Data from mandatory HIV reporting from January 2003 to June 30, 2018

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What information will you find in this database?

This database presents raw (uncorrected) data from mandatory reporting of new HIV diagnoses in France, as well as the results of additional tests conducted by the National HIV Reference Center: recent infection testing and serotyping. HIV surveillance allows for the identification of individuals who test positive for HIV, regardless of their clinical stage.

These are data "as of June 30, 2018," meaning they are based on reports received by Santé publique France by that date.

You can view tables on newly diagnosed HIV-positive cases reported by a laboratory technician and/or a clinician (see the section “Where does this data come from?” below), broken down by three geographic levels: France, a region, or a department. For each geographic level, you can select the variables you wish to cross-tabulate and view the results in a cross-tabulation table, or download all available tables at once.

Where does this data come from?

Under the mandatory reporting (MR) of HIV infection, biologists must report "Any HIV serology confirmed as positive for the first time in their laboratory, even if a positive serology result may have been obtained previously for the same person in another laboratory." Reporting individuals whose HIV-positive status may have been discovered previously in another laboratory:

• is a prerequisite for a consistent case definition, without requiring laboratory technicians to search for any prior history of positive serology—a task not all can perform—

• allows for the inclusion of HIV-positive individuals whose initial diagnosis was not reported, thereby limiting underreporting,

• allows for the assessment of the completeness of mandatory HIV reporting by comparison with the LaboVIH survey, which uses the same case definition (see the "Corrected Data" section below).

Cases reported by laboratory technicians therefore correspond either to a new diagnosis of HIV seropositivity or to a seropositivity already known from another laboratory.

The clinician who ordered the serology test and/or who is managing the HIV-positive individual following diagnosis must report this diagnosis, providing clinical and epidemiological data, including the history of previous HIV serology tests, which allows for distinguishing between a newly diagnosed HIV-positive status within the past year and a status that has been known for more than a year. The clinician also provides information on the mode of transmission, clinical stage, country of birth, etc. See also: Mandatory reporting of HIV infection: how to report?

The table below shows, for each region, the proportion of newly diagnosed HIV-positive cases among all HIV-positive diagnoses between 2010 and June 2018 reported as of June 30, 2018.

* Includes individuals reported for the first time but whose HIV-positive status had been known for more than one year

** Only HIV diagnoses where HIV status has been known for less than one year.

Source: Santé publique France - DO VIH - data as of 06/30/2018, raw i.e., unadjusted (neither for underreporting nor for reporting delays)

The other tables presented below concern only newly diagnosed HIV-positive cases, defined as those known to be HIV-positive for less than one year.

Raw data or adjusted data: which to use?

Data may be adjusted to account for:

• reporting delays: for example, some cases diagnosed in 2016 will not be reported until 2017 or 2018. This adjustment mainly concerns the two most recent years,

• underreporting: this is the proportion of cases that are never reported. This adjustment applies to all years. Underreporting varies from year to year and differs by region.

To describe the characteristics of cases over a given period (proportions of age groups, modes of transmission, clinical stages, countries of birth, etc.), raw data are appropriate.When analyzing variables that include unknown values (mode of transmission, clinical stage, etc.), it is recommended to exclude these unknown values before calculating percentages. The proportion of unknown values is significant for certain variables, due to reports whose medical section was not received by Santé publique France.

To determine the number of people who discover their HIV-positive status each year, to analyze trends over time, or to compare regions or countries by relating cases to the general population, it is necessary to use adjusted data.

• The correction for underreporting is all the more accurate (narrow confidence intervals) when underreporting is low, hence the importance for laboratory technicians and clinicians to report all HIV infections they diagnose. Underreporting is particularly detrimental to the reliability of regional or departmental data. Underreporting is estimated by comparing data from LaboVIH (a survey of all laboratory professionals, collecting data on their HIV testing activities) with mandatory reports received by Santé publique France, based on the same case definition. Underreporting decreased between 2003 (44%) and 2008 (27%), then stabilized.

• The adjustment for reporting delays is made using the distribution of delays observed in previous years. This adjustment is not valid if reporting delays fluctuate significantly, which is the case in certain regions or departments.

Corrections for underreporting and reporting delays allow for estimating the actual number of people who discover their HIV-positive status each year in France. The table below illustrates this correction.

* Revised 2017 data will be available by the end of 2018

Source: Santé publique France - DO VIH - raw data as of 06/30/2018 - corrected data as of 06/30/2017

The searchable database below (France, by region and by department) presents only raw (unadjusted) data. You can find adjusted data in the news and publications sections (slides and articles), or by contacting: ANSP-DMI-VIC@santepubliquefrance.fr.

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