Evidence map›Paper›PMID 32881999›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021

Primary HPV and Molecular Cervical Cancer Screening in US Women Living With Human Immunodeficiency Virus.

Howard D Strickler, Marla J Keller, Nancy A Hessol, Isam-Eldin Eltoum, Mark H Einstein, Philip E Castle, L Stewart Massad, Lisa Flowers, Lisa Rahangdale, Jessica M Atrio and 18 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 3 pooled it
0.9field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 3 syntheses or guidelines pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Article
  6. Observational
  7. HIV Infections and Prevention in Women.Clinical obstetrics and gynecology · 2025
    Review
  8. Article
  9. Article
  10. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

28 authors at 13 institutions in 1 country.

Howard D StricklerAlbert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.
Marla J KellerAlbert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.
Nancy A HessolUniversity of California, San Francisco, California, USA.
Isam-Eldin EltoumUniversity of Alabama, Birmingham, Alabama, USA.
Mark H EinsteinRutgers New Jersey Medical School, Newark, New Jersey, USA.
Philip E CastleAlbert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.ORCID 0000-0003-1082-6554
L Stewart MassadWashington University, St. Louis, Missouri, USA.
Lisa FlowersEmory University School of Medicine, Atlanta, Georgia, USA.
Lisa RahangdaleUniversity of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Jessica M AtrioAlbert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.
Catalina RamirezUniversity of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Howard MinkoffMaimonides Medical Center, Brooklyn, New York, USA.
Adaora A AdimoraUniversity of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Igho OfotokunEmory University School of Medicine, Atlanta, Georgia, USA.
Christine ColieGeorgetown University, Washington, District of Columbia, USA.
Megan J HuchkoUniversity of California, San Francisco, California, USA.
Margaret FischlUniversity of Miami Miller School of Medicine, Miami, Florida, USA.
Rodney WrightAlbert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.
Gypsyamber D'SouzaJohns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Jason LeiderJacobi Medical Center, Bronx, New York, USA.
Olga DiazJacobi Medical Center, Bronx, New York, USA.
Lorraine Sanchez-KeelandUniversity of Southern California, Los Angeles, California, USA.
Sadeep ShresthaUniversity of Alabama, Birmingham, Alabama, USA.
Xianhong XieAlbert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.
Xiaonan XueAlbert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.
Kathryn AnastosAlbert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.
Joel M PalefskyUniversity of California, San Francisco, California, USA.
Robert D BurkAlbert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.
Albert Einstein College of Medicine · USUniversity of California, San Francisco · USUniversity of North Carolina at Chapel Hill · USEmory University · USJacobi Medical Center · USUniversity of Alabama at Birmingham · USGeorgetown University · USJohns Hopkins University · USMaimonides Medical Center · USRutgers, The State University of New Jersey · USUniversity of Miami · USUniversity of Southern California · USWashington University in St. Louis · US

Funding

WORD PROCESSORP30CA013330 · NCI · YESHIVA UNIVERSITY · PI THOMAS E ROHAN · 1985 to 2026
$111.2M
Engaging University of California Stakeholders for Biorespository ResearchUL1TR000004 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GRANDIS, JENNIFER RUBIN · 2012 to 2015
$78.0M
Virology, Immunology, and Microbiology CoreP30AI050410 · NIAID · UNIV OF NORTH CAROLINA CHAPEL HILL · PI DAVID M. MARGOLIS · 2001 to 2026
$76.9M
Women's Interagency HIV Study (WIHS-V)U01AI035004 · NIAID · MONTEFIORE MEDICAL CENTER (BRONX, NY) · PI ANASTOS, KATHRYN M., SHARMA, ANJALI · 1993 to 2018
$65.7M
WOMEN'S INTERAGENCY HIV STUDY ORGANIZATION, MANAGEMENT AND COMMUNICATIONSU01AI034989 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI AOUIZERAT, BRADLEY E, GREENBLATT, RUTH MARTHA · 1993 to 2018
$65.6M
Women's Interagency HIV Study (WIHS) IIIU01AI031834 · NIAID · SUNY DOWNSTATE MEDICAL CENTER · PI GUSTAFSON, DEBORAH R., MINKOFF, HOWARD · 1998 to 2018
$53.5M
WOMEN'S INTERAGENCY HIV STUDY (WIHS) ORGANIZATION AND MANAGEMENTU01AI034994 · NIAID · GEORGETOWN UNIVERSITY · PI KASSAYE, SEBLE G · 1993 to 2018
$52.0M
Women's Interagency HIV Study (WIHS) IV, Chicago ConsortiumU01AI034993 · NIAID · HEKTOEN INSTITUTE FOR MEDICAL RESEARCH · PI COHEN, MARDGE H, FRENCH, AUDREY · 1994 to 2018
$51.0M
WOMENS INTERAGENCY HIV STUDY (WIHS)U01HD032632 · NICHD · UNIVERSITY OF SOUTHERN CALIFORNIA · PI MILAM, JOEL E · 1994 to 2012
$42.0M
WIHS DATA MANAGEMENT AND ANALYSIS CENTER(WDMAC)U01AI042590 · NIAID · JOHNS HOPKINS UNIVERSITY · PI GANGE, STEPHEN J, GOLUB, ELIZABETH T · 1998 to 2018
$38.4M
Atlanta Clinical and Translational Science Institute (ACTSI) RenewalUL1TR000454 · NCATS · EMORY UNIVERSITY · PI STEPHENS, DAVID S · 2012 to 2016
$25.8M
MWCCS: Brooklyn Clinical Research SiteU01HL146202 · NHLBI · SUNY DOWNSTATE MEDICAL CENTER · PI TRACEY ELIZABETH WILSON, Jessica Eve Yager · 2019 to 2026
$23.6M
NCATS NIH HHS UL1 TR000004NCATS NIH HHS UL1 TR000454NCI NIH HHS P30 CA013330NCI NIH HHS R01 CA085178NCI NIH HHS R01 CA174634NHLBI NIH HHS U01 HL146202NIAID NIH HHS P30 AI050410NIAID NIH HHS U01 AI031834NIAID NIH HHS U01 AI034989NIAID NIH HHS U01 AI034993NIAID NIH HHS U01 AI034994NIAID NIH HHS U01 AI035004NIAID NIH HHS U01 AI042590NIAID NIH HHS U01 AI103390NIAID NIH HHS U01 AI103397NIAID NIH HHS U01 AI103401NIAID NIH HHS U01 AI103408NICHD NIH HHS U01 HD032632
6 · The paper itself

Abstract

backgroundPrimary human papillomavirus (HPV) screening (PHS) utilizes oncogenic human papillomavirus (oncHPV) testing as the initial cervical cancer screening method and typically, if positive, additional reflex-triage (eg, HPV16/18-genotyping, Pap testing). While US guidelines support PHS usage in the general population, PHS has been little studied in women living with HIV (WLWH).

methodsWe enrolled n = 865 WLWH (323 from the Women's Interagency HIV Study [WIHS] and 542 from WIHS-affiliated colposcopy clinics). All participants underwent Pap and oncHPV testing, including HPV16/18-genotyping. WIHS WLWH who tested oncHPV[+] or had cytologic atypical squamous cells of undetermined significance or worse (ASC-US+) underwent colposcopy, as did a random 21% of WLWH who were oncHPV[-]/Pap[-] (controls). Most participants additionally underwent p16/Ki-67 immunocytochemistry.

resultsMean age was 46 years, median CD4 was 592 cells/µL, 95% used antiretroviral therapy. Seventy WLWH had histologically-determined cervical intraepithelial neoplasia grade 2 or greater (CIN-2+), of which 33 were defined as precancer (ie, [i] CIN-3+ or [ii] CIN-2 if concurrent with cytologic high grade squamous intraepithelial lesions [HSILs]). PHS had 87% sensitivity (Se) for precancer, 9% positive predictive value (PPV), and a 35% colposcopy referral rate (Colpo). "PHS with reflex HPV16/18-genotyping and Pap testing" had 84% Se, 16% PPV, 30% Colpo. PHS with only HPV16/18-genotyping had 24% Colpo. "Concurrent oncHPV and Pap Testing" (Co-Testing) had 91% Se, 12% PPV, 40% Colpo. p16/Ki-67 immunochemistry had the highest PPV, 20%, but 13% specimen inadequacy.

conclusionsPHS with reflex HPV16/18-genotyping had fewer unnecessary colposcopies and (if confirmed) could be a potential alternative to Co-Testing in WLWH.

Indexed as

AlphapapillomavirusHIV InfectionsPapillomavirus InfectionsUterine Cervical DysplasiaUterine Cervical NeoplasmsEarly Detection of CancerFemaleHIVHuman papillomavirus 16Human papillomavirus 18HumansMass ScreeningMiddle AgedPapillomaviridaePregnancyVaginal Smearscervical cancer screeningHIVhuman papillomavirus (HPV)p16/Ki-67primary HPV screening

Identifiers

PMID32881999
PMCPMC8096228
OpenAlexW3083704163

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.