Improving cervical cancer screening rates in an urban HIV clinic

Abstract

HIV-infected women are at increased risk of invasive cervical cancer, however screening rates remain low. The objectives of this study were to analyze a quality improvement intervention to increase cervical cancer screening rates in an urban academic HIV clinic and to identify factors associated with inadequate screening. Barriers to screening were identified by a multi-disciplinary quality improvement committee at the Washington University Infectious Diseases clinic. Several strategies were developed to address these barriers. The years pre- and post-implementation were analyzed to examine the clinical impact of the intervention. A total of 422 women were seen in both the pre-implementation and post-implementation periods. In the pre-implementation period, 222 women (53%) underwent cervical cancer screening in the form of Papanicolaou (Pap) testing. In the post-implementation period, 318 women (75.3%) underwent cervical cancer screening (p<0.01). Factors associated with lack of screening included fewer visits attended (pre: 4.2 ± 1.5; post: 3.4 ± 1.4; p<0.01). A multidisciplinary quality improvement intervention was successful in overcoming barriers and increasing cervical cancer screening rates in an urban academic HIV clinic.

Knowledge, attitude, and practice of cervical cancer screening among women living with HIV in the Kilimanjaro region, northern Tanzania

“…25 This study's estimate is lower than that of those from high-income countries. [37][38][39] This difference can be due to delayed integration of cervical cancer screening programs with CTC services in Tanzania compared to high resourced countries. 31 Advice from health care providers was the main reason for cervical cancer screening among women in this study, as reported in other studies.…”

“…25 This study's estimate is lower than that of those from high‐income countries. 37 , 38 , 39 This difference can be due to delayed integration of cervical cancer screening programs with CTC services in Tanzania compared to high resourced countries. 31 …”

Prevalence and correlates of cervical HPV infection in a clinic-based sample of HIV-positive Hispanic women

“…Longitudinal HIV care may improves access to cancer care, however, Pap test is still underutilized among HIV-positive women [20] , [21] , [22] , [23] . Thus, efforts should continue to increase Pap test screening in this population, as well as the compliance with recent screening guidelines for female PLWHA from the American College of Obstetricians and Gynecologists [24] , which include HPV testing.…”

Cervical cancer screening among women living with HIV: a cross-sectional study using the baseline questionnaire data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS)

“…OPEN Research intervals to every 3 years following 3 consecutive Pap smears with normal results, and they included consideration of HPV cotesting, where available, for women with HIV who are older than 30 years. 21 Previous studies in high-income countries reported that only 29%-58% of women with HIV had been screened for cervical cancer in the previous 1-3 years, [22][23][24][25] with higher HIV viral loads and lower CD4 counts associated with longer delays. 24 Our primary objectives were to measure the prevalence of self-reported adherence to cervical cancer screening among women with HIV in Canada and to identify factors associated with delays in cervical cancer screening.…”