).

• A resurgence in HIV testing is observed following the documented decline in 2020; the number of reimbursed tests is now at 2019 levels, except among men under 25, where it remains lower.

• The testing rate is significantly higher in Gironde than in the region’s other departments.

• This resurgence in testing has not been accompanied by an increase in the number of positive serology results in 2021.

• The decline in new HIV diagnoses and the number of new patients admitted to the hospital for their HIV infection continues in the region in 2021.

• New HIV diagnoses primarily involve men who have sex with men, aged 25 to 49.

• Approximately 16,000 tests have been conducted in the region as part of the VIHTest program since the beginning of 2022; these tests were primarily performed on individuals aged 20–39 (39%) and 40–59 (38%).

• 66% of HIV reports (DO) included both components (laboratory technicians and physicians).

Chlamydia trachomatis (Ct) infection

• An increase in the number of people tested was observed in 2021, with reimbursed screenings exceeding 2019 levels (+9%), while screenings at CeGIDD centers remained below pre-COVID-19 levels.

• This resurgence in testing is more pronounced among men under the age of 25.

• The screening rate is highest in Gironde, and nearly three-quarters of screenings involve women.

• The diagnosis rate is slightly higher among women (1.8 vs. 1.5 per 1,000 among men) and four times higher among women aged 15 to 25 (7.1 per 1,000 inhabitants) (recommendation for routine screening among young women).

• The increase in Ct infection diagnoses observed since 2014 continues, with a rate slightly higher than that observed in 2019, particularly among women under 25 and men over 25.

• At CeGIDD, the positivity rate for Ct infections is slightly higher among women (9.5% vs. 8.3% among men); this rate is rising particularly among men.

• Approximately 54% of Ct infection cases seen at CeGIDD were men; the majority of them were under 25 years of age, had heterosexual relationships with multiple partners, and showed no suggestive symptoms or history of STIs.

Gonococcal infection

• A resurgence in testing has been observed, with a testing rate exceeding the level recorded in 2019 (+9%) for reimbursed tests but lower for free tests at CeGIDD.

• This increase in testing was particularly observed among men under 25.

• The screening rate is highest in Gironde, and three-quarters of screenings are performed on women.

• The screening rate is particularly high among women under 25 and is similar to the screening rate for Ct infections (co-screening via multiplex).

• At CeGIDD, the positivity rate is 3.5 times higher among men (3.6%); this rate is higher than that observed in 2019 among men and remains stable among women.

• The majority of cases seen at CeGIDD were men over 25 years of age, had sexual relations with men with a history of multiple partners, and frequently had a history of STIs.

Syphilis

• A resurgence in syphilis testing is also observed, with a testing rate higher than in 2019 (+6%) for reimbursed tests; however, this resurgence is less pronounced than for other bacterial STIs. Testing at CeGIDD centers has also increased but remains below the level observed in 2019 before the COVID-19 pandemic.

• The increase in testing has particularly affected women under 25.

• The screening rate is highest in Gironde; two-thirds of screenings are performed on women (mandatory screening during pregnancy), and the rate is particularly high among women under 25.

• At CeGIDD, the positivity rate is low among men (1.7%) and very low among women (0.2%), and is at the same level as in 2019.

• The majority of cases seen at CeGIDD were men aged 25 to 49 who had sex with men; an increase among men who have sex with women was observed in 2021 among cases seen at CeGIDD.