title: Frequency of gynecologic follow-up and cervical cancer screening in the Swiss HIV cohort study.
abstract: BACKGROUND
  According to current recommendations, HIV-infected women should have at least 1 gynecologic examination per year.
  
  
  OBJECTIVE
  To analyze factors associated with frequency of gynecologic follow-up and cervical cancer screening among HIV-infected women followed in the Swiss HIV Cohort Study (SHCS).
  
  
  METHODS
  Half-yearly questionnaires between April 2001 and December 2004. At every follow-up visit, the women were asked if they had had a gynecologic examination and a cervical smear since their last visit. Longitudinal models were fitted with these variables as outcomes.
  
  
  RESULTS
  A total of 2186 women were included in the analysis. Of the 1146 women with complete follow-up in the SHCS, 35.3% had a gynecologic examination in each time period, whereas 7.4% had never gone to a gynecologist. Factors associated with a poor gynecologic follow-up were older age, nonwhite ethnicity, less education, underweight, obesity, being sexually inactive, intravenous drug use, smoking, having a private infectious disease specialist as a care provider, HIV viral load <400 copies/mL, and no previous cervical dysplasia. No association was seen for living alone, CD4 cell count, and positive serology for syphilis.
  
  
  CONCLUSIONS
  Gynecologic care among well-followed HIV-positive women is poor and needs to be improved.
authors.affiliation: Data Center of the Swiss HIV Cohort Study, Lausanne, Switzerland.
authors.forename: Olivia
authors.initials: O
authors.lastname: Keiser
authors.forename: Begoña
authors.initials: B
authors.lastname: Martinez de Tejada
authors.forename: Dorothea
authors.initials: D
authors.lastname: Wunder
authors.forename: Caroline
authors.initials: C
authors.lastname: Chapuis-Taillard
authors.forename: Claudine
authors.initials: C
authors.lastname: Zellweger
authors.forename: Annelies S
authors.initials: AS
authors.lastname: Zinkernagel
authors.forename: Luigia
authors.initials: L
authors.lastname: Elzi
authors.forename: Patrick
authors.initials: P
authors.lastname: Schmid
authors.forename: Enos
authors.initials: E
authors.lastname: Bernasconi
authors.forename: Karoline
authors.initials: K
authors.lastname: Aebi-Popp
authors.forename: Martin
authors.initials: M
authors.lastname: Rickenbach
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D017410:Practice Guidelines as Topic; D013557:Switzerland; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000209:etiology*