Santé publique France, French national public health agency, Saint-Maurice, France.
Université de Paris, CRESS, INSERM, INRA, Paris, France.
Euro Surveill. 2019 Oct;24(40). doi: 10.2807/1560-7917.ES.2019.24.40.1800573.
BackgroundUniversal antenatal HIV screening programmes are an effective method of preventing mother-to-child transmission.AimsTo assess the coverage and yield of the French programme on a nationally representative sample of pregnant women, and predictive factors for being unscreened or missing information on the performance/ result of a HIV test.MethodsData came from the medical records of women included in the cross-sectional 2016 French National Perinatal Survey. We calculated odds ratios (OR) to identify factors for being unscreened for HIV and for missing information by multivariable analyses.ResultsOf 13,210 women, 12,782 (96.8%) were screened for HIV and 134 (1.0%) were not; information was missing for 294 (2.2%). HIV infection was newly diagnosed in 19/12,769 (0.15%) women screened. The OR for being unscreened was significantly higher in women in legally registered partnerships (OR: 1.3; 95% CI: 1.1-1.6), with 1-2 years of post-secondary schooling (OR: 1.6; 95% CI: 1.2-2.1), part-time employment (OR: 1.4; 95% CI: 1.1-1.8), inadequate antenatal care (OR: 1.9; 95% CI: 1.5-2.4) and receiving care from > 1 provider (OR: 1.8; 95% CI: 1.1-2.8). The OR of missing information was higher in multiparous women (OR: 1.4; 95% CI: 1.2-1.5) and women cared for by general practitioners (OR: 1.4; 95% CI: 1.1-1.9).ConclusionsThe French antenatal HIV screening programme is effective in detecting HIV among pregnant women. However, a few women are still not screened and awareness of the factors that predict this could contribute to improved screening levels.
普遍的产前 HIV 筛查计划是预防母婴传播的有效方法。
在全国代表性的孕妇样本中评估法国计划的覆盖率和效果,并评估未接受 HIV 筛查或 HIV 检测结果/结果信息缺失的预测因素。
数据来自 2016 年法国全国围产期调查的女性医疗记录。我们通过多变量分析计算比值比(OR)来确定未接受 HIV 筛查和 HIV 检测结果/结果信息缺失的因素。
在 13210 名女性中,有 12782 名(96.8%)接受了 HIV 筛查,有 134 名(1.0%)未接受筛查;有 294 名(2.2%)信息缺失。在接受筛查的 12769 名女性中,新诊断出 19 例 HIV 感染(0.15%)。在法律上登记为伴侣的女性、接受过 1-2 年中学后教育的女性、兼职工作的女性、产前保健不足的女性和接受超过 1 名提供者护理的女性,未接受 HIV 筛查的可能性显著更高(OR:1.3;95%CI:1.1-1.6),(OR:1.6;95%CI:1.2-2.1),(OR:1.4;95%CI:1.1-1.8),(OR:1.9;95%CI:1.5-2.4)和(OR:1.8;95%CI:1.1-2.8)。多产妇和由全科医生护理的女性,其信息缺失的 OR 更高(OR:1.4;95%CI:1.2-1.5)和(OR:1.4;95%CI:1.1-1.9)。
法国产前 HIV 筛查计划在检测孕妇中的 HIV 方面是有效的。然而,仍有少数女性未接受筛查,对预测这些因素的认识有助于提高筛查水平。