HIV infection and its final stage, AIDS, are a preventable cause of death. Yet in France, approximately 9,700 people are unaware of their HIV-positive status. The medical, economic, and social consequences of the HIV epidemic are significant. Given these various health impacts, prevention and epidemiological surveillance play a crucial role.

To be effective and reduce the incidence of HIV, prevention must rely on a combination of different tools: condom use, repeated and regular HIV testing, appropriate treatment, and pre- and post-exposure prophylaxis. Epidemiological monitoring and a better understanding of the most at-risk populations enable Santé publique France to tailor prevention campaigns specifically for them.

In 2024, Santé publique France conducted an external evaluation of HIV surveillance with the support of the European Centre for Disease Prevention and Control (ECDC). The final report and the ECDC’s recommendations following this evaluation are available on their website.

Work was conducted with stakeholders in the first quarter of 2025 on the evolution of this surveillance in line with the ECDC’s recommendations, and the selected changes are being implemented gradually.

Epidemiological surveillance of HIV

Surveillance of self-service prevention and testing kits

• Condom sales

Santé publique France has been tracking condom sales in France for many years. This includes sales in pharmacies, drugstores, large and medium-sized retail stores, neighborhood stores, stores with a majority of private-label products (e.g., “hard discount” stores), at checkout counters, and through drive-through services. Sales made through online stores (excluding pharmacies) are not included. Data is purchased from IQVIA for pharmacy sales and from Ac-Nielsen for other distribution channels.

In 2024, 113.1 million condoms were sold in mainland France across all channels, and 2.1 million in the overseas departments excluding Mayotte (pharmacies only).

• Sales of self-tests

As with condoms, sales of HIV self-tests in pharmacies are tracked annually. The data is purchased from IQVIA.

In 2024, approximately 47,200 HIV self-tests were sold in pharmacies in mainland France, and approximately 400 in the overseas departments (excluding Mayotte).

Monitoring of HIV testing in specialized facilities

• In laboratories: LaboVIH

To monitor HIV testing activity, Santé publique France requests that biologists from all medical biology laboratories in France collect data on their HIV testing activity. This data allows for monitoring national and regional trends in HIV testing and calculating the completeness of mandatory HIV reporting.

Who is involved?

• Biologists whose laboratories process samples for HIV serology (whether the serology is performed on-site or not).

How can you participate?

• Santé publique France is asking biologists from all clinical laboratories or groups of clinical laboratories in France, both in private practice and in hospitals (more than 4,000 sites), to report the number of people tested for HIV and the number of people confirmed positive for the first time by the laboratory. Serology tests performed anonymously (where the laboratory technician does not know the patient’s name) are included separately in this report.

• Serology tests performed during blood donation are excluded from the scope of LaboVIH; they are tracked by a separate surveillance system (donors).

Data Collection Form

• For the 2024 data collection, a customized form (pre-filled with the laboratories’ contact information) was emailed to each laboratory or group of laboratories. This form allows the laboratory technician, on the one hand, to verify and, if necessary, correct the list of sites for their laboratory, and on the other hand, to report the number of HIV serology tests performed and confirmed positive.

The results of this survey are available on the “Our Data” page, as well as in the national and regional annual reports.

• In the CEGIDDs

Santé publique France is responsible for the epidemiological surveillance of HIV within the Free Centers for Information, Screening, and Diagnosis of Human Immunodeficiency Virus Infections, Viral Hepatitis, and Sexually Transmitted Infections (CeGIDD).

Who is involved?

All CeGIDDs are legally required to participate in this surveillance, which covers HIV infection, viral hepatitis, syphilis, chlamydia, gonorrhea, and mycoplasma infections, genital warts, and genital herpes (individual sociodemographic, behavioral, clinical, and biological data).

How to participate?

Data transmission occurs once a year, with two options available to CeGIDDs:

• CeGIDDs that have software for managing their patient records submit their individual data, recoded into the required format, directly (via the web service: a data exchange protocol between two applications) by activating a feature within the application;

• CeGIDDs that cannot use the web service upload a copy of their individual, recoded database in the required format to Santé Publique France’s secure “sharing” platform.

The required data format is available here.

Epidemiological surveillance of blood donors

Learn more about blood donor surveillance.

Epidemiological surveillance of diagnoses

• Mandatory reporting of HIV infection diagnoses

Mandatory reporting of HIV infection was implemented in 2003. Since 2016, it has been conducted online, simultaneously by the laboratory technician and the clinician. The clinician no longer needs to wait to receive the report from the laboratory technician. There is no redundancy because the sections of the “laboratory technician” and “clinician” parts of the report are different. Both parts of the report are therefore necessary and complementary.

What are its objectives?

The mandatory reporting of HIV diagnoses aims to determine the number and characteristics of people diagnosed with HIV, to monitor the progression of the disease, and to provide data for estimating the number of new infections, i.e., the incidence of HIV.

Who is required to report?

Reporting is mandatory for any laboratory technician who diagnoses an HIV infection for the first time in their laboratory (even if the person may have previously tested positive in another laboratory). Any clinician who has ordered an HIV serology test that is confirmed positive, or who is treating a person whose serology has recently been confirmed positive, or who notes the death of an HIV-positive person, is also required to report.

How do I report a diagnosis of HIV infection?

The online reporting application www.e-do.fr

Since 2016, HIV reporting has been conducted online at www.e-do.fr. HIV reports are anonymized at the source, at the level of the reporter. They include an anonymization code as an identifier, calculated directly within www.e-do.fr.

The online reporting application automatically provides the form appropriate for the reporter’s role (laboratory technician/clinician) and the reported case (child/adult, and, if applicable, full form/abbreviated form/death).

As a temporary measure, reporters who are unable to report online can obtain printable PDF forms from Santé publique France, as well as software to calculate the anonymity code, which must then be entered on the paper form.

More information is available in the section dedicated to mandatory online reporting of HIV/AIDS.

Doctors at the Regional Health Agencies (ARS) and epidemiologists at Santé publique France have access to reports submitted electronically via www.e-do.fr.

At Santé publique France, HIV/AIDS notifications concerning the same individual (notifications from the laboratory technician, the clinician, data from the CNR, and any additional information, duplicates, AIDS or death reports) are compiled and fed into a single file per person. There is no cross-referencing with databases for other notifiable diseases.

Duplicates (multiple reports for the same person) are detected by Santé publique France using the anonymization code. They are not counted as new cases, but are useful because they help complete the initial report.

Materials

• Anonymization software (for reporters who are not yet able to use e-do.fr) available upon request from Santé publique France

• HIV notification forms in printable PDF format, available upon request from Santé publique France. There are several forms, depending on whether the reporter is a biologist or a clinician, and whether the person to be reported is a child (<15 years old) or an adolescent/adult aged 15 or older

• Information sheet on HIV reporting, for the patient

• More general information sheet on reportable diseases, for the patient

Case definition

HIV infection in adults and adolescents aged 15 and older

Reporting is carried out simultaneously by the laboratory biologist who processed the sample and by the clinician who ordered the test (or who is treating a patient recently confirmed to be HIV-positive).

Anonymization is performed at the source, directly in www.e-do.fr when the report is submitted online. If the report cannot be submitted online, it must be submitted on paper; in this case, the anonymization code is generated by the reporter using the anonymization software provided by Santé publique France and entered on the paper form.

HIV infection in children under 15

Reporting is carried out simultaneously by the laboratory technician and by the clinician who ordered the test (or who is treating a child whose HIV infection has been confirmed). Anonymization is performed at the source, either directly in www.e-do.fr when the report is submitted online. If the report cannot be submitted online, it must be submitted on paper; in this case, the anonymization code is generated by the reporter using the anonymization software provided by Santé publique France and entered on the paper form.

• Virological surveillance associated with mandatory reporting of HIV diagnoses

In parallel with mandatory HIV reporting, virological surveillance consists of the National HIV Reference Center (CNR) performing a test for recent infection and serotyping. Following the evaluation of HIV surveillance, this surveillance will end on January 1, 2026. Only test forms submitted for serology tests performed through December 31, 2025, will be analyzed.

What are its objectives?

The recent infection test allows for estimating the proportion of recent infections (on average, less than 6 months prior to diagnosis) among newly identified HIV-positive cases. The result of this test is used to identify early diagnoses among reported cases in adolescents and adults. It is no longer used to estimate HIV incidence, as another method is now routinely used (see the “Our Data” page).

Serotyping allows for monitoring the evolution of rare types and groups of the virus currently circulating in France among newly diagnosed HIV-positive cases in adolescents and adults. If a rare variant (HIV-2, HIV-1 group O) is detected, the CNR informs the laboratory technician.

Who is involved?

All laboratory professionals who report an HIV infection in a person aged 15 or older are asked to participate in HIV virological surveillance.

How to participate?

The clinician who diagnoses an HIV infection submits a serum sample on a filter paper strip taken from the “tube bottom” used for the diagnosis. They send this filter paper strip to the CNR for HIV, along with a copy of their notification (which can be printed directly from www.e-DO.fr). The CNR performs the test for recent infection and serotyping, then transmits the results to Santé publique France, where they are linked to the information from the mandatory HIV notification using an anonymization code.

Virological surveillance is voluntary for both the patient (less than 1% refusal rate since 2015) and the laboratory technician. The laboratory technician does not need to obtain the patient’s consent. If the patient refuses, the clinician reports this refusal to Santé publique France via the notification form; in this case, the filter paper is destroyed.

Supplies:

• Since January 2020, the supplies needed for this surveillance (blotting paper, plastic bags, and pre-addressed T-envelopes) must be ordered online at: https://moncoupon.santepubliquefrance.fr/spf/client/login. When placing the first order, the laboratory technician must create an account and then validate it. For each order, the laboratory technician logs in to the link above, logs in, enters the “product code” for the supplies to be ordered (available on the online HIV reporting form or upon request here), and the desired quantity. These kit orders are strictly reserved for laboratory technicians who submit mandatory HIV infection reports, as these kits are intended exclusively for HIV virological surveillance.

• Fact Sheet on HIV Virological Surveillance for Reporters

• Fact sheet on HIV virological surveillance for patients

• Poster on HIV virological surveillance for patients

• Mandatory reporting of AIDS diagnoses

What are the objectives?

The objective of mandatory reporting of AIDS diagnoses is to determine the number and characteristics of people who have reached the most advanced stage of HIV infection, whether due to treatment failure, lack of or interruption in treatment, or lack of HIV testing.

Who is required to report?

Mandatory reporting of AIDS diagnoses must be carried out by any physician who diagnoses AIDS (characterized by the onset of an opportunistic infection meeting the case definition), whether or not the patient’s HIV-positive status is already known, or who certifies the death of a person at the AIDS stage.

How do you report an AIDS diagnosis?

Since 2016, AIDS reporting, like HIV reporting, has been conducted online at www.e-do.fr. AIDS reports are anonymized at the source, at the reporter’s level. They include an anonymization code as an identifier, calculated directly within www.e-do.fr. The online reporting application automatically suggests the appropriate form for the reported case (child/adult, full/abbreviated form, death form if applicable).

• More information on e-do: click here.

As a temporary measure, reporters who are unable to report online can obtain printable PDF forms from Santé publique France, as well as software to calculate the anonymization code, which must then be entered on the paper form.

Doctors at the Regional Health Agencies (ARS) and epidemiologists at Santé publique France have instant access to reports submitted electronically via www.e-do.fr.

However, paper reports must be sent by mail from the reporting physician to the ARS in their area of practice, and then from the ARS to Santé publique France.

At Santé publique France, HIV/AIDS notifications concerning the same person (HIV notifications, CNR data, potential duplicates, AIDS or death reports) are compiled and used to create a file for each reported individual. There is no cross-referencing with databases for other notifiable diseases. Note that duplicates (multiple reports for the same person) are detected at Santé publique France using an anonymization code. They are therefore not counted as new cases but serve to supplement the initial report.

Equipment

- Anonymization software (for reporters who cannot yet use www.e-do.fr) available upon request from Santé publique France

- AIDS notification forms in printable PDF format, available from Santé publique France. There are several forms, depending on whether the person to be reported is a child (<15 years old) or an adolescent/adult aged 15 or older. In the event of a simultaneous diagnosis of HIV infection and AIDS, the physician may complete both reports on the HIV form. A section is provided for this purpose.

- Information sheet on reportable diseases, for the patient

Case definition

AIDS in adults and adolescents aged 15 and older

Only the clinician is involved in the reporting process. Anonymization is performed at the source directly in www.e-do.fr when the report is submitted online. If the report cannot be submitted online, it must be submitted on paper, and the anonymization code is then generated by the clinician using the anonymization software provided by Santé publique France and entered on the paper form.

AIDS in children under 15 years of age

Reporting is handled solely by the clinician. Anonymization is performed at the source directly in www.e-do.fr when the report is submitted online. If the report cannot be submitted online, it must be submitted on paper, and the anonymization code is then generated by the clinician using the anonymization software provided by Santé publique France and entered on the paper form.

Surveillance of occupational exposures to HIV, HCV, and HBV among healthcare workers

Surveillance of occupational exposures to HIV, HCV, and HBV among healthcare workers, coordinated by Geres in collaboration with Santé publique France, ended on December 31, 2021, due to a thorough understanding of risk factors and the decline in seroconversion cases resulting from prevention efforts: No new cases of HIV infection have been reported since 2012.

Implementation of behavioral surveys

See the sexual health section

HIV/AIDS prevention initiatives

Santé publique France designs social marketing initiatives tailored to different priority populations: the general public, young people, men who have sex with men (MSM), and migrants. The goal of this approach is to change behaviors and help the public adopt habits and attitudes that promote sexual health.

Learn more on our prevention websites:

• question-sexualite.fr

• sexosafe.fr

• onsexprime.fr