Key Points

HIV Infections

• HIV testing continues to increase in Nouvelle-Aquitaine, though at a more moderate rate compared to previous years. Approximately 760,000 HIV tests were conducted in the region in 2024. A significant portion of these tests (30%) were conducted through the VIHTest program, which requires no prescription and involves no upfront costs. This program is highly popular among young people, particularly since its expansion to include STIs (MonTestIST) in September 2024. In 2024, the number of new HIV diagnoses appears to be finally stabilizing after the increase observed since 2021. This downward trend is also evident in HIV incidence, particularly among MSM and among heterosexual individuals born in France.

• Progress in the fight against HIV is thus evident in the region, as evidenced by the downward trend in new HIV diagnoses despite the continued increase in HIV testing, the decline in HIV incidence, and the achievement of the 95-95-95 cascade targets (96% of people living with HIV are diagnosed; of these, 97% are on antiretroviral therapy, with an undetectable viral load [at the threshold of 200/mm³] for 98% of them). Nevertheless, by the end of 2024, approximately 480 people infected with HIV are estimated to remain undiagnosed in the region, primarily among MSM born in France. Furthermore, the proportion of cases detected at an advanced stage (AIDS, CD4 < 200/mm³) is not decreasing. Efforts to screen populations most at risk for HIV must continue.

Chlamydia trachomatis, gonococcal, and syphilis infections

• In Nouvelle-Aquitaine, bacterial sexually transmitted infections (STIs) caused by Chlamydia trachomatis (Ct), gonorrhea, and syphilis are being detected with increasing frequency, with approximately 300,000 tests recorded for each of these STIs in 2024. The increase in testing is evident for all STIs, regardless of the population group, with a more pronounced rise among men and those aged 50 and older. Nevertheless, women and young people aged 15–25 remain the groups with the highest testing rates.

• In 2024, approximately 5,400 Chlamydia infections, 1,900 gonococcal infections, and 470 syphilis infections were diagnosed. Diagnosis rates were all higher than those observed in mainland France excluding the Île-de-France region (between +13% and +17%). An increase in diagnoses of Chlamydia and gonorrhea infections is observed among men, particularly those aged 15–25 and those over 50. The increase in these diagnoses is partly proportional to the rise in screening rates in these populations, except for gonococcal infections, where the increase in diagnoses is higher than that of screening. These findings thus suggest a rise in gonococcal infections among men.

Hepatitis B

• Hepatitis B screening activity is also high and increasing in the region. More than 410,000 people were screened for this infection in Nouvelle-Aquitaine in 2024. The general population screened consists mainly of women and people under 40 years of age. To a lesser extent, hepatitis B screening is also conducted at Cegidd centers; it most often involves men and people aged 20 to 29. Despite extensive screening, those most at risk of infection are likely not being targeted sufficiently, as patients infected with hepatitis B are predominantly men aged 40 or older. Furthermore, in Cegidds, the positivity rate for hepatitis B is higher among men aged 30 and older, whereas screening is primarily conducted among those under 30.

• Improving hepatitis B screening strategies appears essential to better target at-risk populations, particularly men over 30.