Frequency of gynecologic follow-up and cervical cancer screening in the Swiss HIV cohort study

Keiser, Olivia; Martinez de Tejada, Begoña; Wunder, Dorothea; Chapuis-Taillard, Caroline; Zellweger, Claudine; Zinkernagel, Annelies S; Elzi, Luigia; Schmid, Patrick; Bernasconi, Enos; Aebi-Popp, Karoline; Rickenbach, Martin (2006). Frequency of gynecologic follow-up and cervical cancer screening in the Swiss HIV cohort study. Journal of acquired immune deficiency syndromes JAIDS, 43(5), pp. 550-555. Philadelphia, Pa.: Lippincott Williams & Wilkins 10.1097/01.qai.0000245884.66509.7a

Text Keiser JAcquirImmuneDeficSyndr 2006.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (329kB)

BACKGROUND: According to current recommendations, HIV-infected women should have at least 1 gynecologic examination per year. OBJECTIVES: To analyze factors associated with frequency of gynecologic follow-up and cervical cancer screening among HIV-infected women followed in the Swiss HIV Cohort Study (SHCS). METHODS: Half-yearly questionnaires between April 2001 and December 2004. At every follow-up visit, the women were asked if they had had a gynecologic examination and a cervical smear since their last visit. Longitudinal models were fitted with these variables as outcomes. RESULTS: A total of 2186 women were included in the analysis. Of the 1146 women with complete follow-up in the SHCS, 35.3% had a gynecologic examination in each time period, whereas 7.4% had never gone to a gynecologist. Factors associated with a poor gynecologic follow-up were older age, nonwhite ethnicity, less education, underweight, obesity, being sexually inactive, intravenous drug use, smoking, having a private infectious disease specialist as a care provider, HIV viral load <400 copies/mL, and no previous cervical dysplasia. No association was seen for living alone, CD4 cell count, and positive serology for syphilis. CONCLUSIONS: Gynecologic care among well-followed HIV-positive women is poor and needs to be improved.

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