Human immunodeficiency virus screening among pregnant women in France: results from the 1995 National Perinatal Survey.

OBJECTIVE

The aim of the study was to assess how the French legislation requiring physicians to offer human immunodeficiency virus screening routinely at the beginning of prenatal care has been implemented and to explore areas in which improvement is required.

STUDY DESIGN

The survey included all births in France during a 7-day period in February 1995. A total of 12,341 women were asked whether they knew whether they had undergone a human immunodeficiency virus antibody test before or during the pregnancy. Factors that could have influenced their knowledge of whether they had been tested were also assessed.

RESULTS

Of the women questioned, 87.3% stated that they had been tested before or during pregnancy, 7.6% said that they had not been tested, and 5.1% stated that they did not know whether a test had been performed. Among those who said that they had not been tested before the pregnancy in question, 84. 9% reported that they were tested during the pregnancy. The multivariate analysis revealed that women from North Africa differed significantly from French women in both unawareness of screening status and the proportion who reported not being screened (odds ratio 2.1 with 95% confidence interval 1.6-2.9 and odds ratio 2.4 with 95% confidence interval 1.8-3.1, respectively). There was, however, no significant difference between women from sub-Saharan Africa and French women in these variables. A lower educational level was an important predictor of unawareness of screening status (odds ratio 2.6 with 95% confidence interval 2.0-3.4). Associations were observed between reporting of unscreened status and low levels of use of prenatal care services (<6 prenatal consultations odds ratio 1.3 with 95% confidence interval 1.0-1.6, <3 ultrasonographic examinations odds ratio 1.7 with 95% confidence interval 1.3-2.0, and no prenatal consultation at the maternity hospital odds ratio 1. 5 with 95% confidence interval 1.2-1.8).

CONCLUSION

The 1995 National Perinatal Survey, which appears to indicate extensive human immunodeficiency virus screening of pregnant women in France, shows that the nonmandatory nature of the French policy of systematically offering prenatal human immunodeficiency virus screening has not prevented a high proportion of women from learning their screening status. The less comprehensive screening among women in certain subgroups suggests that human immunodeficiency virus information should be better adapted for these women.