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- Title
Prevalence and risk factors of cervical squamous intraepithelial lesions among HIV-infected women in Dar es Salaam, Tanzania.
- Authors
Liu, Enju; McCree, Renicha; Mtisi, Expeditho; Fawzi, Wafaie W.; Aris, Eric; Lema, Irene A.; Hertzmark, Ellen; Chalamilla, Guerino; Li, Nan; Vermund, Sten H.; Spiegelman, Donna
- Abstract
To determine the prevalence and predictors of cervical squamous intraepithelial lesions (SIL) among HIV-infected women in Tanzania, a cross-sectional study was conducted among HIV-infected women at HIV care and treatment clinics. A Papanicolaou (Pap) smear was used as a screening tool for detection of cervical SIL. From December 2006 to August 2009, 1365 HIV-infected women received cervical screening. The median age was 35 (interquartile range [IQR]: 30-42) years, and the median CD4 + cell count was 164 (IQR: 80-257) cells/mm(3). The prevalence of cervical SIL was 8.7% (119/1365). In multivariate analysis, older age (≥50 versus 30-<40 years: prevalence ratio [PR], 2.36; 95% confidence interval [CI], 1.45-3.84, p for trend = 0.001), lower CD4 + cell counts (<100 versus ≥200 cells/mm(3): PR, 1.55; 95% CI, 1.01-2.36, p for trend = 0.03) and cervical inflammation (PR, 1.73; 95% CI, 1.16-2.60, p = 0.008) were associated with an increased risk of cervical SIL. Women with advanced WHO HIV disease stage (IV versus I/II: PR, 3.45; 95% CI, 1.35-8.85, p for trend = 0.01) had an increased risk for high-grade SIL. In resource-limited settings where it is not feasible to provide cervical cancer prevention services to all HIV-infected women, greater efforts should focus on scaling-up services among those who are older than 50 years, with lower CD4 cell counts and advanced HIV disease stage.
- Subjects
DAR es Salaam (Tanzania); TANZANIA; CERVICAL intraepithelial neoplasia; HIV infection complications; DISEASE prevalence; DISEASES in women; CROSS-sectional method; DISEASE risk factors; HIV infection epidemiology; CERVIX uteri diseases; DYSPLASIA; MULTIVARIATE analysis; PAP test; RESEARCH funding; CERVIX uteri tumors; CD4 lymphocyte count
- Publication
International Journal of STD & AIDS, 2016, Vol 27, Issue 3, p219
- ISSN
0956-4624
- Publication type
journal article
- DOI
10.1177/0956462415584466