UK national audit of sexual health care for people with HIV infection: case-notes audit

Carne, C A; McClean, Hugo; Bunting, Paul; Wilkins, E. H.; Tucker, Linda; Baguley, Steve; Daniels, David; Hiv,

doi:10.1258/095646207781568547

Cited by 11 publications

(9 citation statements)

References 3 publications

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“…A 2007 UK national audit found that 73% HIV-infected women had documented annual smears. 4 Our results were comparable (68% within 12 months, 84% within 18 months). Renal patients had a lower uptake (40% within 12 months, 56% within 18 months) and median recency (2.36 years) double that of HIV-infected women.…”

Section: Discussionsupporting

confidence: 61%

Cervical screening uptake in immunocompromised women in Waikato, New Zealand

Lim

Morgan

Fielding³

2010

Int J STD AIDS

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A one-year retrospective case study was undertaken of cervical cytology in two cohorts of immunocompromised women: those with HIV infection or renal transplants in the Waikato region of New Zealand. Uptake of cervical screening in the two groups was compared with national guidelines. The results showed that HIV patients' uptake was close to the national recommendation for annual cytology (84% had a smear in 18 months); they were more likely to have cytology performed in an HIV-related care setting. Renal transplant patients had lower uptake (56% in 18 months), a finding similar to internationally reported data. Local discussions of these results identified potential influencing factors, which included inadequate dissemination of updated guidelines and inadequate documentation of immunocompromised health status on the national cervical screening programme database. This audit supports including cervical cytology as part of an annual review in all immunocompromised patients.

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Section: Discussionsupporting

confidence: 61%

Cervical screening uptake in immunocompromised women in Waikato, New Zealand

Lim

Morgan

Fielding³

2010

Int J STD AIDS

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“…Almost all (99%; 71/72) sexually active women in our group admitted to using some mode of contraception, with 25% (18/72) of sexually active women and 15.8% (18/114) overall using LARC. This is higher than LARC usage in the general population, which was reported as 9% in 2006/2007, 9 and nationally for HIV-positive women from the case-notes audit 10 where LARC methods were used in 10%. A national clinical guideline 11 emphasizes the cost-effective role of LARC methods in reducing unplanned pregnancy and advocates the availability of LARC to all women of reproductive age in the UK.…”

Section: Discussionmentioning

confidence: 81%

A survey of the sexual and reproductive health of HIV-positive women in Leicester

Moses

Dhar

2012

Int J STD AIDS

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This project reports results from a questionnaire survey of sexual practices, contraception use and pregnancy plans in HIV-positive women in Leicester, UK, in order to establish the need for a dedicated sexual and reproductive health (SRH) clinic. The majority (96%) of women were aware of the benefits of antiretroviral therapy (ART) in pregnancy and 39% were planning a future pregnancy. Most (74%) used condoms consistently but their use decreased with the addition of another contraceptive method. Condoms were mostly obtained from non-National Health Service (NHS) settings. Long-acting reversible contraception (LARC) use was higher in this group of women than the general population and mainly provided by family planning services. A dedicated SRH clinic was thought to be useful by 79% of women. Data also identified some limitations of the existing service and need to provide holistic and integrated care.

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“…Two register-based studies from New Zealand and the UK both found a relatively high coverage of cervical screening of 68% and 74%, respectively, within the previous 12 months [33,34]. However, in New Zealand the annual review for WLWH included the option of having cervical cytology performed at the sexual health clinic when attending for HIV-related care.…”

Section: Discussionmentioning

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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UK national audit of sexual health care for people with HIV infection: case-notes audit

Cited by 11 publications

References 3 publications

Cervical screening uptake in immunocompromised women in Waikato, New Zealand

Cervical screening uptake in immunocompromised women in Waikato, New Zealand

A survey of the sexual and reproductive health of HIV-positive women in Leicester

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

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