title: Integrating Cervical Cancer Screening with HIV Care in Cameroon: Comparative Risk Analysis of Cervical Disease in HIV-Infected Women Receiving Antiretroviral Therapy to Women in the General Population.
abstract: BACKGROUND
  While the effect of highly active antiretroviral therapy (HAART) on natural history of cervical lesions remains controversial, resource limited countries need to understand the relevance of their own data to their settings. We compared the risk of cervical disease in HAART-experienced women with that in women in the general population of Cameroon.
  
  
  METHODS
  A retrospective cross sectional survey of women aged 35 years and above, attending a voluntary screening campaign for cervical cancer at the Nkongsamba Regional Hospital in Cameroon between February and May 2014. Squamous intraepithelial lesions (SIL) were determined by Pap smear. Multiple logistic regression was used to compare the odds of SIL in women on HAART to women from the community with unknown HIV status.
  
  
  RESULTS
  Included were 302 women of whom 131(43.4%) were HIV-infected and receiving HAART on the site while 171 (56.6%) were women from the community. Cervical disease was observed in 51(16.9%) persons of whom 15 (11.5%) cases in the HAART group and 36 (21.1%) cases in the general group (p = 0.027). After controlling for age and other covariates, women in the HAART group had a 67% reduction in the odds of cervical lesions compared with the community group [adjusted odd ratio (aOR) = 0.33, 95%CI: 0.15-0.73, p = 0.006).
  
  
  CONCLUSIONS
  HIV-infected women receiving HAART have a lower risk of cancer than women in the general population. This finding may not be attributed to HAART alone but to all the health benefits derived from receiving a comprehensive HIV care.
authors: Centre Médical d'Arrondissement de Baré, Nkongsamba, Cameroon.
authors: Cavin Epie
authors: CE
authors: Bekolo
authors: International Training & Education Center for Health (I-TECH), Seattle, United States of America.
authors: Gillian
authors: G
authors: O'Bryan
authors: Regional Hospital of Nkongsamba, Nkongsamba, Cameroon.
authors: François Edmond
authors: FE
authors: Tchago
authors: University Teaching Hospital, Yaounde, Cameroon.
authors: Charlette
authors: C
authors: Nangue
authors: Regional Hospital of Nkongsamba, Nkongsamba, Cameroon.
authors: Patrick Sylvestre
authors: PS
authors: Bekoule
authors: Department of Public Health, University of Douala, Douala, Cameroon.
authors: Basile
authors: B
authors: Kollo
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D002163:Cameroon / Q000453:epidemiology; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D065006:Papanicolaou Test; D015995:Prevalence; D012044:Regression Analysis; D012189:Retrospective Studies; D065310:Squamous Intraepithelial Lesions of the Cervix / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology