La cohorte hospitali\u00e8re fran\u00e7aise FHDH (French Hospital Database on HIV, ANRS CO4) a analys\u00e9 l\u2019\u00e9volution de la prise en charge des femmes trans vivant avec le VIH en France entre 1997 et 2023, afin d\u2019\u00e9valuer dans quelle mesure elles ont b\u00e9n\u00e9fici\u00e9 des innovations th\u00e9rapeutiques sur cette p\u00e9riode. Sur 160 927 personnes incluses dans la cohorte, 1 781 (1,1 %) ont \u00e9t\u00e9 identifi\u00e9es comme femmes trans ; apr\u00e8s application de crit\u00e8res cliniques (personnes na\u00efves de traitement \u00e0 l\u2019inclusion, donn\u00e9es disponibles sur les CD4, la charge virale initiale et au moins trois mesures de charge virale), 801 femmes trans ont \u00e9t\u00e9 retenues pour l\u2019\u00e9tude.<\/p>\n
Les r\u00e9sultats montrent une am\u00e9lioration importante de la rapidit\u00e9 d\u2019acc\u00e8s au traitement antir\u00e9troviral : le d\u00e9lai entre l\u2019entr\u00e9e en soins et le d\u00e9but du traitement est pass\u00e9 d\u2019environ quatre mois en d\u00e9but de p\u00e9riode \u00e0 quinze jours en 2023. Parall\u00e8lement, la proportion de femmes trans suivies et trait\u00e9es ayant une charge virale contr\u00f4l\u00e9e atteint 95,5 % en 2023, ce qui indique une efficacit\u00e9 \u00e9lev\u00e9e du traitement chez les personnes restant en suivi.<\/p>\n
L\u2019\u00e9tude met toutefois en \u00e9vidence des limites importantes dans la continuit\u00e9 des soins et l\u2019\u00e9galit\u00e9 d\u2019acc\u00e8s. Environ un quart des femmes trans incluses ont \u00e9t\u00e9 perdues de vue au cours du suivi. Par ailleurs, les femmes trans n\u00e9es \u00e0 l\u2019\u00e9tranger initient leur traitement un peu plus tard que les autres, ce qui sugg\u00e8re des disparit\u00e9s d\u2019acc\u00e8s ou de recours aux soins au sein de cette population. Ces \u00e9l\u00e9ments sont susceptibles d\u2019avoir des implications en termes d\u2019organisation des parcours de soins, de lutte contre les in\u00e9galit\u00e9s de sant\u00e9 et d\u2019adaptation des dispositifs de pr\u00e9vention et de suivi.<\/p>\n
Les auteurs signalent \u00e9galement des contraintes m\u00e9thodologiques li\u00e9es \u00e0 l\u2019identification des femmes trans dans les donn\u00e9es m\u00e9dicales. La notion de transidentit\u00e9 n\u2019a \u00e9t\u00e9 introduite dans la FHDH qu\u2019en 2013. Pour les ann\u00e9es ant\u00e9rieures, l\u2019identification a repos\u00e9 sur les informations figurant dans les dossiers m\u00e9dicaux (mention explicite de transidentit\u00e9 ou traitements de transition), ce qui peut affecter l\u2019exhaustivit\u00e9 et la pr\u00e9cision du rep\u00e9rage. Ces limites doivent \u00eatre prises en compte dans l\u2019interpr\u00e9tation des r\u00e9sultats pour le suivi des politiques de sant\u00e9 et de lutte contre le VIH ciblant les femmes trans.\u00a0(contenu r\u00e9sum\u00e9 par l’IA)Lire la Suite<\/a>\u200b<\/p>","protected":false},"excerpt":{"rendered":" La cohorte hospitali\u00e8re fran\u00e7aise FHDH (French Hospital Database on HIV, ANRS CO4) a analys\u00e9 l\u2019\u00e9volution de la prise en charge des femmes trans vivant avec le VIH en France entre […]<\/p>\n","protected":false},"author":1,"featured_media":4499,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[3],"tags":[227,118],"class_list":["post-22275","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-sante-publique-prevention-epidemiologie","tag-ia","tag-vih-org"],"_links":{"self":[{"href":"https:\/\/veilles-affaires-sociales.fr\/index.php?rest_route=\/wp\/v2\/posts\/22275","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/veilles-affaires-sociales.fr\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/veilles-affaires-sociales.fr\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/veilles-affaires-sociales.fr\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/veilles-affaires-sociales.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=22275"}],"version-history":[{"count":0,"href":"https:\/\/veilles-affaires-sociales.fr\/index.php?rest_route=\/wp\/v2\/posts\/22275\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/veilles-affaires-sociales.fr\/index.php?rest_route=\/wp\/v2\/media\/4499"}],"wp:attachment":[{"href":"https:\/\/veilles-affaires-sociales.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=22275"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/veilles-affaires-sociales.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=22275"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/veilles-affaires-sociales.fr\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=22275"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}