Cervical cancer awareness and presence of abnormal cytology among HIV-infected women on antiretroviral therapy in rural Andhra Pradesh, India

Abstract

Cervical cancer is a leading cause of death among women in low- and middle-income countries, and women living with HIV are at high risk for cervical cancer. The objective of this study was to estimate the prevalence and correlates of cervical cancer and pre-cancer lesions and to examine cervical cancer knowledge among women living with HIV receiving antiretroviral therapy in rural Andhra Pradesh, India. We conducted cytology-based screening and administered a standardized questionnaire among 598 HIV-infected women. We found 5 (0.8%), 39 (6.5%), 29 (4.9%), and 4 (0.7%) had atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), and squamous cervical carcinoma (SCC), respectively. In multivariable logistic regression analysis, ASCUS/LSIL was independently associated with age >16 years old at first sexual encounter and smokeless tobacco use. We found no factors associated with HSIL/SCC. In total, 101 women (16.9%) had heard of cervical cancer and 28 (27.7%) of them correctly identified HIV infection as a risk factor. In light of the high prevalence of pre-cancer lesions and low level of cervical cancer knowledge in our study population, focused interventions are needed to improve cervical cancer literacy and prevention among rural women living with HIV.

Epidemiological and Cytopathological Profile of Dysplastic Lesions of the Cervix in South-Kivu/Dr Congo

“…Our study reveals a low rate of women consuming tobacco (2.5%). Shin SS et al [23] had a slightly lower rate than ours of 1.8% of women who had used tobacco in the past.…”

“…[21] found in Mali a much higher rate than ours of married women (90%); Catarino R et al [16] reported a rate of 58.2% of married women versus 33.8% of single, almost the same rate as Gordon JR et al [22] (56.0% of married women) and moderately higher than Shin SS et al [23] (48.2% of married women) in their respective studies in India, but much higher than that of Mitchell SM et al [24] in sub-Saharan Africa (10.55% of married women). This rate, close to half of the married women in our study, is linked to the increase in early weddings, which is becoming increasingly important, especially in rural areas, the main bastions of the majority of our patients.…”

“…In our series, the number of sexual partners did not exceed five (87%). Several authors made similar studies and came up with the following results: Catarino R et al [16] found in their study in Cameroon that the number of sexual partners was largely between 2 and 5 (45.4%); Shin SS et al [23] also reported in India a rate of 77.3% of women with a number of sexual partners between 2 and 5; Jolly PE et al [34], meanwhile, obtained in their study in Swaziland a rate of 88.6% of women with more than one sexual partner; Wudtisan J et al [35] in Thailand and Hooi DJ et al [37] in the Netherlands, for their part, had rates of 66.7% and 69.9% of women with a number of at least two sexual partners in their respective studies.…”

“…For Arora et al [33], this rate was 50.6% Open Journal of Obstetrics and Gynecology of women who had had their first sexual intercourse before the age of 19. As for Shin SS et al [23], they reported in India a rate of 51.4% of women who had their first sexual intercourse before the age of 17 years.…”

Determinant of Primary Preventive Behaviour Cervical Cancer in an Adolescent Girl

“…Support from other people such as family is a determining factor for this because support from family will provide reinforcement of motivation to carry out cervical cancer prevention behavior. families who have good knowledge can provide understanding and support for young women to carry out healthy behaviors (22,23) .…”