ArticleBMC infectious diseases2026
Evolution of HIV epidemic trends and diagnostic delays in French Guiana: how can we make further progress?
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAs antiretroviral treatment indications evolved, an increasing proportion of patients have been treated; since 2017, most patients receive antiretroviral treatment, irrespective of their CD4 count, in French Guiana and neighboring countries. In this context, we aimed to model the epidemic and to study the evolution of the estimates of the intervals between HIV-infection and HIV diagnosis in French Guiana.
methodsThe study was descriptive and comparative. Anonymous data from all persons in the DAT'AIDS HIV cohort based on quality-controlled clinical records was aggregated into yearly statistics between 2000 and 2023. We estimated year of infection using the rate of CD4 decline between the CD4 count at diagnosis and the estimation of the CD4 count at the time of HIV infection. The HIV modelling platform version 3.0.2 used the annual number of new HIV infections, the number of new AIDS cases, the number of new HIV infections that had AIDS, and CD4 strata to compute incidence, number of diagnosed and undiagnosed persons, and diagnostic delay.
resultsAll indicators improved markedly over time. Incidence declined, diagnostic delay declined, the proportion of undiagnosed patients declined, and deaths declined. However, the estimated interval between HIV infection and diagnosis was heterogenous between groups: It was about 2 years longer among males than among females, and it was about 3 years longer among Surinamese or Brazilian immigrants. Overall, 5% of all persons with HIV were undiagnosed, 9% of diagnosed persons were not on antiretroviral therapy and 6% of those on antiretroviral therapy were in virological failure. For a population of about 4,000 persons with HIV this represents a residual source of transmission.
conclusionsThe scaling up of testing, antiretroviral treatment, and preexposure prophylaxis has led to remarkable progress. Nevertheless, further shrinking the reservoir of undiagnosed infections and maximizing the proportion of successfully treated persons living with HIV is still likely to further improve control of the epidemic. CLINICAL TRIAL: This is not a clinical trial.
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