Utilisation and outcomes of cervical cancer prevention services among HIV-infected women in Cape Town
OBJECTIVE: An audit of outcomes of cervical cancer screening and prevention services for HIV-positive women in Cape Town, South Africa. DESIGN: Retrospective review of clinic registers, patient records and pathology databases at three HIV primary health clinics and a tertiary colposcopy referral centre. SUBJECTS: Women recently diagnosed with HIV at three primary health clinics between 2006 and 2008 (N=2 240); new patients seen for colposcopy at a tertiary referral centre between 2006 and 2009 (N=2 031). OUTCOME MEASURES: The proportion of women undergoing cervical cancer screening after HIV diagnosis at primary health clinics, demographic characteristics of women referred for colposcopy at a tertiary centre, and outcomes of therapy for precancerous lesions of the cervix. RESULTS: The proportion of women undergoing at least one Pap smear at HIV primary health clinics after HIV diagnosis was low (13.1%). Women referred for colposcopy tended to be HIV-positive and over the age of 30 years, and in most (70.2%) cytological examination revealed high-grade cervical dysplasia. HIV-positive women treated with excision for precancerous lesions of the cervix were significantly more likely than their HIV-negative counterparts to undergo incomplete excision, experience persistent cervical disease after treatment, and be lost to follow-up. CONCLUSION: Cervical cancer screening efforts must be scaled up for women with HIV. Treatment and surveillance guidelines for cervical intraepithelial neoplasia in HIV-positive women may need to be revised and new interventions developed to reduce incomplete treatment and patient default
| Main Authors: | , , |
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| Format: | Digital revista |
| Language: | English |
| Published: |
South African Medical Association
2010
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| Online Access: | http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742010000100018 |
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