Introduction Women living with human immunodeficiency virus (HIV) have an increased risk of persistent human papillomavirus infection (HPV) of developing cervical cancer precursors and are, therefore, considered at higher risk for cervical cancer. Despite the higher risk, screening for cervical cancer is extremely low among HIV-positive women in India. Objectives Given the limited usefulness of cytology-based screening programs, the current study retrospectively evaluated the comparative performance of visual inspection with 5% acetic acid (VIA), conventional cytology, and human papillomavirus (HPV) testing among HIV-positive women attending the cancer screening clinic at the tertiary cancer center. Materials and Methods Retrospective analysis of 291 HIV-positive women attending cervical cancer screening services in a tertiary cancer center in Mumbai was undertaken. All underwent simultaneous screening with VIA, Pap cytology, and HPV DNA testing, followed by diagnostic colposcopy and histopathology. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) to detect cervical intraepithelial neoplasia (CIN) 2/3 on histology were estimated. Results The screen positivity rate for cervical cancer screening by VIA, high-risk HPV DNA, and Pap cytology was 35.7, 34.4, and 6.2% respectively. At the CIN2+ disease threshold, the sensitivity, specificity, PPV, and NPV estimates were 80.00% (59.30–93.17), 68.42% (62.46–73.96), 19.23% (15.46–23.67), 97.33% (94.30–98.77) for VIA; 80.00% (68.78–97.45), 70.68% (64.81–76.08), 22.00% (18.22–26.32), 98.43% (95.58–99.45) for HPV DNA; and 64.00% (42.52–82.03), 98.12% (95.67–99.39), 76.19% (56.13–88.89), 96.67% (94.50–98.00) for cytology (HSIL cutoff). Conclusion The diagnostic performance of VIA and HPV DNA was comparable and better than cytology indicating that VIA as a cost-effective cervical cancer screening test can be incorporated within the services under sexually transmitted diseases /HIV testing and counseling centers within the country.

Background: Road traffic accidents (RTAs) pose a significant burden on the health care system in India with high out of pocket medical expenditure. Awareness about this public health problem is necessary to combat it and this study was carried out to assess knowledge and practice towards road safety among the adult population in the coastal region of Udupi taluk in Karnataka. Methods: A cross-sectional survey was carried out among 381 adults aged 18 years and above residing in the region for more than one year. A semi-structured questionnaire was used to assess their knowledge and practice towards road safety measures. Results: Most of the participants were in the age bracket of 18-44 years (61.4%), were females (65.1 %) and had up to 10 years of schooling. Overall knowledge was found to be low with only 30% reporting good knowledge. As regards practice, drivers fared better with a good majority (87%) reporting desirable practice. Younger age (OR=0.57, 95% CI, 0.36-0.92), male gender (OR=0.14, 95% CI, 0.08-0.23), higher level of schooling (OR=0.32, 95% CI, 0.20 -0.50) and knowing to drive (OR=0.04, 95% CI, 0.02-0.07) were found to be significantly associated with a greater level of knowledge regarding road safety measures. Conclusions: The study showed inadequate knowledge and poor road safety practices among good number of participants. This emphasises the need for a customized community based awareness campaign on road safety measures coupled with stringent legislation measures to bring about the desired change.

No abstract