title: Investigating Potential Associations between Cervical Procedures and HIV Acquisition.
abstract: Objective. Cervical human papillomavirus (HPV) infection has been associated with human immunodeficiency virus (HIV) acquisition in populations with a high prevalence of both infections. Procedures performed in the management of cervical dysplasia may facilitate HIV entry via mechanical injury. We sought to investigate the association between cervical procedures and incident HIV. Methods. Data on cervical cancer screening and procedures were collected in a cohort study evaluating the diaphragm for HIV prevention in 2040 women. In this secondary analysis, we investigated the association between cervical procedures and HIV acquisition. Results. Out of 2027 HIV-negative women at baseline, 199 underwent cervical procedures. Cumulative risk of HIV was 4.3% over 21 months of median followup (n = 88). Compared with women without cervical procedures, we observed no difference in HIV incidence after a cervical biopsy (RR 0.92, 95% CI 0.39-2.16), endocervical curettage (RR 0.29, 95% CI 0.07-1.22), or loop electrosurgical excision procedure (RR 1.00, 95% CI 0.30-3.30). Conclusions. In this cohort, cervical procedures were not associated with HIV incidence. This lack of association could be due to the small number of events.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA 94143, USA.
authors.forename: Khady
authors.initials: K
authors.lastname: Diouf
authors.forename: George F
authors.initials: GF
authors.lastname: Sawaya
authors.forename: Stephen
authors.initials: S
authors.lastname: Shiboski
authors.forename: Tsitsi
authors.initials: T
authors.lastname: Magure
authors.forename: Rudo
authors.initials: R
authors.lastname: Makunike-Mutasa
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Darragh
authors.forename: Jennifer
authors.initials: J
authors.lastname: Tuveson
authors.forename: Tsungai
authors.initials: T
authors.lastname: Chipato
authors.forename: Joel M
authors.initials: JM
authors.lastname: Palefsky
authors.forename: Anna-Barbara
authors.initials: AB
authors.lastname: Moscicki
authors.forename: Michael
authors.initials: M
authors.lastname: Chirenje
authors.forename: Karen
authors.initials: K
authors.lastname: Smith-McCune