21% fewer HIV cases diagnosed in 2020 due to the coronavirus

There were less than 21% of HIV cases diagnosed in 2020, but that does not mean that they are fewer. As with cancer, part of the screenings could not take place with the Covid-19 health crisis. This is not the only reason. Sciensano and the AIDS prevention platform list them in a report published on Monday.

Less testing

The decrease in the number of HIV diagnoses has largely coincided with the reduction in testing activity observed mainly during periods of containment linked to Covid-19“, explains Sciensano in a press release.

This decrease is clearly visible in the graph below which shows the number of tests performed. At the time of strict containment in April 2020, there is a 58% decrease in tests. In November, during the second wave, less 25% of the tests. So there are so many people who have not been screened.

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This graph shows the number of tests carried out between 2017 and 2020. It is clear that there were fewer tests at the time of the two lockdowns in 2020. © Sciensano

Less sex with new partners

By reducing social contact and closing meeting places such as nightclubs, there have necessarily been fewer meetings. And therefore less sex with new partners. This is the second factor that explains a drop in the number of people carrying the AIDS virus.

A first observation in this direction is the halving of the number of diagnoses of acute HIV infections compared to 2019“, explains the public health institute.

He adds another explanation: there has been less demand for preventive treatment that allows HIV-negative people to protect themselves before having sex. “The decrease in the use of preventive treatment (pre-exposure prophylaxis or PrEP) for HIV from April 2020 also goes in the direction of a reduction in risky sexual behavior among men who have sex with men.”

Fewer trips

Third effect of the health crisis: we have not traveled and the number of people who have immigrated has also fallen. There were therefore fewer diagnoses in these populations according to Sciensano.

Among foreigners, the decrease in the number of HIV diagnoses has been observed mainly during periods of Covid-19 containment, can we read in the report. During these times, access to testing centers was limited, but strict travel restrictions were also in place, which had a major impact on international migration flows to Belgium and, most likely, on diagnosis of HIV infections in foreigners. “

Less accessible screening structures

Finally, who says strict confinement, says reduced access to structures such as screening centers. This is what explains Thierry Martin, director of the AIDS prevention platform. We must actually catch up because in 2020 with the confinements, the closures of screening centers, fewer people were detected. So if we screen less, we find less. However, we know that there are contaminations. “

The director stresses the need for screening because when a case is diagnosed it can be treated and transmission stopped. “The objective for us, to break the chains of transmission of HIV, is effectively to strengthen this access to testing by going into the field by reaching the most vulnerable groups. Today, the key is If an HIV-positive person knows they are, they will take treatment and have an improved quality of life. Above all, they will have an undetectable viral load and therefore no longer transmit HIV. This is really a challenge in terms of public health. “

Do not rely only on testing centers but go out into the field to meet target audiences, this is what the AIDS prevention platform does as we can hear in the radio report below.

A day center for the homeless is one of the places where we find the profiles who are most affected. Sciensano describes them as diverse but identifies two in particular.

“Since the start of the epidemic in Belgium, two key populations have been particularly affected: men who have sex with men (MSM), of Belgian nationality, heterosexual men and women from sub-Saharan Africa.”

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Evolution of the number of patients in follow-up by grouped nationality and probable mode of transmission, 2006-2020. © Sciensano

And since there are fewer diagnoses in these populations, there have been proportionately more cases detected in the others, Sciensano explains.

Covid has also had an impact on healthcare

Once diagnosed, you no longer die of AIDS. It is possible to undergo treatment that makes it possible to lead a life similar to that of HIV-negative people. On one condition: follow his treatment. And again, the covid had a deleterious effect on these follow-ups.

“The organization of HIV care had to be adapted during periods of confinement. Some HIV follow-up examinations were delayed and a slight increase in the number of HIV-positive patients discontinuing care in 2020 was observed.”

Because yes, “AIDS still exists “. This will also be the slogan of the next AIDS prevention platform campaign on the occasion of the world day against this disease on December 1. She finally recommends to “strengthen access to HIV and STI prevention and testing services as well as to various prevention tools. “

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