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产前 HIV 筛查:法国 2016 年全国围产儿调查结果。

Antenatal HIV screening: results from the National Perinatal Survey, France, 2016.

机构信息

Santé publique France, French national public health agency, Saint-Maurice, France.

Université de Paris, CRESS, INSERM, INRA, Paris, France.

出版信息

Euro Surveill. 2019 Oct;24(40). doi: 10.2807/1560-7917.ES.2019.24.40.1800573.

Abstract

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.

摘要

背景

普遍的产前 HIV 筛查计划是预防母婴传播的有效方法。

目的

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。

方法

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。

结果

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)。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4142/6784449/4c81d8e096b6/1800573-fa.jpg

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