In 2019, six million HIV tests were performed in the laboratory. With the Covid epidemic, screening fell 15% last year. Making the HIV screening test free, in the laboratory, is what provides for one of the measures of the social security financing bill which arrives in committee at the National Assembly on Monday, October 11. Today, a test without a prescription costs between 17 and 25 euros, depending on the laboratories. And if the blood test remains the reference test for AIDS screening, there are also self-tests, TRODs, which can be purchased in pharmacies but are chargeable. Each year between 5,000 and 6,000 people discover their HIV status in France.
This device, “In the lab without ordo”, has been tested until now in Paris and in the Provence-Alpes-Côte d’Azur region. “This offer is a good answer”, reacted on franceinfo Pascal Pugliese, president of the French Society for the fight against AIDS and president of the regional coordination committee for the fight against HIV in the PACA-East zone.
franceinfo: Is the generalization of the “Au labo sans ordo” system good news?
Pascal Pugliese: Yes, this is good news. We have had a very significant drop in the number of serologies carried out in France since the start of the pandemic. The impact of Covid-19 is very strong on the fight against HIV and to meet our objectives of ending the epidemic by 2030, we need to multiply the offers and this offer is a good answer.
How to explain that HIV testing has declined so much since the Covid-19 pandemic?
The confinement period, the fact that our health was perhaps a little less the priority. In any case, we made a big focus on the Covid-19. There are also probably people who have been less exposed to the virus. We also had perhaps fewer foreign personnel who arrived in France, but probably also a reduction in prevention, with a risk of having a delay in diagnosis compared to a new infection and a resumption of the epidemic. .
The device at the “Au labo sans ordo” has been tested in two regions. Has it made it possible to relaunch HIV testing?
Over the experimentation period and despite the confinement period and the Covid-19, “In the lab without ordo” represents 7% of the total volume of the number of serologies performed. When compared to 2018, this generally increases the volume of screening. It was the first objective. The second objective was to attract people who were potentially at risk of HIV. Indeed, we also realize that we have a seropositivity rate with this offer of non-prescription screening which is higher than with the prescribed tests. We have the impression that we are attracting particularly exposed people. Rather, they are heterosexual people, men or women who were born in France and for whom, in fact, the rate of seropositivity is not necessarily high. On the other hand, the delay in diagnosis is very high in France since it can reach 4 years. And within this period, of course, the person alters their immunity and can also transmit the virus.
Very concretely, from next January 1, if the law is validated, how will it work?
Everyone knows this now with the Covid-19. Indeed, it is the demedicalization of screening. You enter a laboratory anywhere in France, you can already do it now in the Alpes-Maritimes and Paris, you enter a laboratory with your vital card, you request an HIV test and you have the results within 24 hours. It is people who expose themselves, have sex that is not systematically protected by a condom. This particularly concerns the most exposed populations. Of course, men who have sex with other men, but also people who are born abroad. And then, anyone who has multiple partners and who does not always protect themselves with a condom.