title: An Insight Into Cervical Cancer Screening and Treatment Capacity in Sub Saharan Africa.
abstract: OBJECTIVE
  Approximately 85% of cervical cancer cases and deaths occur in resource-constrained countries where best practices for prevention, particularly for women with HIV infection, still need to be developed. The aim of this study was to assess cervical cancer prevention capacity in select HIV clinics located in resource-constrained countries.
  
  
  METHODS
  A cross-sectional survey of sub-Saharan African sites of 4 National Institutes of Health-funded HIV/AIDS networks was conducted. Sites were surveyed on the availability of cervical cancer screening and treatment among women with HIV infection and without HIV infection. Descriptive statistics and χ or Fisher exact test were used as appropriate.
  
  
  RESULTS
  Fifty-one (65%) of 78 sites responded. Access to cervical cancer screening was reported by 49 sites (96%). Of these sites, 39 (80%) performed screening on-site. Central African sites were less likely to have screening on-site (p = .02) versus other areas. Visual inspection with acetic acid and Pap testing were the most commonly available on-site screening methods at 31 (79%) and 26 (67%) sites, respectively. High-risk HPV testing was available at 29% of sites with visual inspection with acetic acid and 50% of sites with Pap testing. Cryotherapy and radical hysterectomy were the most commonly available on-site treatment methods for premalignant and malignant lesions at 29 (74%) and 18 (46%) sites, respectively.
  
  
  CONCLUSIONS
  Despite limited resources, most sites surveyed had the capacity to perform cervical cancer screening and treatment. The existing infrastructure of HIV clinical and research sites may provide the ideal framework for scale-up of cervical cancer prevention in resource-constrained countries with a high burden of cervical dysplasia.
authors.affiliation: 1Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD; 2Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; 3The Warren Alpert Medical School of Brown University, Providence, RI; 4Department of Obstetrics and Gynecology, University of Nairobi; 5Kenya Medical Research Institute FACES, Nairobi, Kenya; 6 Division of Infectious Diseases, Weill Cornell Medical College, New York, NY; 7Université Bordeaux and 8INSERM, ISPED, Centre INSERM U897-Epidémiologie-Bio statistique, Bordeaux, France; 9Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; 10Department of Medicine, Montefiore Medical Center, Bronx, NY; and 11Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, IN.
authors.forename: Jenell S
authors.initials: JS
authors.lastname: Coleman
authors.forename: Michelle S
authors.initials: MS
authors.lastname: Cespedes
authors.forename: Susan
authors.initials: S
authors.lastname: Cu-Uvin
authors.forename: Rose J
authors.initials: RJ
authors.lastname: Kosgei
authors.forename: May
authors.initials: M
authors.lastname: Maloba
authors.forename: Jean
authors.initials: J
authors.lastname: Anderson
authors.forename: Timothy
authors.initials: T
authors.lastname: Wilkin
authors.forename: Antoine
authors.initials: A
authors.lastname: Jaquet
authors.forename: Julia
authors.initials: J
authors.lastname: Bohlius
authors.forename: Kathryn
authors.initials: K
authors.lastname: Anastos
authors.forename: Kara
authors.initials: K
authors.lastname: Wools-Kaloustian
mesh_terms: D017954:Africa South of the Sahara; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer; D005260:Female; D006268:Health Facilities; D006302:Health Services Research; D006801:Humans; D013514:Surgical Procedures, Operative; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000628:therapy*