ArticleJournal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada2026
Adherence to cervical screening and follow-up care in HIV-positive women at a Canadian tertiary care centre.
Article in Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada, 2026. 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
Background: Women with HIV are at a significantly increased risk of developing cervical cancer. However, adherence to cervical screening guidelines remains suboptimal.The objective was to assess adherence to Pap test initial screening and follow-up at St. Joseph's Hospital (SJH) in London, Ontario, and to analyze their association with sociodemographic characteristics. Methods: A retrospective cohort study was conducted of women with HIV ≥21 years of age who were attending SJH's HIV clinic between 2015 and 2024. Medical records were reviewed to determine Pap test completion at HIV diagnosis, follow-up adherence, and management of abnormal results. Results: Of 235 women identified, 211 were included. Only 29% (n = 62) underwent Pap testing at the time of HIV diagnosis. Among 148 women with normal initial cytology, only 28 (19%) completed three consecutive annual follow-up screenings. Thirty-four women (17%) had atypical squamous cells of undetermined significance (ASC-US) results, of whom 29 (85%) underwent appropriate repeat cytology within 6 to 12 months. Fifty-three women (27%) were diagnosed with low-grade squamous intraepithelial lesion (LSIL) or higher-grade lesions, and 42 (79%) were appropriately referred for colposcopy. Adherence to cervical screening was positively associated with year of HIV diagnosis ( Conclusions: Substantial gaps exist in cervical cancer screening and follow-up among women with HIV. Despite guideline recommendations, less than one-third of patients in our cohort received Pap test at the time of HIV diagnosis, and long-term follow-up adherence was low. Enhanced system-based interventions are required to improve screening continuity and outcomes in this high-risk population.
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