Frequency of gynecologic follow-up and cervical cancer screening in the Swiss HIV cohort study.
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.
Keiser
Olivia
O
Data Center of the Swiss HIV Cohort Study, Lausanne, Switzerland.
Martinez de Tejada
Begoña
B
Wunder
Dorothea
D
Chapuis-Taillard
Caroline
C
Zellweger
Claudine
C
Zinkernagel
Annelies S
AS
Elzi
Luigia
L
Schmid
Patrick
P
Bernasconi
Enos
E
Aebi-Popp
Karoline
K
Rickenbach
Martin
M
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*