title: Comparison of Abnormal Cervical Cytology from HIV Positive Women, Female Sex Workers and General Population.
abstract: BACKGROUND
  Sex workers and HIV seropositive women are at high risk of abnormal cervical cytology. The objective of this study was to compare the cervical cytology among three groups of women: active sex workers, HIV-infected women, and general population in Iran.
  
  
  METHODS
  This was a cross-sectional study performed in Hazrat Zeinab, Lavan clinics and drop in center (DIC) in Shiraz, Iran. This study was performed from October 2009 to October 2011. A total of 266 patients were assigned into three groups: sex-workers (85), HIV positive patients (100), and general population (81). Pap smear was performed for all participants from the exocervix and endocervix, using a plastic Ayres's spatula and cytobrush. The samples were sent to a pathology center, using a liquid-based media.
  
  
  RESULTS
  The risk of cervical infection in sex workers and HIV positive women was greater than the general population (OR=5.47, 95% confidence interval [CI]:2.24, 13.40), (OR=3.71, 95% CI:1.52, 9.09), respectively. The frequency of abnormal cervical cytology in the HIV positive and sex worker groups was higher than the general population (OR=6. 76, 95% CI:2.25, 20.32), (OR=3. 80, 95% CI:1.19, 12.07), respectively. Low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL) were associated with CD4 cell count<200Í106/L, P=0.021 and P<0.001, respectively.
  
  
  CONCLUSIONS
  Vaginal infections were seen more often in the sex worker group, and abnormal cervical cytology was greater in the HIV positive group.
authors.affiliation: Maternal Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;
authors.forename: Homeira
authors.initials: H
authors.lastname: Vafaei
authors.affiliation: Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran;
authors.forename: Nasrin
authors.initials: N
authors.lastname: Asadi
authors.affiliation: Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran;
authors.forename: Leila
authors.initials: L
authors.lastname: Foroughinia
authors.affiliation: Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran;
authors.forename: Alireza
authors.initials: A
authors.lastname: Salehi
authors.affiliation: Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran;
authors.forename: Safieh
authors.initials: S
authors.lastname: Kuhnavard
authors.affiliation: Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran;
authors.forename: Mojgan
authors.initials: M
authors.lastname: Akbarzadeh
authors.affiliation: Biomedical Science Centre, Charles Sturt University, Melbourne, Australia;
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Ravanbod
authors.affiliation: Nursing School and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Ferdos
authors.initials: F
authors.lastname: Mohamadalian
authors.affiliation: Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran;
authors.forename: Maryam
authors.initials: M
authors.lastname: Kasraeian
keywords: HIV/AIDs; Iran; Pap smear; Sex Worker