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Risk factors for HIV-1 infection among pregnant women in French Guiana.

Surveillance data on HIV-1 seroprevalence among pregnant women in French Guiana revealed substantial ethnic group differences. A retrospective record review was conducted of all 8143 deliveries at the countrys gynecology and obstetrics centers in 1994 and 1995. Among the 8082 pregnant women tested for HIV-1 105 (1.3%) were seropositive. HIV seroprevalence was significantly higher among pregnant women from Haiti (68/1492 or 4.56%) and Guyana (7/318 or 2.2%) than in other ethnic groups. There were no cases of HIV infection among Chinese French Amerindian or Surinamian women. Seroprevalence was higher in urban areas (1.66%) than rural areas (0.38%) but this association lost significance after control for ethnicity. HIV prevalence increased with age but this trend was significant only among Haitian women. Parity above 4 and gravidity above 2 were associated with an increased risk of HIV-1; however this association also lost significance after adjustment for age. Of the 81 HIV-positive women for whom risk factor data were available 4 were prostitutes 71 had multiple sex partners during the preceding 10 years and 1 was an intravenous drug user. The differential HIV rate by ethnic group presumably reflects poor intraethnic mixing due to sociocultural and geographic factors. Although this low level of mixing has protected some communities from HIV national policy should seek to control the spread of infection among all residents of French Guiana.