Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2026
Adherence to cervical screening and follow-up care in HIV-positive women at a Canadian tertiary care centre.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Foote Rachel, Julkipli Julia, Alanazi Alhanouf, Bishara Ahmed, BuMurah Noor, Azizam Nor Azmaniza, Adams Janica, Silverman Michael, Shahmirzadi MohammadReza Rahimi
Аннотация
BACKGROUND: Women with HIV are at a significantly increased risk of developing cervical cancer. However, adherence to cervical screening guidelines remains suboptimal.The objective was to assess adherence to Pap test initial screening and follow-up at St. Joseph's Hospital (SJH) in London, Ontario, and to analyze their association with sociodemographic characteristics.
METHODS: A retrospective cohort study was conducted of women with HIV ≥21 years of age who were attending SJH's HIV clinic between 2015 and 2024. Medical records were reviewed to determine Pap test completion at HIV diagnosis, follow-up adherence, and management of abnormal results.
RESULTS: Of 235 women identified, 211 were included. Only 29% (n = 62) underwent Pap testing at the time of HIV diagnosis. Among 148 women with normal initial cytology, only 28 (19%) completed three consecutive annual follow-up screenings. Thirty-four women (17%) had atypical squamous cells of undetermined significance (ASC-US) results, of whom 29 (85%) underwent appropriate repeat cytology within 6 to 12 months. Fifty-three women (27%) were diagnosed with low-grade squamous intraepithelial lesion (LSIL) or higher-grade lesions, and 42 (79%) were appropriately referred for colposcopy. Adherence to cervical screening was positively associated with year of HIV diagnosis (p < 0.001); an association with history of injection drug use was observed in unadjusted analyses (p = 0.018), but did not persist in post-hoc analysis.
CONCLUSIONS: Substantial gaps exist in cervical cancer screening and follow-up among women with HIV. Despite guideline recommendations, less than one-third of patients in our cohort received Pap test at the time of HIV diagnosis, and long-term follow-up adherence was low. Enhanced system-based interventions are required to improve screening continuity and outcomes in this high-risk population.
METHODS: A retrospective cohort study was conducted of women with HIV ≥21 years of age who were attending SJH's HIV clinic between 2015 and 2024. Medical records were reviewed to determine Pap test completion at HIV diagnosis, follow-up adherence, and management of abnormal results.
RESULTS: Of 235 women identified, 211 were included. Only 29% (n = 62) underwent Pap testing at the time of HIV diagnosis. Among 148 women with normal initial cytology, only 28 (19%) completed three consecutive annual follow-up screenings. Thirty-four women (17%) had atypical squamous cells of undetermined significance (ASC-US) results, of whom 29 (85%) underwent appropriate repeat cytology within 6 to 12 months. Fifty-three women (27%) were diagnosed with low-grade squamous intraepithelial lesion (LSIL) or higher-grade lesions, and 42 (79%) were appropriately referred for colposcopy. Adherence to cervical screening was positively associated with year of HIV diagnosis (p < 0.001); an association with history of injection drug use was observed in unadjusted analyses (p = 0.018), but did not persist in post-hoc analysis.
CONCLUSIONS: Substantial gaps exist in cervical cancer screening and follow-up among women with HIV. Despite guideline recommendations, less than one-third of patients in our cohort received Pap test at the time of HIV diagnosis, and long-term follow-up adherence was low. Enhanced system-based interventions are required to improve screening continuity and outcomes in this high-risk population.