ABSTRACT
Introduction - The CeGIDDs are centres of information, screening and diagnosis for HIV, viral hepatitis and bacterial sexually transmitted infections (STIs), a network of French free-to-use clinics created in 2016. This article describes the characteristics of CeGIDD visitors as well as the screening and diagnostic activities carried out by the structures for the year 2020, comparing them with 2018. Method - We present a repeated cross-sectional study, based on continuous monitoring data from the SurCeGIDD system, which relies on the secure transmission of individual visitor data according to a predefined format. The socio-demographic and behavioural data of the visitors, and their reasons for consultation, are described. The proportions of visitors tested and the positivity rates for HIV, hepatitis B (HBV) and C (HCV), syphilis, gonococcus (NG), Chlamydia trachomatis (CT) and Mycoplasma genitalium (MG) are described according to sexual practices. Results - In 2020, 336,333 consultations were reported by 50.3% of the 336 CeGIDDs identified in 2020. Attendance at CeGIDDs fell sharply in the second quarter of 2020 (-58% compared to the first quarter). In 2020, the visitors were mostly men (62.1%) and young people under 30 (64.5%). About a quarter (23.5%) of the visitors were born abroad. The proportion of men having sex with men (14.8%) and trans people (0.38%) had increased compared to 2018. The most frequent reasons for consultation remained risk exposure (60.4%) and systematic screening (43.3%). Some reasons for consultation increased between 2018 and 2020, such as initiating or monitoring a post-exposure prophylaxis. An increase in positivity rate between 2018 and 2020 is observed for HIV (from 0.37% to 0.41%), but especially for NG (from 2.8% to 4.0%), undoubtedly related to changes in visitor characteristics. At the same time, positivity rates decreased for HBV (from 1.3% to 0.93%) and HCV (from 0.94% to 0.60%). They are relatively stable for CT (7.0% in 2020), MG (6.8%) and syphilis (1.0%). Conclusion - Despite a drop in consultations in 2020 related to the COVID-19 pandemic, the CeGIDDs continued to carry out their screening/diagnostic missions in a comprehensive sexual health approach. SurCeGIDD surveillance provides elements for monitoring the national sexual health strategy, hence the need to improve the comprehensiveness and completeness of the data collected.
ABSTRACT
Introduction - The CeGIDD (French STI clinics) were implemented in 2016. This study analyzes testing activity for HIV, hepatitis B and C and other STIs using individual data from the SurCeGIDD surveillance. Method - SurCeGIDD relies on secured transmission of individual data in a predefined format. Sociodemographic data, tests for HIV, hepatitis B or C, syphilis, gonococcus (NG), Chlamydia trachomatis (CT) and Mycoplasma genitalium (MG), diagnoses and sexual behaviors were analysed. Proportion of tested attendees and positivity rates were estimated for each pathogen by exposed populations. Results - In 2018, 382,890 consultations were reported by 44.6% (n=143) of CeGIDDs. Majority of consultants (59.8%) were men, 40.0% women and 0.2% transgender people. The positivity rates were 0.37% for HIV, 1.31% for HBV, 0.94% for HCV, 7.16% for CT, 2.83% for NG, 1.04% for syphilis and 5.96% for MG. Considering pathogens, positivity rates were higher among men who have sex with men, people born abroad, transgender population and people visiting CeGIDDs in the French overseas departments and Paris area. Further analysis might give a better understanding of the vulnerability for these populations. Conclusion - Despite perfectible coverage and completeness, the SurCeGIDD data enable a better understanding of the vulnerability of populations visiting CeGIDDs. Contextualized analysis of these data will help to adjust the national sexual health strategy to territories and populations.