title: Papanicolaou smear abnormalities in ambulatory care sites for women infected with the human immunodeficiency virus.
abstract: OBJECTIVE
  We attempted to determine the prevalence of cervical dysplasia in human immunodeficiency virus-infected women in ambulatory care settings and to correlate Papanicolaou smears with demographic and clinical variables.
  
  
  METHODS
  Papanicolaou smears of 135 women attending three ambulatory care clinics were reviewed. Chart review identified demographic and clinical variables, including CD4 count. Prevalence of abnormal smears was compared with baseline community rates. Demographic and clinical variables were correlated with Papanicolaou results with the chi 2 test.
  
  
  RESULTS
  Fivefold to eightfold increased rates of abnormal smears in human immunodeficiency virus-infected women were observed. Prevalence of abnormal smears increased from 21% in women with CD4 counts greater than 600/mm3 to 45% in women with CD4 counts less than 400/mm3. Age, ethnicity, or mode of human immunodeficiency virus transmission was not significantly correlated with Papanicolaou smear findings.
  
  
  CONCLUSIONS
  Increased rates of abnormal Papanicolaou smears and significant correlation with CD4 counts were observed in human immunodeficiency virus-infected women at ambulatory care sites. We recommend comprehensive gynecologic care, including semiannual Papanicolaou smears, for all human immunodeficiency virus-infected women.
authors.affiliation: Department of Nursing, State University of New York Health Science Center, Brooklyn.
authors.forename: C
authors.initials: C
authors.lastname: Marte
authors.forename: P
authors.initials: P
authors.lastname: Kelly
authors.forename: M
authors.initials: M
authors.lastname: Cohen
authors.forename: R G
authors.initials: RG
authors.lastname: Fruchter
authors.forename: A
authors.initials: A
authors.lastname: Sedlis
authors.forename: L
authors.initials: L
authors.lastname: Gallo
authors.forename: V
authors.initials: V
authors.lastname: Ray
authors.forename: C A
authors.initials: CA
authors.lastname: Webber
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000473:pathology* / Q000503:physiopathology / Q000635:transmission; D000328:Adult; D000553:Ambulatory Care; D015704:CD4 Antigens / Q000032:analysis; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000276:immunology / Q000473:pathology; D015588:Observer Variation; D065006:Papanicolaou Test; D002578:Uterine Cervical Dysplasia / Q000473:pathology; D014626:Vaginal Smears
chemical_list: D015704:CD4 Antigens