title: Screening, prevalence, and risk factors for cervical lesions among HIV positive and HIV negative women in Swaziland.
abstract: Cervical Cancer (CC) is the number one cancer among women in sub-Saharan Africa. Although CC is preventable, most women in developing countries do not have access to screening.
  
  
  
  This cross-sectional study was conducted to determine the prevalence and risk factors for cervical lesions using visual inspection with acetic acid (VIA) among 112 HIV positive and 161 negative women aged 18-69 years.
  
  
  
  The presence of cervical lesions was greater among HIV positive (22.9%) than HIV negative women (5.7%; p < 0.0001). In logistic models, the risk of cervical lesions among HIV positive women was 5.24 times higher when adjusted by age (OR 5.24, CI 2.31-11.88), and 4.06 times higher in a full model (OR 4.06, CI 1.61-10.25), than among HIV negative women. In the age-adjusted model women who had ≥2 lifetime sexual partners were 3 times more likely (OR 3.00, CI 1.02-8.85) to have cervical lesions compared to women with one lifetime partner and the odds of cervical lesions among women with a history of STIs were 2.16 greater (OR 2.16, CI 1.04-4.50) than among women with no previous STI. In the fully adjusted model women who had a previous cervical exam were 2.5 times more likely (OR 2.53, CI 1.06-6.05) to have cervical lesions than women who had not.
  
  
  
  The high prevalence of HIV infection and the strong association between HIV and cervical lesions highlight the need for substantial scale-up of cervical screening to decrease the rate of CC in Swaziland.
authors.affiliation: Department of Epidemiology, School of Public Health, Ryals Public Health Building, University of Alabama at Birmingham, 1665 University Boulevard Birmingham, Birmingham, AL, 35294-0022, USA. jollyp@uab.edu.
authors.forename: Pauline E
authors.initials: PE
authors.lastname: Jolly
authors.affiliation: Ministry of Health and Social Welfare, 2nd Floor Ministry of Justice & Constitutional Affairs Building, Mhalambanyatsi Road, Mbabane, Swaziland.
authors.forename: Simangele
authors.initials: S
authors.lastname: Mthethwa-Hleta
authors.affiliation: Department of Epidemiology, School of Public Health, Ryals Public Health Building, University of Alabama at Birmingham, 1665 University Boulevard Birmingham, Birmingham, AL, 35294-0022, USA.
authors.forename: Luz A
authors.initials: LA
authors.lastname: Padilla
authors.affiliation: Department of Epidemiology, School of Public Health, Ryals Public Health Building, University of Alabama at Birmingham, 1665 University Boulevard Birmingham, Birmingham, AL, 35294-0022, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Pettis
authors.affiliation: Department of Epidemiology, School of Public Health, Ryals Public Health Building, University of Alabama at Birmingham, 1665 University Boulevard Birmingham, Birmingham, AL, 35294-0022, USA.
authors.forename: ShaCoria
authors.initials: S
authors.lastname: Winston
authors.affiliation: Department of Epidemiology, School of Public Health, Ryals Public Health Building, University of Alabama at Birmingham, 1665 University Boulevard Birmingham, Birmingham, AL, 35294-0022, USA.
authors.forename: Tomi F
authors.initials: TF
authors.lastname: Akinyemiju
authors.affiliation: Department of Epidemiology, School of Public Health, Ryals Public Health Building, University of Alabama at Birmingham, 1665 University Boulevard Birmingham, Birmingham, AL, 35294-0022, USA.
authors.forename: Hannah J
authors.initials: HJ
authors.lastname: Turner
authors.affiliation: Department of Epidemiology, School of Public Health, Ryals Public Health Building, University of Alabama at Birmingham, 1665 University Boulevard Birmingham, Birmingham, AL, 35294-0022, USA.
authors.forename: Amarachi
authors.initials: A
authors.lastname: Ejiawoko
authors.affiliation: Department of Epidemiology, School of Public Health, Ryals Public Health Building, University of Alabama at Birmingham, 1665 University Boulevard Birmingham, Birmingham, AL, 35294-0022, USA.
authors.forename: Raina
authors.initials: R
authors.lastname: Brooks
authors.affiliation: Swaziland Breast and Cervical Cancer Network (SBCN), Stall A31 Printpak Building, Industrial Site, Sheffield Road, Mbabane, Swaziland.
authors.forename: Lena
authors.initials: L
authors.lastname: Preko
authors.affiliation: Care and Treatment Lead for the President's Emergency Plan for AIDS Relief (PEPFAR), Jubela Street, Kent Rock, Mbabane, Swaziland.
authors.forename: Peter O
authors.initials: PO
authors.lastname: Preko
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D013541:Eswatini / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D018023:HIV Seronegativity; D006679:HIV Seropositivity; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D011230:Precancerous Conditions / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000150:complications; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult
keywords: Cervical lesions; HIV positive women; Swaziland; VIA