ArticleJCO global oncology2025
Association Between the Test-and-Treat Strategy and the Severity of Cervical Dysplastic Lesions Among Women Living With HIV in Tanzania (2015-2023).
Article in JCO global oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeCervical cancer remains a leading cause of morbidity and mortality in Tanzania where HIV exacerbates the risk of cancer and dysplasia. In 2017, Tanzania adopted the Test-and-Treat program for patients with HIV, which mandates immediate antiretroviral therapy for people living with HIV, regardless of CD4 count. This study examined the impact of this strategy on the severity of cervical dysplasia among women living with HIV (WLWH) at the Ocean Road Cancer Institute (ORCI).
methodsWe used existing data of women who came to the ORCI cervical cancer early detection clinic between 2015 and 2023 for cervical cancer early detection. Of the 3,385 women screened, 1,686 were diagnosed with dysplastic lesions and included in the analysis. This subset consisted of 349 WLWH, 605 HIV-negative women, and 732 women with unknown HIV status. The remaining women either were visual inspection with acetic acid-negative or had suspected cervical cancer and were not included in the final analysis of dysplastic lesions. The year 2017 was chosen as a pivotal point for analysis because it marked the implementation of the Test-and-Treat strategy at the ORCI. The severity of dysplasia before and after 2017 was compared using trend and logistic regression analyses.
resultsThe Test-and-Treat strategy was associated with a significant increase in detecting small/moderate lesions (
conclusionThe Test-and-Treat strategy has significantly reduced the severity of cervical dysplasia among WLWH at the ORCI, highlighting the importance of integrating HIV treatment into cervical cancer prevention programs. Continuous research focusing on the long-term effects of the Test-and-Treat strategy and expansion of on-site pathology services, including timely histopathologic diagnosis, are essential to further reduce cervical cancer incidence, morbidity, and mortality among WLWH.
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