Pierre-Yves Geoffard ^1* Florence Jusot ² Antoine Sireyjol ³ Josiane Warszawski ⁴ Nathalie Bajos ³

• ¹ Paris School of Economics, Paris, France
• ² UMR8007 Laboratoire d’Economie de Dauphine (LEDA), Paris, Ile-de-France, France
• ³ INSERM U997 Institut de recherche interdisciplinaire sur les enjeux sociaux Sciences sociales, Politique, Santé (IRIS), Paris, Île-de-France, France
• ⁴ INSERM U1018 Centre de Recherche en Épidémiologie et Santé des Populations (CESP), Villejuif, Île-de-France, France

Testing for COVID-19 has been strongly recommended for individuals experiencing COVID-19like symptoms or those with a close relative who tested positive. In France, tests were free of charge and became widely available after June 2020. Our main objective was to investigate whether access to COVID-19 testing in France was associated with socioeconomic conditions, considering gender and ethno-racial status.A random population-based cohort survey was conducted in France in May 2020 and November 2020, including 95,388 participants aged 18 and over. We used logistic regressions to identify how having been tested in 2020 was associated with socio-economic status and exposure factors among two groups of individuals. The first group consisted of individuals who had no close relative test positive but reported Covid-19-like symptoms (N=12,729). The second group included individuals who reported that a close relative had tested positive for Covid-19 (N=5,360).In both groups, testing was more frequent among individuals living in urban areas. For individuals who had no close relative test positive but reported Covid-19-like symptoms, women were 1.04 (95%CI [1.01-1.06]) more likely than men to be tested, and testing decreased with age up to 35. Individuals holding a university degree were 1.08 [1.04-1.12]) more likely than those who only completed high school to be tested, as well as those in one of the three top income deciles with reference to the bottom decile (OR 1.07,[1.02-1.13] for the top decile). Ethno-racial status was not significantly associated with testing. For respondents who had a close relative test positive, testing was strongly associated with having experienced some symptoms, especially after September 1 (OR 1.34,[1.30-1.39]). However, there was no link between testing and income, education, or ethno-racial status. The availability of tests at no cost is not sufficient in itself to eliminate socio-economic inequalities in testing.