title: Improving cervical cancer screening rates in an urban HIV clinic.
abstract: Human immunodeficiency virus (HIV)-infected women are at increased risk of invasive cervical cancer; however, screening rates remain low. The objectives of this study were to analyze a quality improvement intervention to increase cervical cancer screening rates in an urban academic HIV clinic and to identify factors associated with inadequate screening. Barriers to screening were identified by a multidisciplinary quality improvement committee at the Washington University Infectious Diseases clinic. Several strategies were developed to address these barriers. The years pre- and post-implementation were analyzed to examine the clinical impact of the intervention. A total of 422 women were seen in both the pre-implementation and post-implementation periods. In the pre-implementation period, 222 women (53%) underwent cervical cancer screening in the form of Papanicolaou (Pap) testing. In the post-implementation period, 318 women (75.3%) underwent cervical cancer screening (p < 0.01). Factors associated with lack of screening included fewer visits attended (pre: 4.2 ± 1.5; post: 3.4 ± 1.4; p < 0.01). A multidisciplinary quality improvement intervention was successful in overcoming barriers and increasing cervical cancer screening rates in an urban academic HIV clinic.
authors.affiliation: a Division of Infectious Diseases , Washington University School of Medicine , St. Louis , MO , USA.
authors.forename: Sara L
authors.initials: SL
authors.lastname: Cross
authors.forename: Sanaa H
authors.initials: SH
authors.lastname: Suharwardy
authors.forename: Phani
authors.initials: P
authors.lastname: Bodavula
authors.forename: Kenneth
authors.initials: K
authors.lastname: Schechtman
authors.forename: E Turner
authors.initials: ET
authors.lastname: Overton
authors.forename: Nur F
authors.initials: NF
authors.lastname: Onen
authors.forename: Michael A
authors.initials: MA
authors.lastname: Lane
mesh_terms: D000328:Adult; D055088:Early Detection of Cancer; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008403:Mass Screening / Q000592:standards*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D058996:Quality Improvement; D012307:Risk Factors; D014505:Urban Population; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears; D014861:Washington / Q000453:epidemiology
keywords: HIV/AIDS; cervical cancer screening; health maintenance; quality improvement