Key points

HIV/AIDS

• Participation in the LaboVIH survey and the reporting of new HIV diagnoses via e-DO by clinicians and laboratory professionals are essential for the production of reliable surveillance indicators. Estimates of the rate of positive serology results (LaboVIH) and new HIV diagnoses (HIV incidence) and AIDS cases for the Guadeloupe region were not possible in 2021, as was the case in 2019–2020 (limitations of the correction factor); nevertheless, the participation of laboratory technicians in LaboVIH in 2021 (85%) and the mandatory reporting of cases by clinicians allow for reliable monitoring of the HIV epidemic in our region.

• A resurgence in HIV testing was observed in 2021 following the significant decline documented in 2020, but the rate remains lower than that observed in 2019 (-22%); Guadeloupe is among the regions with the highest testing activity in France, alongside French Guiana and Martinique in 2021.

• The number of new HIV diagnoses remained stable in 2021 compared to 2020 (63 vs. 62 cases); this stability in the number of new HIV diagnoses in 2021 was observed regardless of the mode of transmission; The majority of cases are among people aged 25–49 and are heterosexual, a proportion significantly higher than the national average (71% vs. 43% in mainland France excluding the Île-de-France region), with more than one-third of cases involving foreign nationals.

• In 2021, nearly one-third of HIV infections were diagnosed at an advanced stage of the infection.

• Significant decline in the use of rapid diagnostic tests (RDTs) in 2021 (-31%) compared to 2020.

• Decrease in sales of HIV self-tests in 2021 compared to 2020 (-12%).

Chlamydia trachomatis infection

• In 2021, the rate of reimbursed screenings was 82.1 per 1,000 inhabitants, significantly higher than the national rate (41.8 per 1,000).

• After a downward trend in 2020 across all age groups, the rate of reimbursed screenings rose again in 2021 (+14%), particularly among women and men under 25, while free screenings at the region’s CeGIDDs decreased in 2021 (-21%).

• Between 2020 and 2021, the number of Ct infection diagnoses increased by 45%, exceeding the 2019 rate (2.5 per 1,000). In 2021, the regional rate was 3.0 per 1,000 inhabitants (compared to 1.7 per 1,000 nationally).

• This increase is more pronounced among women than among men (+59% vs. +33%) and even more so among young people (+65% among women aged 15–24 and +58% among men aged 15–24).

• The positivity rate at the region’s CeGIDD is rising in 2021, higher among men (14%) than among women (12%).

• Approximately 60% of Ct infection cases who sought care at CeGIDD centers in Guadeloupe were men; the majority were under 26 years old, reported heterosexual relationships with multiple partners, 30% had suggestive symptoms, and 1 in 10 had a history of STIs.In Saint Martin, the characteristics of Chlamydia infection cases seen at CeGIDD centers showed that the majority were women (78%); one-third of cases were foreign nationals, and one-quarter had a history of STIs. Multiple sexual partners were reported at a lower rate than in Guadeloupe (57% vs. 81%).

Gonococcal infection

• In 2021, the rate of reimbursed screenings was 84.3 per 1,000 inhabitants, significantly higher than the national rate (48.5 per 1,000)

• An increase in testing was observed in 2021 (+11%) for reimbursed tests, while free testing at the region’s CeGIDD centers decreased (-21%). The testing rate is particularly high among women under 25, close to the testing rate for Ct infections (joint multiplex testing).

• In 2021, the screening rate for gonococcal infection increased more among men (+16% vs. 9% among women) compared to 2020, particularly among those under 25.

• At CeGIDD, the positivity rate was twice as high among men (6%) in 2021; this rate was the highest observed among men (+2.1 percentage points in 2021 compared to 2019), while it remained stable among women compared to 2019.

• The majority of cases seen at the CeGIDD in Guadeloupe were men under 26 years of age, born in France, reporting mostly heterosexual intercourse with multiple partners, and frequently presenting with symptoms suggestive of STIs (>50%). In Saint Martin, approximately twenty cases were diagnosed in 2021 with characteristics nearly identical to those described in Guadeloupe, except for a higher prevalence of foreign nationality (42% vs. 6%).

Syphilis

• A resurgence in syphilis screening was observed in 2021, with a screening rate of 112.6 per 1,000 inhabitants—the highest in the region since 2014; As with screening for Chlamydia and gonorrhea, the highest syphilis screening rates in France are found in French Guiana and the Antilles.

• This increase applies to both women and men (+15% compared to 2020), particularly those under 25 (+25% among young men vs. +20% among young women).

• The screening rate is higher among women (mandatory screening during pregnancy). It should be noted that the rate among men over 25 is higher than that of those under 25, unlike in other regions of France

• As with testing for other STIs in the CeGIDD, syphilis testing decreased in 2021 (-18%).

• In the CeGIDD region, the positivity rate was low among men (<1%) and zero among women in 2021, down compared to 2020.

• In total, 5 cases of syphilis were diagnosed in 2021 in the region (compared to 14 in 2020).