ArticleSexually transmitted diseases2019
Integrating Cervical Cancer Screening Into Safer Conception Services to Improve Women's Health Outcomes: A Pilot Study at a Primary Care Clinic in South Africa.
Article in Sexually transmitted diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.
- Interventions and Strategies to Increase Cervical Cancer Screening, Treatment, and Retention in Care among Persons with HIV in Low- and Middle-Income Countries: A Systematic Review.AIDS and behavior · 2025Pooled it
- Factors Associated With Cervical Cancer Awareness Among Women of Reproductive Age in the Democratic Republic of the Congo: Evidence From a Nationwide DHS Analysis.Cancer reports (Hoboken, N.J.) · 2026Article
- Health System Strategies to Improve the Uptake of Cervical Cancer Screening in Sub-Saharan Africa: A Scoping Systematic Review.Health promotion practice · 2026Article
- Strategies to integrate non-communicable disease interventions in HIV and tuberculosis care contexts in low- and middle-income countries: a scoping review.BMJ global health · 2026Article
- The relationship between rural residence and cervical cancer screening in three sub-Saharan countries with different national screening policies.BMJ global health · 2025Article
- Integration of cervical cancer screening into healthcare facilities in low- and middle-income countries: A scoping review.PLOS global public health · 2024Article
- Baseline assessment of cervical cancer screening and treatment capacity in 25 counties in Kenya, 2022.Frontiers in oncology · 2024Article
- Facilitators and Barriers to HPV Self-Sampling as a Cervical Cancer Screening Option among Women Living with HIV in Rural Uganda.International journal of environmental research and public health · 2023Article
- A Framework for Cervical Cancer Elimination in Low-and-Middle-Income Countries: A Scoping Review and Roadmap for Interventions and Research Priorities.Frontiers in public health · 2021Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSub-optimal cervical cancer screening in low- and middle-income countries contributes to preventable cervical cancer deaths, particularly among human immunodeficiency virus (HIV)-positive women. We assessed feasibility and outcomes of integrating cervical cancer screening into safer conception services for HIV-affected women.
methodsAt a safer conception service in Johannesburg, South Africa, HIV-affected women desiring pregnancy received a standard package of care designed to minimize HIV transmission risks while optimizing prepregnancy health. All eligible women were offered Papanicolaou smear, and those with significant pathology were referred for colposcopy before attempting pregnancy. Multivariable analyses identified associations between patient characteristics and abnormal pathology.
resultsIn total, 454 women were enrolled between June 2015 and April 2017. At enrolment, 91% were HIV-positive, 92% were on antiretroviral therapy (ART) and 82% virally suppressed. Eighty-three percent (376 of 454) of clients were eligible for cervical cancer screening and 85% (321 of 376) of these completed screening. More than half had abnormal cervical pathology (185 of 321) and 20% required colposcopy for possible high-grade or persistently atypical lesions (64 of 321). Compared with HIV-negative women, abnormal pathology was more likely among HIV-positive women, both those on ART <2 years (adjusted prevalence ratio, 2.5; 95% confidence interval, 1.2-5.0) and those on ART 2 years or longer (adjusted prevalence ratio, 2.1; 95% confidence interval, 1.0-4.2).
conclusionsIntegrating cervical cancer screening into safer conception care was feasible with high coverage, including for HIV-positive women. Significant pathology, requiring colposcopy, was common, even among healthy women on ART. Safer conception services present an opportunity for integration of cervical cancer screening to avert preventable cancer-related deaths among HIV-affected women planning pregnancy.
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