title: Performance of Cervical Cancer Screening Techniques in HIV-Infected Women in Uganda.
abstract: OBJECTIVE
  Women infected with human immunodeficiency virus (HIV) have a higher risk of HPV infections and developing cervical cancer, thus screening them is imperative. This study was aimed to evaluate and compare the performance of 3 cervical cancer screening options among HIV-infected women in Uganda.
  
  
  METHODS
  Data from 2,337 Ugandan women who reported their HIV status were obtained from a population-based cervical cancer screening study. Women were offered 3 screening tests: vaginal and cervical careHPV and visual inspection with acetic acid (VIA), and the results were evaluated by HIV status.
  
  
  RESULTS
  The prevalence of HIV infection was 16.5%. Women infected with HIV had a higher prevalence of cervical intraepithelial neoplasia grade 2+ (CIN2+) than uninfected women (12.9% vs 1.7%; p < .001). The sensitivity for cervical careHPV among the HIV-infected women was 94.3% compared to 81.3% among the uninfected women. Whereas the sensitivity for vaginal careHPV was also higher among the HIV-infected women, the sensitivity of VIA was higher among the uninfected women. The mean vaginal and cervical careHPV signal strength was higher in the HIV-infected women than in the uninfected women (p < .001).
  
  
  CONCLUSIONS
  CareHPV is very sensitive for detecting CIN2+ in HIV-infected women, even using a vaginal sample. The sensitivity of careHPV in HIV-infected women is higher than in HIV-uninfected women. However, additional research is needed to determine the best option for screening and triage of HPV-positive women that can be implemented in low-resource settings, especially among HIV- and HPV-positive women.
authors.affiliation: 1Reproductive Health Global Program, PATH, Seattle, WA; 2Department of Gynaecology and Obstetrics, Makerere University, Kampala, Uganda; 3Reproductive Health Global Program, PATH, Kampala, Uganda; and 4Department of Obstetrics and Gynecology, Mulago National Referral Hospital, Kampala, Uganda.
authors.forename: Pooja
authors.initials: P
authors.lastname: Bansil
authors.forename: Jeanette
authors.initials: J
authors.lastname: Lim
authors.forename: Josaphat
authors.initials: J
authors.lastname: Byamugisha
authors.forename: Edward
authors.initials: E
authors.lastname: Kumakech
authors.forename: Carol
authors.initials: C
authors.lastname: Nakisige
authors.forename: Jose A
authors.initials: JA
authors.lastname: Jeronimo
mesh_terms: D019342:Acetic Acid; D000328:Adult; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000453:epidemiology*; D012680:Sensitivity and Specificity; D014454:Uganda / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology*; D014626:Vaginal Smears; D016387:Women's Health; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology*
chemical_list: D019342:Acetic Acid