Background: Worldwide, nearly 570,000 women are diagnosed with cervical cancer each year, with 85% of new cases in low-and middle-income countries. The African continent is home to 35 of 40 countries with the highest cervical cancer mortality rates. In 2014, a partnership involving a rural region of Senegal, West Africa, was facing cervical cancer screening service sustainability barriers and began adapting regional-level policy to address implementation challenges. Objective: This manuscript reports the findings of a systematic literature review describing the implementation of decentralized cervical cancer prevention services in Africa, relevant in context to the Senegal partnership. We report barriers and policy-relevant recommendations through Levesque's Patient-Centered Access to Healthcare Framework and discuss the impact of this information on the partnership's approach to shaping Senegal's regional cervical cancer screening policy. Methods: The systematic review search strategy comprised two complementary subsearches. We conducted an initial search identifying 4272 articles, then applied inclusion criteria, and ultimately 19 studies were included. Data abstraction focused on implementation barriers categorized with the Levesque framework and by policy relevance. Results: Our findings identified specific demand-side (clients and community) and supplyside (health service-level) barriers to implementation of cervical cancer screening services. We identify the most commonly reported demand-and supply-side barriers and summarize salient policy recommendations discussed within the reviewed literature. Conclusions: Overall, there is a paucity of published literature regarding barriers to and best practices in implementation of cervical cancer screening services in rural Africa. Many articles in this literature review did describe findings with notable policy implications. The Senegal partnership has consulted this literature when faced with various similar barriers and has developed two principal initiatives to address contextual challenges. Other initiatives implementing cervical cancer visual screening services in decentralized areas may find this contextual reporting of a literature review helpful as a construct for identifying evidence for the purpose of guiding ongoing health service policy adaptation.

HIV counseling and testing are the first steps to diagnosing and managing HIV infection. This article describes factors associated with HIV testing and counseling in prisons with different policies for HIV testing (voluntary, during medical evaluation; voluntary, during peer-led class; mandatory) and counseling (all counseled, or pretest counseling not required and posttest for positive only). Prisoner testing rates were 46% “voluntary, peer-led”, 78% “mandatory”, and 86% “voluntary, medical.” Less than 50% received any counseling. Results suggest the potential value of coordinating HIV and STD/hepatitis services across all policies. Risk behaviors or demographic factors were only associated with one testing or one counseling policy. Prisons can achieve high rates of HIV testing by routinely offering voluntary HIV testing during the medical intake process, and this may result in increased diagnosis of HIV infection.

Backgrounds: Cervical cancer (CC) is one of the leading cause of death in women worldwide, HPV infection is the major risk factor in the disease development, 0and however other risk factor such as chemical carcinogens, genetic susceptibility and altered immune system are also a cause of the disease progression. In the light of the above statement we studied the base excision repair pathway (BER). Methods: We identified and studied the association of Single Nucleotide polymorphisms in the DNA repair genes of XRCC1 ( Arg194Trp, Arg399G ,) and APE-1Asp/148Glu to the susceptibility of cervical cancer (CC) in North Indian population. In our study of cases (n=102). Controls (n=109) were recruited from among women without cervical abnormalities. Genotypes were determined by PCR-CTPP method, Taking DNA from peripheral blood in a case control study. Results: A positive association was observed between the polymorphisms of XRCC1 genes, that is, in codons 194 (P=0.03, odds ratio (OR) =2.39, 95% confidence interval (CI)=5.2–1.1), 280 (P=0.01, OR=4.1, 95% CI=11.5–1.3) and 399 (P=0.01, OR=3.4, 95% CI=8.6–1.3) while APE-1 genotype GG (p=0.03,odds ratio(OR)=0.2,95% confidence interval (CI)=0.97-0.004) we observed a statistically significant protective role in developing cervical cancer. Conclusion: Our results suggested that, XRCC1 gene is an important candidate gene for susceptibility to cervical cancer. Although the sample size was small, the present study indicate a statistical association between cervical cancer and XRCC1 SNPs . Future studies are needed that may provide a better understanding of the association between gene polymorphism and cervical carcinoma risk.

The rates of HIV, STD, and hepatitis infection are high among persons entering prisons, and many of these persons engage in high-risk behaviors after release. Therefore, innovative programs that reduce risk behaviors after release are urgently needed. Project START developed and evaluated two interventions designed for young men leaving prison. This article describes both interventions: the single-session intervention and the enhanced intervention. The single-session intervention focused on HIV/STD/hepatitis prevention only. The enhanced intervention consisted of two prerelease and four postrelease sessions that focused on HIV/STD/hepatitis prevention and more broadly on health and reintegration into the community. Specific procedures used to implement the interventions in correctional settings are described. Process data describing intervention attendance and fidelity to the intervention protocols are presented. Implications for future intervention studies are discussed.

Objectives Cervical cancer (CC) is one of the most destructive disease caused by persistent HPV infection which affects women worldwide, especially in developing countries. The genetic basis of host immune response especially cytokine function has been shown to influence CC susceptibility. Studies have demonstrated that IL-10 gene polymorphism have been associated with numerous malignancies, but in context to CC results were inconclusive. Though, aim of our study to investigate the association between IL-10 -1082A/G and -819C/T promoter polymorphism and CC susceptibility. Material and Methods This study comprised 192 women with CC and 200 controls. HPV detection was done by RT-PCR and genotyping was assessed through PCR-RFLP method. Serum concentration of IL-10 measured by ELISA. Results Women with AG and AG+GG genotypes of IL-10 -1082A/G had two-fold increased risk of CC [OR, 2.35 (95% CI, 1.54–3.58), p = 0.005], [OR, 2.03 (95% CI, 1.36–3.04), p = 0.0005] compared to controls. Women with G allele of -1082A/G polymorphism had linked with CC susceptibility [OR, 1.39 (95% CI, 1.02–1.88), p = 0.036] compared to controls. No significant difference was found between patients and controls in the genotype or allele frequencies of IL–10 -819C/T polymorphism [OR, 1.00 (95% CI, 0.63–1.58), p = 0.99]. The level of serum concentration of IL-10 was significantly higher in cases compared to controls. Conclusion These findings help to understand that polymorphism of IL-10 -1082A/G gene is associated with increased risk of CC development and can serve as a marker of genetic susceptibility to CC.