title: Cervical cytology and histopathologic abnormalities in women living with AIDS in São Paulo, Brazil.
abstract: BACKGROUND
  Women living with HIV/AIDS present with a higher prevalence of human papillomavirus (HPV) infection, higher rates of squamous intraepithelial lesions, and are more susceptible to invasive cervical carcinoma progression.
  
  
  OBJECTIVE
  We assessed the frequency of precursory cervical lesions of cancer and its risk factors for women living with HIV/AIDS.
  
  
  METHODS
  Sociodemographic, clinical, behavioral, and laboratory data were collected from medical records from 2008 to 2009 and analyzed using forward stepwise logistic regression.
  
  
  RESULTS
  Medical records of 631 women were reviewed; mean age at AIDS diagnosis was 34 years old (interquartile range = 29-40 years old), 32% were <16 years old at first sexual intercourse; 61% had ≤5 sexual partners during life; 43% had been living with AIDS for ≥9 years; 47% reported previous sexually transmitted infections; 44% presented with HPV infection; and 10% presented with high squamous intraepithelial lesions. Presenting high squamous intraepithelial lesions was significantly associated with home district Human Development Index, age at AIDS diagnosis (>40 years old), time of AIDS diagnosis (>8 years), CD4 cell count <350/mm, and HPV infection.
  
  
  CONCLUSIONS
  Frequent squamous intraepithelial neoplasia in these women shows the importance of gynecologic examinations in routine care and follow-up required by those who present with cervical lesions.
authors.affiliation: Departamento de DST, AIDS e Hepatites virais, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brazil. vmpinto@usp.br; valdir.pinto@aids.gov.br
authors.forename: Valdir Monteiro
authors.initials: VM
authors.lastname: Pinto
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Golub
authors.forename: Mariza Vono
authors.initials: MV
authors.lastname: Tancredi
authors.forename: Rosa Souza
authors.initials: RS
authors.lastname: Alencar
authors.forename: Angelica Espinosa
authors.initials: AE
authors.lastname: Miranda
mesh_terms: D000328:Adult; D017677:Age Distribution; D001938:Brazil / Q000453:epidemiology; D002584:Cervix Uteri / Q000166:cytology*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors; D012725:Sexual Behavior; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000473:pathology*