Routine testing to reduce late HIV diagnosis in France

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Abstract
Testing policy Since the 1980s, France's institutional framework of HIV testing has been based on wide access to free voluntary counselling and testing, routine testing in blood and tissue donors, and routinely offering HIV tests to pregnant women and to people getting married or entering prison. Since 1997, national and regional information campaigns have been launched to increase the awareness of the potential benefits of early diagnosis. However, these efforts remained mainly focused on people with high risk behaviours. The result of this policy is a high rate of testing, with 82 tests per 1000 population in 2004, the highest rate in Europe after Austria,1 and a positive test ratio of 2.4/1000 tests in 2004.1Around half the French population has had at least one HIV test.2 But, despite this high level of testing, 40% of people already have AIDS or CD4 cells count below 200×106/l when the HIV infection is first detected.3 4 Therefore, of the estimated 7000 people newly diagnosed with HIV in France in 2004,1 3000 may have advanced disease.