title: Building capacity for cervical cancer screening in outpatient HIV clinics in the Nyanza province of western Kenya.
abstract: OBJECTIVE
  To evaluate outcomes of cervical cancer screening within HIV care and treatment clinics in Kenya.
  
  
  METHODS
  Beginning in October 2007, visual inspection with acetic acid (VIA), colposcopy, and loop electrosurgical excision procedure (LEEP) were added to the clinical services offered at Family AIDS Care and Education Services (FACES) clinics in Kisumu, Kenya, after a systematic campaign to build capacity and community awareness.
  
  
  RESULTS
  From October 2007 to October 2010, 3642 women underwent VIA as part of routine HIV care. Cervical intraepithelial neoplasia 2/3 was identified in 259 (7.1%) women, who were offered excisional treatment by LEEP in the clinic. Among those women offered screening, uptake was 87%. Clinical staff reported a high level of satisfaction with training for and implementation of cervical cancer screening strategies.
  
  
  CONCLUSIONS
  Cervical cancer screening and prevention are feasible, acceptable, and effective within HIV care and treatment clinics. Screening test performance characteristics need to be defined for an HIV-positive population to determine the cost/benefit ratio of lower cost strategies that will ultimately be necessary to provide universal access to cervical cancer screening in low-resource settings.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California, San Francisco, CA 94105, USA. megan.huchko@ucsf.edu
authors.forename: Megan J
authors.initials: MJ
authors.lastname: Huchko
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Bukusi
authors.forename: Craig R
authors.initials: CR
authors.lastname: Cohen
mesh_terms: D019342:Acetic Acid; D000328:Adult; D000554:Ambulatory Care Facilities; D057191:Capacity Building; D003127:Colposcopy; D055088:Early Detection of Cancer; D004598:Electrosurgery / Q000379:methods; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000628:therapy; D006801:Humans; D007630:Kenya; D010342:Patient Acceptance of Health Care; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000601:surgery; D014626:Vaginal Smears
chemical_list: D019342:Acetic Acid