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 re quiring physicians to offer human immunodeficiency Virus screening routinel y at the beginning of prenatal care has been implemented and to explore are as in which improvement is required. STUDY DESIGN: The survey included all births in France during a 7-day perio d in February 1995. A total of 12,341 women were asked whether they knew wh ether they had undergone a human immunodeficiency virus antibody test befor e or during the pregnancy. Factors that could have influenced their knowled ge of whether they had been tested were also assessed. RESULTS: Of the women questioned, 87.3% stated that they had been tested be fore 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 tho se who said that they had not been tested before the pregnancy in question, 84.9% reported that they were tested during the pregnancy. The multivariat e analysis revealed that women from North Africa differed significantly fro m French women in both unawareness of screening status and the proportion w ho 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, respectiv ely). There was. however, no significant difference between women from sub- Saharan Africa and French women in these variables. A lower educational lev el was an important predictor of unawareness of screening status (odds rati o 2.6 with 95% confidence interval 2.0-3.4). Associations were observed bet ween reporting of unscreened status and tow levels of use of prenatal care services (<6 prenatal consultations odds ratio 1.3 with 95% confidence inte rval 1.0-1.6, <3 ultrasonographic examinations odds ratio 1.7 with 95% conf idence interval 1.3-2.0, and no prenatal consultation at the maternity hosp ital odds ratio 1.5 with 95% confidence interval 1.2-1.8). CONCLUSION: The 1995 National Perinatal Survey which appears to indicate ex tensive 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 c omprehensive screening among women in certain subgroups suggests that human immunodeficiency virus information should be better adapted for these wome n.