Association of cervical SIL and HIV-1 infection among Zimbabwean women in an HIV/STI prevention study.
A cross-sectional study was conducted on women attending family planning clinics in Harare, Zimbabwe to determine the prevalence of cervical neoplasia among HIV-1 positive women relative to an HIV-1 negative control group. Five hundred and fifty four women were recruited and the prevalence of HIV-1 was 36.8%. Cervical cytology was abnormal in 25.6% of HIV-infected women compared to only 6.7% HIV-1 seronegative women. Cervical neoplasia was significantly associated with HIV infection (chi(2)=42.4, P<0.001). Cellular changes typical of HPV infection (koilocytocis) were recorded in 6.4% of HIV infected women compared with 1.7% of HIV-1-uninfected women (chi(2)=8.43, P=0.004). HIV-1-positive women had twice the risk of having abnormal cervical cells than HIV-negative women (relative risk 2.47, odds ratio 10.14, P<0.001). Therefore the introduction of national cervical screening programme in HIV-1 endemic countries like Zimbabwe where the highest burden of pre-malignant lesions is among HIV-1-infected women needs careful planning because these women have other competing health needs including high rates of opportunistic infections.
Chirenje
Z M
ZM
Department of Obstetrics and Gynaecology, University of Zimbabwe, Harare, Zimbabwe. chirenje@zol.co.zw
Loeb
L
L
Mwale
M
M
Nyamapfeni
P
P
Kamba
M
M
Padian
N
N
D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000473:pathology*; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000150:complications / Q000473:pathology*; D006801:Humans; D030361:Papillomavirus Infections / Q000150:complications / Q000473:pathology; D011230:Precancerous Conditions / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D015995:Prevalence; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D015030:Zimbabwe / Q000453:epidemiology; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology