BMJ  2007;334:1354-1356 (30 June), doi:10.1136/bmj.39225.458218.94

Analysis

Routine testing to reduce late HIV diagnosis in France

Cyrille Delpierre, epidemiologist1, Lise Cuzin, physician2, France Lert, researcher3

1 INSERM U558 F-31073, Toulouse, France, 2 Unit of Infectious and Tropical Diseases, Hôpital Purpan, Toulouse, France, 3 INSERM U687 F-94410, Saint-Maurice, France

Correspondence to: C Delpierre, Department of Society, Human Development and Health, Harvard School of Public Health, Landmark Center, 401 Park Drive, Boston MA, USA cdelpier@hsph.harvard.edu

Although around half the French population has had an HIV test, many people are still not diagnosed until the disease is advanced. Cyrille Delpierre and colleagues believe the answer is to expand routine testing

The first 150 words of the full text of this article appear below.

Around 130 000 people in France were infected with HIV in 2005. Among the 7000 people newly diagnosed in 2004, 58% became infected through heterosexual intercourse, 29% through homosexual intercourse, and 2% through intravenous drug use. Around half of those infected through heterosexual intercourse came from sub-Saharan Africa.

In France, testing is free in all healthcare settings, and anonymous counselling and testing is provided in dedicated sites all over the country. Besides prenatal routine testing, current policy focuses on high risk groups (men who have sex with men, sub-Saharan migrants) and behaviours (unprotected sex). This policy results in a large number of tests annually. However, around 40% of cases identified are in people with advanced infection, most of whom belong to groups not focused on by the current testing policy. We discuss the consequences of late testing on mortality and spread of infection and recommend expanding HIV testing to all . . . [Full text of this article]


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