title: Abnormal pap tests and human papillomavirus infections among HIV-infected and uninfected women who have sex with women.
abstract: OBJECTIVE
  To estimate the frequency of abnormal Pap and human papillomavirus (HPV) positivity among human immunodeficiency virus (HIV)-seropositive and -seronegative women who have sex with women (WSW).
  
  
  METHODS
  Pap and HPV DNA polymerase chain reaction tests were obtained every 6 months from women in a US cohort of HIV-seropositive and -seronegative women. Women who have sex with women were women reporting no male and at least 1 female sex partner for 5 years. They were frequency matched 1:5 to women reporting sex only with men (WSM) and assessed using multivariable generalized estimating equation logistic regression models.
  
  
  RESULTS
  Paps at study entry were abnormal in 12 (21%) of 49 HIV-seropositive WSW, 151 (64%) of 245 HIV-seropositive WSM, 3 (9%) of 24 HIV-seronegative WSW, and 16 (11%) of 120 HIV-seronegative WSM. Human papillomavirus was found at entry in 18 (42%) HIV-seropositive WSW, 109 (52%) HIV-seropositive WSM, 6 (27%) HIV-seronegative WSW, and 13 (13%) HIV-seronegative WSM. After controlling for HIV serostatus and CD4 count, WSW had marginally lower odds than WSM of Pap abnormality (odds ratio = 0.59, 95% confidence interval = 0.33-1.03) and of HPV (odds ratio = 0.53, 95% confidence interval = 0.32-0.89). After controlling for partner's gender, HIV seropositivity and lower CD4 count were associated with any HPV, oncogenic HPV, any abnormal Pap result, and high-grade squamous intraepithelial lesion or worse (p < .0001 for all).
  
  
  CONCLUSIONS
  Although risks for abnormal Pap and HPV are modestly lower in WSW than in WSM, both are common in HIV-seropositive women regardless of sexual preference. Both WSW and WSM should be screened similarly.
authors: 1Washington University School of Medicine, St. Louis, MO; 2Albert Einstein College of Medicine, Bronx, NY; 3Maimonides Medical Center, Brooklyn, NY; 4University of California, San Francisco, CA; 5Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; 6University of Southern California, Los Angeles, CA; 7Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD; and 8Georgetown University, Washington, DC.
authors: L Stewart
authors: LS
authors: Massad
authors: Xianhong
authors: X
authors: Xie
authors: Howard
authors: H
authors: Minkoff
authors: Teresa M
authors: TM
authors: Darragh
authors: Gypsyamber
authors: G
authors: D'Souza
authors: Lorraine
authors: L
authors: Sanchez-Keeland
authors: D Heather
authors: DH
authors: Watts
authors: Christine
authors: C
authors: Colie
authors: Howard D
authors: HD
authors: Strickler
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D018452:Homosexuality, Female; D061809:Human Papillomavirus DNA Tests; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult
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