Treatment as prevention rejected by French ministry of health

via Aidsmap, by Roger Pebody

The endorsement of treatment as prevention by the French National AIDS Council has been dismissed by the country’s ministry of health.

In April, the National AIDS Council (Conseil National du Sida) issued a lengthy and nuanced analysis of the potential impact of greater use of antiretroviral treatment on HIV transmission and prevention. It recommended campaigns to raise awareness of the benefits of HIV testing and earlier treatment, and that negative messages about side-effects and pill burden should receive less emphasis.

The National AIDS Council is independent body of experts (academics, clinicians, politicians etc.) who are nominated by various parts of the government. It has a consultative role.

However a press statement issued by the Direction générale de la santé (the section of the health ministry responsible for public health) rejected the National AIDS Council’s analysis.

The statement insisted that only male or female condom use could guarantee a maximum protection against HIV and other sexually transmitted infections, and that condoms must be used consistently during casual sex or when the HIV status of a stable partner was not known. The statement said there was no conclusive evidence concerning men who have sex with men, the efficacy of antiretroviral treatment as a sole prevention strategy or the risks of resistance if more people took treatment.

The ministry announced that a new group of experts would be asked to reconsider treatment as prevention as part of their review of HIV prevention strategies. The opinions of this group are likely to feed into France’s next three-year HIV strategy.

The campaigning group The Warning denounced the conservatism of the Direction générale de la santé. They said that the health ministry “remains silent” about the residual infection risk associated with condom use, and did not address the issue of the growing number of people who don't use a condom, either some or all of the time. “They show that they still believe it is possible to put into place a prevention strategy that takes no notice of the choices and behaviours of individuals,” the group commented.