VESPA 3: 3rd survey on the living conditions of people living with HIV
How are people living with HIV in France today? The third ANRS VESPA survey, financed and promoted by the agency, has been launched to answer this question. 3,000 people living with HIV (PLHIV) will be surveyed between autumn 2023 and 2024.
Published on 01 December 2023
A long-term research project
The results of previous VESPA surveys have fed into the recommendations of experts in the field of social care for people living with HIV (PLHIV), and have made a major contribution to informing professionals, associations and institutions.
Indeed, ANRS VESPA, carried out in 2003, was the first nationally representative study to focus on the living conditions and social needs of PLHIV. It was carried out at a time when the effectiveness of antiretroviral treatments was revealing the chronic nature of the disease, but when the constraints of monitoring and treatment were weighing heavily on the daily lives of PLWHA. Seven years later, the VESPA 2 survey enabled us to assess social and relational difficulties in the period following diagnosis, and to measure the frequency of co-morbidities that appeared with age, the methods and quality of their management, and their impact on health, social situation and quality of life.
Since 2011, the context of HIV prevention and care has undergone major changes in terms of screening (arrival of self-tests and demedicalized screening in associations), prevention (TasP or “treatment as prevention”, PrEP) and treatment (anti-integrases in 1st line, with improved tolerance and efficacy on viral load, leading to better quality of life, diversification of galenic forms). The characteristics of PLWHA have evolved, with an aging infected population, posing new challenges in terms of HIV management and co-morbidities, which could become more frequent.
New research questions
These changes are leading to new research questions that the ANRS VESPA 3 study will address:
- Analyzing the diversity of living with HIV today, and relating it to the context of discovery of seropositivity and the different life trajectories of PLHIV, using a generational approach;
- Investigating emerging themes since 2010 (therapeutic and preventive innovations, new practices, chemsex, etc.) and their influence on the living conditions of PLHIV;
- The study of social inequalities in health and their influence on living conditions, relationships to care and practices;
- Measure the social and therapeutic consequences of the Covid-19 health crisis for different populations of PLHIV;
- Analysis of relations between healthcare staff and patients, and their impact on PLHIVs’ relationship with healthcare;
- The study of life trajectories, in particular the impact of age and duration of infection.
VESPA 3
The VESPA 3 questionnaire, to which 3,000 people will respond, has been revised to address these issues, with the addition of questions on follow-up and side effects of injectable treatment, cancer-related comorbidities, anal health, menopause-related disorders, breastfeeding, health literacy, chemsex and sexual violence.
Participation in the survey will be offered on a random basis to people living with HIV over the age of majority who attend one of the 68 hospitals selected at random in mainland France.
Social science researchers will conduct individual interviews with a sub-group of participants to explore the generational dimensions of living with HIV, as well as the experience of various forms of discrimination from an intersectional approach. These interviews will enable us to gain a better understanding of the experience of older people, regardless of how long they have been infected, and of younger people, including those living with HIV since childhood, in relation to vertical transmission of the infection.
A more specific version of the survey, co-sponsored by local investigators, is currently under consideration.
The VESPA3 survey is being carried out under the joint supervision of Bruno Spire (Director of Research at Inserm), Marie Préau (Professor at Lyon II University) and Cyrille Delpierre (Director of Research at Inserm), by the SanteRCom teams at SESSTIM (Aix-Marseille University/IRD/Inserm), CERPOP (Inserm/Université Toulouse III) and the social psychology unit of Université Lyon II/Inserm, as well as the TRT-5 CHV inter-associative group.
Initial results are expected by the end of 2025.
VESPA 3 survey website Main results of the VESPA and VESPA 2 surveys