Cervical screening and management of cervical intraepithelial neoplasia in HIV-positive women

Danso, Dennis; Lyons, F; Bradbeer, Caroline

doi:10.1258/095646206778113087

Cited by 25 publications

(20 citation statements)

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“…An even larger proportion (81%) of women reported adhering to the recommended annual Pap test. These findings are promising, but remain less than optimal given that WLH progress more rapidly to invasive cervical cancer, and have a lower rate of treatment success and survival compared to women without HIV [14, 15]. Additional efforts to promote recommended cervical cancer screening utilization are central to the survival of WLH as prevention and control (i.e., early intervention) are most critical for this population who bear excess burden of cervical disease.…”

Section: Discussionmentioning

confidence: 99%

Assessing the Influence of Health Literacy on HIV-Positive Women’s Cervical Cancer Prevention Knowledge and Behaviors

et al. 2013

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Women living with HIV (WLH) bear a disproportionate burden of cervical cancer and may face challenges understanding health information. The purpose of this study was to assess the influence of health literacy on WLH cervical cancer screening knowledge and behaviors. WLH were recruited from clinic- and community-based settings in the southeastern USA. The majority of women completing a questionnaire assessing factors related to cervical cancer were African American (90 %). About 38 % of women reported low health literacy. Compared to women with high health literacy, these women were more likely to report having had ≥2 Pap tests during the year after HIV diagnosis (p=0.02), and less likely to have had a Pap test <1 year previously (p=0.05). There was no difference in cervical cancer or human papillomavirus knowledge among those with low versus high health literacy. Results revealed mixed finding on the influence of health literacy on screening knowledge and behaviors.

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Section: Discussionmentioning

confidence: 99%

Assessing the Influence of Health Literacy on HIV-Positive Women’s Cervical Cancer Prevention Knowledge and Behaviors

et al. 2013

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“…The prevalence of cervical neoplasia among HIV-infected women ranges from 11% to 60%, and increases with the degree of immunosuppression 5–8 . Cervical cytologic abnormalities tend to progress more rapidly to invasive cervical cancer in HIV-infected than in non-infected women 9 .…”

Section: Introductionmentioning

confidence: 99%

Cervical Pap Screening Cytological Abnormalities among HIV-Infected Adolescents in the LEGACY Cohort

Setse¹,

Siberry²,

Moss³

et al. 2012

Journal of Pediatric and Adolescent Gynecology

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Objectives To determine the prevalence of cervical Pap screening (CPAP-S), identify factors associated with CPAP-S, and explore risk factors for abnormal cervical cytology in female adolescents with perinatally and behaviorally acquired HIV infection. Design Cross-sectional Setting LEGACY is a national observational cohort chart review study of 1478 HIV-infected persons (≤ age 24 years) managed in 22 HIV specialty clinics in the United States. Participants Sexually active females aged ≥13–24 years in the LEGACY cohort Main Outcome measures CPAP-S & abnormal cervical cytology. Results Of 231 sexually active female participants (>= 13 years) in 2006, 49% had CPAP-S documented since 2001. 58% of 113 cervical tests were abnormal (2% high-grade). In multivariable analysis, perinatal HIV infection and black race were associated with decreased likelihood of CPAP-S (adjusted prevalence ratio [APR] 0.66, 95% CI 0.45, 0.96 and APR 0.74, 95% CI 0.56, 0.96, respectively). Presence of any STI was independently associated with increased likelihood of CPAP-S (APR 1.56, 95% CI 1.21, 2.02). CD4+ T-lymphocyte count <200 cells/mL and previous STI were independently associated with increased likelihood of abnormal cervical cytology (APR 2.19, 95% CI 1.26, 3.78 & APR 1.94, 95% CI 1.29, 2.92, respectively). Conclusions Among sexually active HIV-infected adolescent females, prevalence of CPAP-S was low and cytology was abnormal in more than half of Pap smears. Perinatally HIV-infected, sexually active females were less likely to undergo CPAP-S than their behaviorally HIV-infected counterparts. Interventions targeted at HIV-infected adolescents and care providers are needed to improve CPAP-S in HIV-infected young women, especially those with perinatally acquired HIV infection.

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“…Women living with HIV (WLWH) have an increased prevalence of Human Papillomavirus (HPV) infection [1,3-5], which is the main cause of ICC [1,3,6-8]. Furthermore, an increased risk of progression to cervical dysplasia and ICC is reported in WLWH compared to non-HIV-infected peers [1,3,7-11].…”

Section: Introductionmentioning

confidence: 99%

Adherence to the cervical cancer screening program in women living with HIV in Denmark: comparison with the general population

et al. 2014

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BackgroundWomen living with HIV (WLWH) are at increased risk of invasive cervical cancer (ICC). International HIV guidelines suggest cervical screening twice the first year after HIV diagnosis and thereafter annually. Adherence to the HIV cervical screening program in Denmark is unknown.MethodsWe studied women from a population-based, nationwide HIV cohort in Denmark and a cohort of age-matched females from the general population. Screening behaviour was assessed from 1999–2010. Adjusted odds ratios (OR’s) for screening attendance in the two cohorts and potential predictors of attendance to guidelines were estimated. Pathology specimens were identified from The Danish Pathology Data Bank.ResultsWe followed 1143 WLWH and 17,145 controls with no prior history of ICC for 9,509 and 157,362 person-years. The first year after HIV diagnosis 2.6% of WLWH obtained the recommended two cervical cytologies. During the different calendar intervals throughout the study period between 29-46% of WLWH followed the HIV cervical screening guidelines. Adjusted OR’s of attendance to the general population screening program for WLWH aged 30, 40 and 50 years, compared to controls, were 0.69 (95% CI: 0.56-0.87), 0.67 (0.55-0.80) and 0.84 (0.61-1.15). Predictors of attendance to the HIV cervical screening program were a CD4 count > 350 cells/μL and HIV RNA < 500 copies/mL. Calendar period after 2002 and HIV RNA < 500 copies/mL predicted attendance to the general population cervical screening program.ConclusionsThe majority of WLWH do not follow the HIV guidelines for cervical screening. We support the idea of cytology as part of an annual review and integration of HIV care and cervical screening in a single clinic setting.

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Cervical screening and management of cervical intraepithelial neoplasia in HIV-positive women

Cited by 25 publications

References 0 publications

Assessing the Influence of Health Literacy on HIV-Positive Women’s Cervical Cancer Prevention Knowledge and Behaviors

Assessing the Influence of Health Literacy on HIV-Positive Women’s Cervical Cancer Prevention Knowledge and Behaviors

Cervical Pap Screening Cytological Abnormalities among HIV-Infected Adolescents in the LEGACY Cohort

Adherence to the cervical cancer screening program in women living with HIV in Denmark: comparison with the general population

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