Integrating Cervical Cancer Screening with HIV Care in Cameroon: Comparative Risk Analysis of Cervical Disease in HIV-Infected Women Receiving Antiretroviral Therapy to Women in the General Population
BACKGROUND:
While
the effect of highly active antiretroviral therapy (HAART) on natural history of
cervical lesions remains controversial, resource limited countries need to understand
the relevance of their own data to their settings. We compared the risk of cervical disease in HAART-experienced women with
that in women in the general population of Cameroon.
METHODS:
A retrospective
cross sectional survey of women aged 35 years and above, attending a voluntary screening
campaign for cervical cancer at the Nkongsamba Regional Hospital in Cameroon between
February and May 2014. Squamous intraepithelial lesions (SIL) were determined by
Pap smear. Multiple logistic
regression was used to compare the odds of SIL in women on HAART to women from the
community with unknown HIV status.
RESULTS:
Included were
302 women of whom 131(43.4%) were HIV-infected and receiving HAART on the site while 171
(56.6%) were women from the community. Cervical disease was observed in 51(16.9%)
persons of whom 15 (11.5%) cases in the HAART group and 36 (21.1%) cases in the
general group (p = 0.027). After controlling for age and other covariates, women
in the HAART group had a 67% reduction in the odds of cervical lesions compared
with the community group [adjusted odd ratio (aOR) = 0.33, 95%CI: 0.15-0.73, p =
0.006).
CONCLUSION:
HIV-infected women receiving HAART have a lower risk of cancer than women in the general population. This
finding may not be attributed to HAART alone but to all the health benefits derived
from receiving a comprehensive HIV care.
Below: Prevalence of abnormal Pap smear cytology in the study groups
- 1Centre Médical d'Arrondissement de Baré, Nkongsamba, Cameroon.
- 2International Training & Education Center for Health (I-TECH), Seattle, United States of America.
- 3Regional Hospital of Nkongsamba, Nkongsamba, Cameroon.
- 4University Teaching Hospital, Yaounde, Cameroon.
- 5Department of Public Health, University of Douala, Douala, Cameroon.
- PLoS One. 2016 Feb 11;11(2):e0149152. doi: 10.1371/journal.pone.0149152. eCollection 2016.
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