Screening for cervical cancer in HIV-infected women receiving care in the United States.
OBJECTIVE
We examined the sociodemographic, clinical and provider factors associated with screening for cervical cancer among HIV-infected women.


METHODS
We studied a national sample representing 43,490 women receiving treatment of HIV infection who completed first follow-up surveys of the HIV Cost and Service Utilization Study (HCSUS). All women were asked, "In the past 12 months, have you had a Pap test?" Women reporting an abnormal Pap test result were asked whether they had been told antibiotics could cure abnormal cells, and whether they were scheduled for another Pap test or for a colposcopy within 3 months.


RESULTS
Of the population represented, 81% had had a Pap test in the past 12 months. Women who reported having a gynecologist and primary care physician at the same clinical site were almost twice as likely (odds ratio, 1.9; 95% confidence interval, 1.3-3.0) as other women to report Pap testing. Among women who reported abnormal Pap test results and were not told antibiotics could cure abnormal cells, 95% were scheduled for a repeat Pap test or colposcopy, but 15% of the women had not received their repeat Pap test or colposcopy.


CONCLUSIONS
Although Pap test rates and appropriate referral for abnormal findings were high among HIV-tested women, many women with initially abnormal Pap test results did not actually receive follow-up Pap testing or colposcopy. Providing gynecologic care at the same site as primary HIV care would likely improve delivery of needed gynecologic care for women.
Stein
M D
MD
Division of General Internal Medicine, Rhode Island Hospital, Brown University, 593 Eddy Street, Providence, RI 02903, USA. mstein@lifespan.org
Cunningham
W E
WE
Nakazono
T
T
Turner
B J
BJ
Andersen
R M
RM
Bozzette
S A
SA
Shapiro
M F
MF
D000293:Adolescent; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006296:Health Services; D006301:Health Services Needs and Demand; D006801:Humans; D008403:Mass Screening; D011795:Surveys and Questionnaires; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears