title: Individual and partner risk factors associated with abnormal cervical cytology among women in HIV-discordant relationships.
abstract: Individual and sexual partner characteristics may increase the risk of abnormal cervical cytology among women in human immunodeficiency virus (HIV)-discordant relationships. Papanicolaou smears were obtained in a prospective cohort of Kenyan HIV-discordant couples. Of 441 women, 283 (64%) were HIV-infected and 158 (36%) were HIV-uninfected with HIV-infected partners. Overall, 79 (18%) had low-grade and 25 (6%) high-grade cervical abnormalities. Male herpes simplex virus type 2 (HSV-2) seropositivity and lower couple socioeconomic status were associated with cervical abnormalities (p < 0.05). HIV-uninfected women with HIV-infected male sex partners (CD4 > 350 cells/µL) had the lowest prevalence of high-grade cervical lesions. HIV-infected women (CD4 > 350 cells/µL) and HIV-uninfected women with HIV-infected partners (CD4 ≤ 350 cells/µL) were at similar intermediate risk (p > 0.05), and HIV-infected women (CD4 ≤ 350 cells/µL) had significantly higher risk of high-grade cervical abnormalities (p = 0.05). Women in HIV-discordant relationships have high rates of cervical lesions and this may be influenced by couple-level factors, including HIV status and CD4 count of the infected partner.
authors.affiliation: School of Medicine, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Soh
authors.forename: Anne F
authors.initials: AF
authors.lastname: Rositch
authors.forename: Laura
authors.initials: L
authors.lastname: Koutsky
authors.forename: Brandon L
authors.initials: BL
authors.lastname: Guthrie
authors.forename: Robert Y
authors.initials: RY
authors.lastname: Choi
authors.forename: Rose K
authors.initials: RK
authors.lastname: Bosire
authors.forename: Ann
authors.initials: A
authors.lastname: Gatuguta
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Smith
authors.forename: James
authors.initials: J
authors.lastname: Kiarie
authors.forename: Barbara
authors.initials: B
authors.lastname: Lohman-Payne
authors.forename: Carey
authors.initials: C
authors.lastname: Farquhar
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D005260:Female; D006679:HIV Seropositivity / Q000150:complications* / Q000453:epidemiology / Q000635:transmission*; D015497:HIV-1; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012747:Sexual Partners; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D014626:Vaginal Smears; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000473:pathology / Q000821:virology
keywords: AIDS; Africa; HIV; HPV; cervical cancer; cervical intraepithelial neoplasia; cytology; discordant couples; human papillomavirus; sexually transmitted infection
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