A new collaborative project, “Battant·es” (“Fighters”), is building on decades of HIV prevention and treatment advancements as it charts a course toward ending the epidemic by 2030. The initiative, spurred by promising data presented at a November 2024 conference, aims to assess the current state of HIV response in France and beyond, with a particular focus on vulnerable populations like migrants and LGBTQ+ individuals. Driven by organizations like VPSS and guided by a robust scientific advisory board, “Battant·es” seeks to foster collaboration and address emerging challenges-including declining funding and rising hate crimes-that threaten progress toward achieving the enterprising 95-95-95 targets set by the Paris Declaration.
How the “Battant·es” Project Began and Its Primary Goal
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A new initiative, dubbed “Battant·es” (roughly translated as “Fighters”), is aiming to build on decades of progress in the fight against HIV and chart a course for the future. The project emerged from discussions about the potential to reach the ambitious 2030 goals set by the Paris Declaration, which aims to end the HIV epidemic. These goals include achieving 95% diagnosis rates, 95% treatment coverage for those diagnosed, and 95% viral suppression among those on treatment – often referred to as the 95-95-95 strategy.
Christophe Martet explained that the idea originated with a desire to bring together associations and researchers to celebrate advancements in HIV prevention and treatment. Following a November 2024 conference hosted by Action Traitement, encouraging data presented by Stéphanie Dominguez and Sophie Grabar sparked a deeper conversation. “We realized we were less than five years away from the 2030 objective, perhaps having already reached it or being very close,” Martet said. “This led us to ask what that means, and what new indicators we should track to continue ending the epidemic and improve our response.”
The initial phase involved brainstorming and developing a roadmap for future work. The team at VPSS (an organization not further defined in the source material) then focused on organizing thematic groups representing diverse populations, including sex workers, men who have sex with men (MSM) born abroad and in France, transgender individuals, and migrants. Simultaneously, they convened a scientific advisory board, established in 2023, comprised of scientists, physicians, and epidemiologists.
This collaborative effort culminated in a call to action. While acknowledging the successes – including declines in new infections and increased testing rates in the Île-de-France region, particularly in Paris – the project also recognized the challenges facing the HIV response. “The period is very difficult,” Martet noted, emphasizing the need for a unified approach.
The project aimed to create a common ground for collaboration and assess the current state of the HIV response, while also engaging the public with a celebratory and festive dimension.
Elodie Aïna highlighted the positive trends observed since the launch of the Paris Declaration in 2014. “We celebrated our tenth anniversary last year,” she said. “There’s been a 33% decrease in new infections, a 25% increase in testing, and more people are starting pre-exposure prophylaxis (PrEP).” These gains demonstrate the effectiveness of the current strategy, she added.
However, Aïna also emphasized the broader context of challenges facing HIV prevention efforts. Declining national and international funding has led to a resurgence of the epidemic in some regions, particularly in Africa. In France, access to healthcare for migrants is under threat, and there’s been a rise in LGBTQ+ hate crimes and violence. The November 20th commemoration of the Transgender Day of Remembrance – marking the deaths of 20 transgender individuals in France and one per day globally – underscored the vulnerability of these communities.
The name “Battant·es” reflects this spirit of solidarity and resilience. “It’s about sticking together and recognizing that we are stronger together,” Aïna explained. “It was quite moving – the day after the November 20th event, we received many messages from people saying it felt good, and that the event had given them hope. That was the goal.”
The project’s white paper will serve as a roadmap for future work through 2030, providing a platform for advocacy with institutions, local governments, and public and private partners. VPSS’s strong community ties are a key asset, allowing them to leverage the expertise of grassroots organizations serving specific populations. “What needs to be done with white Parisian MSM is not the same as what needs to be done with newly arrived LGBTQ+ migrants,” Aïna explained.
The project also aims to advance scientific advocacy, challenging the limitations of the cascade model in revealing inequalities between different key populations. “It’s a benchmark, almost a slogan at first, but insufficiently precise to tell us how to move forward,” Aïna said.
Martet added that alongside the event and white paper, a large-scale public awareness campaign is underway in Paris, with 1,000 posters provided by the city during World AIDS Day week. The campaign will also be displayed in Paris laboratories and distributed by the city and the Seine-Saint-Denis department in municipal locations, such as town halls, health centers, and social service centers.
Aïna explained that the campaign builds on a previous effort in 2023, which revealed concerning gaps in public knowledge about PrEP, treatment as prevention (TasP), and the VihTest program. The new visuals focus on “Mon Test IST” (My STI Test), as free and accessible STI testing has now been expanded to include four additional sexually transmitted infections.
Addressing HIV Exposure Among Migrant Populations in France
Migrant populations in France face a disproportionately high risk of HIV infection, not only after arriving in the country but also during their journey. Recognizing this, “Vers Paris sans sida” is developing targeted interventions to address the unique needs of these communities.
Aïna noted that recent data shows that migrants are often infected later after arriving in France, which is understandable given the ongoing epidemic within the country. VPSS is developing tools that consider the cultural norms and specific health needs of these populations, always working with and for the people they are intended to serve. This year, they published leaflets on PrEP for African women, heterosexual African men, and African MSM, which are distributed by associations alongside negative TROD (tests for recent HIV infection) results. Aïna also participated in a broadcast on Africa Radio on December 1st to disseminate information and prevention messages.
The organization conducts outreach testing in social centers and shelters, recognizing that social workers are often the first point of contact for migrants. They provide resources such as multilingual leaflets with condoms included in hygiene kits, and organize pop-up testing events in frequented locations like day centers and temporary housing facilities.
Aïna emphasized the effectiveness of community-based approaches, citing the work of organizations like Afrique Avenir. “They work in African hair salons, exotic food stores, Senegalese festivals in Sarcelles, Ivorian gatherings in Ivry, and tontine meetings,” she said. “These associations are the most effective because they have a personalized approach, answer people’s questions, adapt their messaging to address misconceptions, and understand the cultural codes to avoid directly addressing sexuality in a way that might be shocking. Having someone from the same community address them eliminates mistrust related to race.” The main challenge, she added, is the precarious financial situation of these community associations.
Digital communication is also being utilized to reach targeted audiences. “Reaching people on their phones can be quite effective,” Aïna said. “Without significant resources, we can target specific communities – for example, sub-Saharan migrants living in the Île-de-France region who are women – using algorithms that direct content based on the interests of social media users.”
Martet highlighted the importance of PrEP adoption among these populations, particularly women. “It would be a game-changer if we could say that within two to three years, 94% of PrEP prescriptions currently going to men are split 50/50 between men and women,” he said. He suggested that injectable PrEP could be a key tool in achieving this goal.
Engaging the Medical Community in the Fight Against HIV
The project recognizes the crucial role of physicians in the HIV response, but acknowledges the challenges of mobilizing the scientific community. There’s a concern that some may believe the epidemic is “solved.”
Aïna stated that physicians are often misinformed about PrEP, TasP, and testing options, similar to the general population. “There’s a lot of work to be done with doctors,” she said. She cited reports from the États Généraux des PVVIH (National States General on People Living with HIV) detailing discrimination faced by people living with HIV, including refusals of care from physicians who lacked knowledge of undetectable equals untransmittable (I=I).
Efforts are underway to improve physician education, including the development of a prescribing guide for general practitioners, which has been regularly updated and reprinted. The guide is being disseminated throughout VPSS territories and in areas of Seine-Saint-Denis with high rates of late diagnosis. The organization is also offering short, CME-accredited training sessions led by experienced prescribers.
Aïna pointed to instances of physicians expressing reluctance to prescribe PrEP to migrants, despite a lack of evidence to support this practice. “Victoria Manda’s preliminary research suggests the opposite,” she said. “This indicates that healthcare professionals are influenced by biases that are difficult to change. And the people attending the SFLS conference are already sensitized. That’s a bit scary.”
In 2026, the project plans to launch an influence campaign through social media to reach healthcare professionals, recognizing the challenges of cutting through the clutter of pharmaceutical marketing and other communications. Collaboration with organizations like the Assurance maladie (French health insurance) and the ANRS-MIE (National Agency for Research on AIDS and Viral Hepatitis) will be crucial to gaining visibility.
Martet reiterated that the issues surrounding PrEP also apply to I=I. “We still see doctors hesitant to discuss it with patients,” he said. “One of our recommendations is to include an interpretation of test results on lab reports – similar to cholesterol levels – stating ‘Less than 20 copies means you can no longer transmit HIV.’ For many people, this would be empowering and facilitate testing, as it all starts there.”
Aïna emphasized the importance of collaboration between researchers, healthcare providers, community organizations, and institutions. “Our clear public health objectives build trust with institutions and scientists, while our freedom of action and commitment earn the trust of community organizations, especially the most activist ones,” she said. “This allows us to identify needs, bring different partners to the table, secure funding, and implement projects. Once a project is successful, we step back. We are constantly renewing our approach.”
Looking Ahead to 2030 and Beyond
With five years remaining until the 2030 goal of ending the HIV epidemic, the project is focused on maintaining momentum and adapting to the evolving landscape of the HIV response.
Martet explained that “Vers Paris sans sida” was founded in 2016 to implement the Paris Declaration of 2014, aiming to end HIV transmission, AIDS-related mortality, and discrimination by 2030, particularly against people living with HIV.
Aïna added that 2030 is central to the organization’s identity. “Vers Paris sans sida was born from that goal,” she said. “Whether it’s 95-95-95, zero new infections, zero discrimination, the idea is to end the epidemic. Whether it’s 2030, 2035, or 2028 isn’t as important. And even when we reach that goal, there will be other things to do: people living with HIV are an aging population, and we need to support this new face of the epidemic.”
Martet acknowledged that achieving the 95-95-95 targets won’t be the end of the story, but emphasized the importance of maintaining a positive dynamic. “We’ve lived through a period where we had no solutions, where everything was bleak,” he said. “Of course, associations are playing their role in raising awareness, criticizing, and advocating. We need to denounce, challenge, and demand. But sometimes, there are figures that offer hope – for example, people arriving in France are tested on average within four months. These are the kinds of data we wanted to present in ‘Battant·es.’ We wanted to show – and I think it’s important – that this is an achievable goal that we’ve almost reached and that we need to continue to pursue. It’s something concrete and positive. That’s what ‘Vers Paris sans sida’ generally conveys. We always try to have something that informs, in a positive way, because we also talk about people’s experiences and what they’ve been through. When I tell people ‘I got tested 40 years ago and I’m here talking to you,’ they immediately understand that HIV wasn’t a death sentence. We have all the tools now, and we control things. It’s not about trivializing the issue. Of course, there are still very complicated aspects to HIV, but sometimes diabetes is more complicated. Telling someone they’re infected isn’t the best news of the day, but it’s not necessarily the worst either. Now, we know what we can do.”
