Journal
JOURNAL OF LOWER GENITAL TRACT DISEASE
Volume 20, Issue 1, Pages 31-37Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/LGT.0000000000000165
Keywords
HIV; cervical cancer; Pap; HPV; VIA
Categories
Funding
- Johns Hopkins University Center for AIDS Research (CFAR)
- National Institutes of Health (NIH) [P30AI094189]
- NIH [U01AI069911, UM1 A1068636]
- NIAID, National Cancer Institute (NCI), NICHD, NHLBI, NIDA, NIMH, NIA, FIC, NIGMS, NIDDK, and OAR
- NIAID, NCI, NICHD
- Lifespan/Tufts/Brown CFAR [P30AI42853]
- Miriam Hospital AIDS Clinical Trials Group [U10AI069472]
- University of Washington CFAR [5P30AI027757]
- Case Western Reserve University [CFAR 5P30AI036219]
- University of North Carolina Chapel Hill [CFAR 5P30AI050410]
- University of California San Francisco [CFAR 5P30AI027763]
- Harvard Medical School [CFAR P30AI060354]
- Albert Einstein College of Medicine [CFAR 5P30AI051519]
- NCI
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
- National Institute of Allergy and Infectious Diseases (NIAID) of the US NIH as part of the IeDEA [U01AI069911, U01AI069919]
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Objective Approximately 85% of cervical cancer cases and deaths occur in resource-constrained countries where best practices for prevention, particularly for women with HIV infection, still need to be developed. The aim of this study was to assess cervical cancer prevention capacity in select HIV clinics located in resource-constrained countries. Materials and Methods A cross-sectional survey of sub-Saharan African sites of 4 National Institutes of Health-funded HIV/AIDS networks was conducted. Sites were surveyed on the availability of cervical cancer screening and treatment among women with HIV infection and without HIV infection. Descriptive statistics and (2) or Fisher exact test were used as appropriate. Results Fifty-one (65%) of 78 sites responded. Access to cervical cancer screening was reported by 49 sites (96%). Of these sites, 39 (80%) performed screening on-site. Central African sites were less likely to have screening on-site (p = .02) versus other areas. Visual inspection with acetic acid and Pap testing were the most commonly available on-site screening methods at 31 (79%) and 26 (67%) sites, respectively. High-risk HPV testing was available at 29% of sites with visual inspection with acetic acid and 50% of sites with Pap testing. Cryotherapy and radical hysterectomy were the most commonly available on-site treatment methods for premalignant and malignant lesions at 29 (74%) and 18 (46%) sites, respectively. Conclusions Despite limited resources, most sites surveyed had the capacity to perform cervical cancer screening and treatment. The existing infrastructure of HIV clinical and research sites may provide the ideal framework for scale-up of cervical cancer prevention in resource-constrained countries with a high burden of cervical dysplasia.
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