Acceptance of voluntary HIV testing and the prevalence of HIV infection in women with cervical neoplasia in Toronto.
Over a 13-month period (1998-99), 661 adult women under the age of 50 years with a diagnosis of high grade squamous intraepithelial lesions (HSIL) or invasive cervical cancer in the previous 5 years and who were unaware of their HIV status were approached to participate in this study. After pretest counseling, patients completed a short questionnaire about risk factors for HIV infection, had blood samples drawn for HIV testing,and arranged a follow-up appointment for test results and post-test counseling. The acceptance rate for HIV testing was 73% (N = 432 with HSIL and N = 51 with invasive cervical cancer). Most women reported heterosexual intercourse as their only risk factor for HIV infection, with the majority (95.1%) reporting more than one lifetime sexual partner. Women who declined participation were significantly older (P < 0.01) than participants and nonwhites were more likely to decline (P < 0.001). None of the study participants had positive HIV test results (0/483; 95% CI, 0.00-0.009). Although HIV testing was accepted by most women following pretest counseling, there were no women who tested HIV-positive who were previously unaware of their status. Consequently we do not recommend routine HIV testing in this population.
Department of Gynaecologic Oncology, Princess Margaret Hospital;Department of Medicine, Toronto General Hospital; and University Health Network, University of Toronto, Toronto, Canada.
J.
J
Neuman
J.
J
Murphy
S.
S
Walmsley