ArticlePloS one2013
Validation of cervical cancer screening methods in HIV positive women from Johannesburg South Africa.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 73 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
73 citing papers in PubMed, 3 syntheses or guidelines pooled it, 120 citations in OpenAlex.
- Prevention of cervical cancer in HIV-seropositive women from developing countries through cervical cancer screening: a systematic review.Systematic reviews · 2018Pooled it
- Noncommunicable diseases among HIV-infected persons in low-income and middle-income countries: a systematic review and meta-analysis.AIDS (London, England) · 2018Pooled it
- Cervical cancer prevention and treatment research in Africa: a systematic review from a public health perspective.BMC women's health · 2016Pooled it
- A Qualitative Exploration of Barriers to Treatment Among HPV-Positive Women in a Cervical Cancer Screening Study in Western Kenya.The oncologist · 2023Trial
- A Randomized Clinical Trial of Human Papillomavirus Test-and-Treat as Compared to Cytology-Based Screening for Prevention of Cervical Cancer Among Women With Human Immunodeficiency Virus: AIDS Clinical Trials Group Protocol A5282.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Trial
- Human Papillomavirus Vaccination Prior to Loop Electroexcision Procedure Does Not Prevent Recurrent Cervical High-grade Squamous Intraepithelial Lesions in Women Living With Human Immunodeficiency Virus: A Randomized, Double-blind, Placebo-controlled Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Trial
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- Bridging the gap: exploring healthcare professionals' perceptions and barriers towards cervical cancer screening services uptake amongst women in rural communities.Journal of the Egyptian National Cancer Institute · 2026Article
- Single visit screen-triage-treat strategy using GeneXpert-based HPV testing of self-collected cervicovaginal samples and thermal ablation treatment for cervical cancer prevention among women in Lilongwe, Malawi.International journal of cancer · 2026Article
- Digital cervicography using mobile phones with real-time consultation (DCRC) to improve performance of Visual Inspection with Acetic Acid (VIA) in cervical cancer screening of HIV-infected women. A cross-sectional study.Gynecologic oncology reports · 2025Article
- The performance of single and combination test strategies using visual inspection, cytology, high-risk HPV DNA and HPV16/18 to screen South African women with and without HIV-infection.Infectious agents and cancer · 2024Article
- Accuracy of screening tests for cervical precancer in women living with HIV in low-resource settings: a paired prospective study in Lusaka, Zambia.BMJ oncology · 2024Article
- Feasibility of adjuvant self-administered intravaginal 5-fluorouracil cream following primary treatment of cervical intraepithelial neoplasia grade 2 or 3 among women living with HIV in Kenya: study protocol for a pilot trial.medRxiv : the preprint server for health sciences · 2023Article
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- Diagnostic accuracy of cervical cancer screening strategies for high-grade cervical intraepithelial neoplasia (CIN2+/CIN3+) among women living with HIV: A systematic review and meta-analysis.EClinicalMedicine · 2022Article
- Modelling cervical cancer elimination using single-visit screening and treatment strategies in the context of high HIV prevalence: estimates for KwaZulu-Natal, South Africa.Journal of the International AIDS Society · 2022Article
- The IARC Perspective on Cervical Cancer Screening.The New England journal of medicine · 2021Article
- Cervical cancer prevention and control in women living with human immunodeficiency virus.CA: a cancer journal for clinicians · 2021Review
13 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundHIV-infected women are at increased risk for developing cervical cancer. Women living in resource-limited countries are especially at risk due to poor access to cervical cancer screening and treatment. We evaluated three cervical cancer screening methods to detect cervical intraepithelial neoplasia grade 2 and above (CIN 2+) in HIV-infected women in South Africa; Pap smear, visual inspection with 5% acetic acid (VIA) and human papillomavirus detection (HPV).
methodsHIV-infected women aged 18-65 were recruited in Johannesburg. A cross-sectional study evaluating three screening methods for the detection of the histologically-defined gold standard CIN-2 + was performed. Women were screened for cervical abnormalities with the Digene HC2 assay (HPV), Pap smear and VIA. VIA was performed by clinic nurses, digital photographs taken and then later reviewed by specialist physicians. The sensitivity, specificity and predictive valves for CIN-2 + were calculated using maximum likelihood estimators.
results1,202 HIV-infected women participated, with a median age of 38 years and CD4 counts of 394 cells/mm(3). One third of women had a high grade lesion on cytology. VIA and HPV were positive in 45% and 61% of women respectively. Estimated sensitivity/specificity for HPV, Pap smear and VIA for CIN 2+ was 92%/51.4%, 75.8%/83.4% and 65.4/68.5% (nurse reading), respectively. Sensitivities were similar, and specificities appeared significantly lower for the HPV test, cytology and VIA among women with CD4 counts ≤200 cells/mm(3) as compared to CD4 counts >350 cells/mm(3).
conclusionsAlthough HPV was the most sensitive screening method for detecting CIN 2+, it was less specific than conventional cytology and VIA with digital imaging review. Screening programs may need to be individualized in context of the resources and capacity in each area.
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Registered trials
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