Women living with HIV infection are at higher risk for
cervical cancer, an AIDS-defining diagnosis. We examined the prevalence of
cervical cancer and sexually transmitted disease (STD) screening among human
immunodeficiency virus (HIV)-infected women and factors associated with the
receipt of Papanicolaou (Pap) tests.
We did a cross-sectional analysis of weighted data from a
sample of HIV-infected adults receiving outpatient medical care. We used
matched interview (report of Pap test) and medical record data (STD screenings)
from HIV-infected women. We performed logistic regression to compute adjusted
prevalence ratios and 95% confidence intervals for the association between
demographic, behavioral, and clinical factors and receipt of Pap tests among
HIV-infected women.
Data were available for 2,270 women, who represent 112,894
HIV-infected women; 62% were African American, 17% were Hispanic/Latina, and
18% were white. Most (78%) reported having a Pap test in the past year. Among
sexually active women (n = 1234), 20% reported sex without condoms, 27% were
screened for gonorrhea, and 29% were screened for chlamydia. Being screened for
STDs was less likely among women who did not have a Pap test in the past year
(adjusted prevalence ratios 0.82, 95% confidence interval 0.77-0.87). Women who
were ≥50 years of age and reported income above federal poverty level, no
sexual activity, depression, no HIV care from an obstetrician/gynecologist, and
no documented STD tests, were less likely to report a Pap test (p < 0.05).
Screening for cervical cancer and STDs among HIV-infected
women is suboptimal. Clinical visits for Pap tests are an important opportunity
for HIV-infected sexually active women to also receive STD screenings and
counseling regarding condoms.
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By:
- 1Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia .
- 2ICF International , Atlanta, GA.
- 3Rollins School of Public Health, Emory University , Atlanta, Georgia .
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