| Cervical screening within HIV care: findings from an HIV-positive cohort in Ukraine. | |
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MedLine Citation:
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PMID: 22545087 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: HIV-positive women have an increased risk of invasive cervical cancer but cytologic screening is effective in reducing incidence. Little is known about cervical screening coverage or the prevalence of abnormal cytology among HIV-positive women in Ukraine, which has the most severe HIV epidemic in Europe. METHODS: Poisson regression models were fitted to data from 1120 women enrolled at three sites of the Ukraine Cohort Study of HIV-infected Childbearing Women to investigate factors associated with receiving cervical screening as part of HIV care. All women had been diagnosed as HIV-positive before or during their most recent pregnancy. Prevalence of cervical abnormalities (high/low grade squamous intraepithelial lesions) among women who had been screened was estimated, and associated factors explored. RESULTS: Overall, 30% (337/1120) of women had received a cervical screening test as part of HIV care at study enrolment (median 10 months postpartum), a third (115/334) of whom had been tested >12 months previously. In adjusted analyses, women diagnosed as HIV-positive during (vs before) their most recent pregnancy were significantly less likely to have a screening test reported, on adjusting for other potential risk factors (adjusted prevalence ratio (APR) 0.62, 95% CI 0.51-0.75 p<0.01 for 1(st)/2(nd) trimester diagnosis and APR 0.42, 95% CI 0.28-0.63 p<0.01 for 3(rd) trimester/intrapartum diagnosis). Among those with a cervical screening result reported at any time (including follow-up), 21% (68/325) had a finding of cervical abnormality. In adjusted analyses, Herpes simplex virus 2 seropositivity and a recent diagnosis of bacterial vaginosis were associated with an increased risk of abnormal cervical cytology (APR 1.83 95% CI 1.07-3.11 and APR 3.49 95% CI 2.11-5.76 respectively). CONCLUSIONS: In this high risk population, cervical screening coverage as part of HIV care was low and could be improved by an organised cervical screening programme for HIV-positive women. Bacterial vaginosis testing and treatment may reduce vulnerability to cervical abnormalities. |
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Authors:
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Heather Bailey; Claire Thorne; Igor Semenenko; Ruslan Malyuta; Rostislav Tereschenko; Irina Adeyanova; Elena Kulakovskaya; Lyudmila Ostrovskaya; Liliana Kvasha; Mario Cortina-Borja; Claire L Townsend |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2012-04-24 |
Journal Detail:
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Title: PloS one Volume: 7 ISSN: 1932-6203 ISO Abbreviation: PLoS ONE Publication Date: 2012 |
Date Detail:
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Created Date: 2012-04-30 Completed Date: 2012-08-27 Revised Date: 2013-05-20 |
Medline Journal Info:
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Nlm Unique ID: 101285081 Medline TA: PLoS One Country: United States |
Other Details:
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Languages: eng Pagination: e34706 Citation Subset: IM |
Affiliation:
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MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, University College London, London, United Kingdom. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Cervix Uteri / microbiology, pathology*, virology Cohort Studies Female HIV Infections / complications*, diagnosis, epidemiology HIV-1 / isolation & purification Humans Pregnancy Ukraine / epidemiology Uterine Cervical Neoplasms / complications, diagnosis*, pathology Vaginal Smears Vaginosis, Bacterial / complications, diagnosis*, pathology Young Adult |
| Grant Support | |
ID/Acronym/Agency:
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081082//Wellcome Trust; 081082//Wellcome Trust; G0400546//Medical Research Council; //Department of Health |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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